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Vulnerable Adult Incident Report NAME DATE REPORTED AGE TIME REPORTEDDOBEMERGENCY CONTACTPHONEDATE AND TIME INCIDENT OCCUREDFILE NO:INCIDENT LOCATIONREPORTING OFFICERVULNERABLE + HARM MANDATORY Reporting
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How to fill out vulnerable adult incident report
How to fill out vulnerable adult incident report
01
Start by gathering all relevant information about the incident, such as names of individuals involved, date and time of the incident, and any witnesses present.
02
Begin filling out the vulnerable adult incident report form by providing the basic information of the vulnerable adult, such as their name, age, and contact information.
03
Describe the incident in detail, including what happened, where it occurred, and any injuries sustained by the vulnerable adult.
04
Provide a clear and concise account of any actions taken by caregivers or staff members at the time of the incident.
05
Include any additional relevant information, such as any prior incidents or concerns regarding the vulnerable adult's safety.
06
Make sure to sign and date the completed incident report form, and ensure that any other required signatures are obtained as well.
07
Submit the filled out vulnerable adult incident report to the appropriate authority or organization as instructed.
Who needs vulnerable adult incident report?
01
Vulnerable adult incident reports are required by organizations or authorities responsible for the welfare and protection of vulnerable adults.
02
This includes but is not limited to:
03
- Nursing homes or assisted living facilities
04
- Adult protective services agencies
05
- Law enforcement agencies
06
- Healthcare providers and hospitals
07
- Social services organizations
08
- Rehabilitation centers and mental health facilities
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