Get Ca Submersion Incident Report Form (sirf) 2012-2025

Completing the CA Submersion Incident Report Form (SIRF) online is an essential step in reporting drowning or near-drowning incidents. This guide will provide clear and detailed instructions to help you navigate each section of the form effectively.

Follow the steps to fill out the CA Submersion Incident Report Form online

1. Click 'Get Form' button to obtain the form and open it for filling out.
2. Enter the basic incident information. Begin by providing the date and time of the incident, your agency's incident number, and the reporting agency details. Specify the street name, incident city, and zip code.
3. Select the type of dwelling where the incident occurred by checking the appropriate box: House, Apartment/Condo, Hotel/Motel, N/A, or Other.
4. Provide information about the victim. Indicate their sex and race/ethnicity, and document when the victim was last seen engaging in activities such as swimming, sleeping, or playing.
5. Estimate the length of time the victim was submerged and specify what type of clothing the victim was wearing. Indicate if there was any evidence of alcohol or drug use.
6. Complete the water source information. Indicate where the incident took place and the clarity and depth of the water.
7. Provide details on whether a Child Protective Services (CPS) referral was made.
8. Fill out victim information including their age and details about the supervisor(s) present at the time of the incident.
9. List any toys or objects in the water and determine whether the pool or spa was constructed before 1998.
10. Assess any barriers present around the water source and how the victim accessed the water area.
11. Document any rescue equipment that was near the water, if CPR was performed, who conducted it, and if the victim had taken swimming lessons.
12. Provide information on whether the victim was pronounced dead at the scene and where they were transported.
13. Write a narrative detailing the incident, complete the form with your name, email address, and contact phone number.
14. Once all sections are filled out accurately, you can save your changes, download, print, or share the completed form.

Complete the CA Submersion Incident Report Form online today to ensure accurate reporting.