Child safety incident report

Child Safety Incident Report

If you believe a child is in immediate danger, call 000.

Thank you for taking the time to complete this child safety incident report. Ardoch takes seriously the safety of our people and the children that we work with. We are grateful that you are committed to helping us keep children safe and providing a safe and healthy environment for all children and young people. This form is available for you to report all types of child safety issues, as well as all forms of child abuse and neglect.

Please provide as much detail as possible, so that we can address any issues or incidents with accuracy and in a timely way. We assure you that we will follow up this report as quickly as possible. Depending on the incident reported and the incident location, there may also be legal reporting requirements to the Police or child protection. Ardoch staff can help you to complete this reporting. Thank you again for your partnership in keeping children and young people safe.

This form will be submitted to Ardoch's Child Safety Officer for action. If you need support with reporting or would like to speak to the Child Safety Officer you can email [email protected] or call (03) 9537 2414.

Details of person submitting report

Full Name

Position (if applicable)

Your Preferred Phone number

Your Email address

Are you a paid Ardoch Employee submitting this report?

YesNo

Incident Details

Where did this incident occur?

On what date did the incident occur?

At approximately what time did the incident occur?

Example format required: 01:00AM or 01:00PM

Please describe what happened (the incident)

Details of the Child / Children Affected

Full Name of Child (if known)

Name of School child attends (if known)

Details of people who witnessed the incident

Witness Name

Witness position

Witness Email address

Witness Phone Number

Files & Attachments

If you have any documentation (for example, photos, emails, letter, other) relevant to your incident report please upload it here.

Note: Only click on 'Add another file/attachment' if you have additional files to add. If you click 'Add another file/attachment' and then leave the fields blank, it will cause a submission error. If you end up with more fields than you have attachments, please use the 'Remove' button to remove those empty fields, so the form can submit correctly.

Incident Management

List any corrective action/s already taken

Names and contact details of people to be advised?

Any recommendations from the incident to improve overall child safety?

Child Safety Incident Report

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