Get Wa Dcyf 15-941 2021-2025

The WA DCYF 15-941, also known as the Child Care Injury/Incident Report, is a critical document for reporting incidents or injuries that occur in child care settings. This guide provides step-by-step instructions on how to complete the form accurately and effectively online.

Follow the steps to successfully fill out your Child Care Injury/Incident Report.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering the child’s name at the top of the form. Ensure that you spell the name correctly to avoid any confusion.
3. Input the provider's name and provider ID. This information identifies who is reporting the incident and their credentials.
4. Record the child’s age, date, and time of the incident. Use the format specified in the form to maintain consistency.
5. Indicate whether the incident occurred indoors or outdoors by checking the appropriate box and specify a.m. or p.m. for the incident's timing.
6. Detail the treatment that was provided to the child while in care, including names of the staff members who administered the treatment.
7. List all staff present and/or witnesses to the incident in the designated area on the form.
8. Check all applicable situations that required an emergency response, such as contacting emergency services or the poison center.
9. If there was a serious injury, select the type of injury from the options provided. Be specific to ensure proper documentation.
10. Provide a brief description of the incident, including the exact location where it took place.
11. Document whether the parent/guardian has been contacted, including the date and time of this communication.
12. If applicable, input the licensor's contact details, including the date and time of contact.
13. Include any comments from the parent/guardian in the designated area on the form.
14. Both the parent/guardian and licensee/staff must sign and date the form to acknowledge receipt and accuracy.
15. Once you have completed all sections of the form, save your changes. You can then download, print, or share the form as needed.

Complete your documents online to ensure timely and efficient reporting.