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Cabinet for Health and Family Services Office of Inspector General Application for Certification to Operate a Personal Services Agency OIG1180, September 2021 906 CAR 1:180 Division of Health Care

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How to fill out incident report - chfs

01

Collect all necessary information related to the incident.

02

Use the CHFS incident report form to document the details.

03

Include a clear description of what happened and any factors that may have contributed to the incident.

04

Provide any relevant supporting documentation or evidence.

05

Submit the completed incident report to the appropriate CHFS personnel.

Who needs incident report - chfs?

01

CHFS employees and staff members who are involved in or witness an incident that occurs within the organization's facilities or programs.

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What is incident report - chfs?

An incident report - CHFS is a form used to report any events or occurrences that may affect the health and safety of individuals receiving services from the Cabinet for Health and Family Services.

Who is required to file incident report - chfs?

Any staff member or provider who becomes aware of an incident must file an incident report with CHFS.

How to fill out incident report - chfs?

To fill out an incident report for CHFS, the person reporting must provide detailed information about the incident, including date, time, individuals involved, and a description of what occurred.

What is the purpose of incident report - chfs?

The purpose of an incident report for CHFS is to ensure that any potential health and safety issues are addressed promptly and appropriately.

What information must be reported on incident report - chfs?

Information that must be reported on an incident report for CHFS includes date, time, location, individuals involved, description of the incident, and any follow-up actions taken.

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