CA Submersion Incident Report Form (SIRF) 2012-2025 free printable template

SUBMERSION INCIDENT REPORT FORM (SIR) FOR ALL DROWNING OR NEAR DROWNING INCIDENTS IN SAN BERNARDINO COUNTY BASIC INCIDENT INFORMATION A: ADULT SUPERVISION Date of Incident: Time of Incident: Your

How to fill out CA Submersion Incident Report Form SIRF

How to fill out CA Submersion Incident Report Form (SIRF)

1. Obtain the CA Submersion Incident Report Form (SIRF) from the appropriate regulatory agency or online resource.
2. Fill in the date and time of the incident at the top of the form.
3. Provide the location of the incident, including specific details of the site.
4. Include the names and contact information of all individuals involved in the incident.
5. Describe the circumstances surrounding the incident in detail, including what led to the submersion.
6. Indicate the response action taken during the incident, including rescue efforts.
7. List any injuries or fatalities that resulted from the incident.
8. Attach any additional documentation, such as witness statements or medical reports, if applicable.
9. Review the completed form for accuracy and completeness before submission.
10. Submit the completed SIRF to the designated regulatory authority as instructed.

Who needs CA Submersion Incident Report Form (SIRF)?

1. Individuals or organizations involved in a submersion incident, such as lifeguards, pool operators, or water safety officials.
2. Emergency responders who need to document the incident for legal or reporting purposes.
3. Insurance companies requiring detailed incident reports for claims processing.
4. Regulatory agencies monitoring compliance with safety standards in aquatic environments.

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What is CA Submersion Incident Report Form (SIRF)?

The CA Submersion Incident Report Form (SIRF) is a standardized document used to report incidents of submersion, particularly involving children, to relevant authorities in California.

Who is required to file CA Submersion Incident Report Form (SIRF)?

Individuals or organizations, such as pool owners, daycare providers, or schools, that witness or are involved in a submersion incident involving a child are required to file the CA Submersion Incident Report Form (SIRF).

How to fill out CA Submersion Incident Report Form (SIRF)?

To fill out the CA Submersion Incident Report Form (SIRF), follow the instructions provided on the form, which generally require personal information, details about the incident, and any responding emergency services.

What is the purpose of CA Submersion Incident Report Form (SIRF)?

The purpose of the CA Submersion Incident Report Form (SIRF) is to ensure proper documentation of submersion incidents, to facilitate investigations, and to help in preventing future occurrences by providing data to public health authorities.

What information must be reported on CA Submersion Incident Report Form (SIRF)?

The CA Submersion Incident Report Form (SIRF) requires information such as the date and time of the incident, location, description of the event, demographic details of the victim, and any medical response provided.