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Incident/Injury Reporting


When an incident/injury occurs, the NOCAC Staff in charge of the child will complete an Incident/Injury Report for Child Care (JFS01299)


  1. The staff member will fill out the form completely (each section must be marked). See sample.
  2. An illness or incident/injury is considered minor if a child is able to return to normal activity or when basic first aid is given.
    1. If a child becomes ill or has an injury that requires First Aid it is considered a minor incident.
    2. A JFS 01299 – Incident/Injury Report must be completely filled out.
      1. A copy must be signed by the parent or caregiver the day of the incident.
      2. Parent/Caregiver gets one copy
      3. Send one copy to the Transportation/Safety Specialist at the Central Office.
  3. Serious Incident, Injury or Unusual Event
    1. Includes any situation occurring while a child is in the care of the provider
      1. Death of child at the center
      2. Bus accident with or without injury
      3. A child receives a bump or blow to the head that requires first aid or medical attention.
      4. An incident, injury or illness requires a child to be removed by the parent or emergency services from the center for medical treatment, professional consultation or transportation for emergency treatment.
      5. An unusual or unexpected incident which jeopardizes the safety of children or staff
      6. A child left unattended
      7. An incident defined as a serious risk noncompliance in appendix A to ODJFS rule 5101:2-12-03
    2. NOCAC Staff will report all Serious Incident, Injury or Unusual events to the Center Manager.
    3. NOCAC Center Manager will go to https://oclqs.force.com and file a Serious Incident Report by the next business day.
      1. The Center Manager will print a completed copy of the JFS 01156 Serious Incident Reporting for Child Care and give to each parent. This meets the parent notification requirement of 2b and takes the place of JFS 01299 – Incident/Injury Report
      2. Copy of the JFS 01156 Serious Incident Reporting for Child Care will be sent to the Health and Safety Manager, Transportation, Facilities & Safety Assistant and the NOCAC Child Development Director.
      3. This notification does not replace reporting to ODJFS Children Services if there are concerns of child abuse/neglect.

Forms and Additional Guidance:

This policy complies with the following

Head Start Program Performance Standard:   1302.47(b)(5)
ODJFS Child Care Manual:   5101:2-12-03, 5101:2-12-16
CACFP Regulation:    
Caring for Our Children:    
Other Sources:    


Effective Date:   8/7/17 Reviewed Date:   6/8/22
Approved By Policy Council:   8/7/17 Revision Approved By Policy Council:    
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