Get Tn Hs-3310 2019-2026

This guide provides comprehensive instructions for completing the TN HS-3310, the Child Care Provider Serious Injury Incident Report. It is designed to assist users in accurately filling out this form in an online format to ensure compliance with the Tennessee Department of Human Services requirements.

Follow the steps to accurately complete the TN HS-3310 online

1. Press the ‘Get Form’ button to acquire the document and open it in the online editor.
2. Begin by filling in the child care provider's name. Include the Federal Employer Identification Number (FEID) along with any necessary extensions.
3. Enter your contact details, including the provider's telephone number and physical address, followed by the email address for further communication.
4. Specify your county and indicate the regulatory agency overseeing your operations, choosing from TDHS or the Department of Education.
5. Select the type of child care provider from available options such as center, family, drop-in, group, or license-exempt.
6. Indicate whether your agency participates in the Child Care Certificate Program by selecting 'yes' or 'no.'
7. Provide information about the child involved, including their gender (choose M or F) and age in months. Also, record the date and time of the incident and when the parent or guardian was notified.
8. Next, check all applicable types of injuries sustained by the child. Include options such as head injuries, broken bones, and allergic reactions.
9. Indicate the specific location of the bodily injury, checking all applicable body parts such as the head, arms, legs, etc.
10. Provide a detailed description of the injuries, and if needed, attach additional pages while ensuring no identifying information about the child or parent is included.
11. Identify the location where the incident occurred (e.g., classroom, lunchroom, or on a field trip), and specify if it was on-site or off-site.
12. Describe how the incident occurred, including any potential causes or equipment involved, while attaching additional pages as necessary.
13. Detail your agency’s immediate response to the serious injury, ensuring to keep child and parent identification anonymous.
14. Finally, enter the name of the provider's staff member reporting the incident before you proceed to save your changes, or choose to download, print, or share the form.

Complete your documents online today with confidence!