Pre-School & Day Care Incident Reporting
Smart Kids Pre School & Day Care , Makola
Report of Incident
Date & Time of the Incident
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Reported By
*
Please Select
Teacher
Child
Parent
Visitor
Other
Name of Reporter
*
Back
Next
Detail of Incident
Type of the Incident
*
Please Select
Physical Incidents
Behavioral Incidents
Safety and Security Incidents
Health-Related Incidents
Environmental Incidents
Emotional or Developmental Incidents
Staff-Related Incidents
Emergencies
Other
Physical Incidents
Accidents: Minor injuries like cuts, bruises, or falls while playing.
Bumps and Scrapes: Common during activities or outdoor play.
Choking: On small toys or food items.
Illness: Sudden illness such as vomiting, fever, or allergic reactions.
Toileting Accidents: When a child doesn’t make it to the restroom in time.
Behavioral Incidents
Tantrums: Emotional outbursts common in young children.
Aggression: Hitting, biting, pushing, or kicking other children or staff.
Defiance: Refusal to follow instructions or participate in activities.
Social Conflicts: Arguments or disagreements between children during group activities or playtime.
Safety and Security Incidents
Lost Child: A child accidentally leaving the designated area or getting separated from the group.
Unauthorized Pickup: A child being picked up by someone not on the approved list.
Dangerous Situations: Children accessing unsafe areas or items like cleaning supplies or sharp objects.
Health-Related Incidents
Allergic Reactions: Reactions to food, insect bites, or environmental allergens.
Medication Issues: Errors in administering prescribed medications or forgetting doses.
Communicable Illnesses: Spread of illnesses like colds, flu, or hand-foot-mouth disease.
Environmental Incidents
Hazards: Playground equipment malfunctions or unsafe classroom materials.
Weather-Related: Sudden storms or extreme heat requiring quick sheltering.
Power Outages: Affecting safety, visibility, or heating/cooling.
Emotional or Developmental Incidents
Separation Anxiety: Difficulty adjusting to being away from parents or caregivers.
Sensory Overload: Stress from noise, light, or other sensory inputs.
Developmental Milestones: Challenges or delays noticed during activities.
Staff-Related Incidents
Supervision Lapses: Instances where a child is left unsupervised.
Miscommunication: Between staff or with parents about routines or care.
Inappropriate Behavior: Staff not adhering to professional guidelines or best practices.
Emergencies
Fire Drills/Alarms: Accidental activation or planned drills.
Medical Emergencies: Serious injuries requiring external medical assistance.
Natural Disasters: Earthquakes, floods, or other localized events.
Other
Other
Detail Description of Incident
*
Back
Next
Incident Related Other Information
Victim of Incident (Should mention Name, Age, ID)
*
Witnesses
*
Back
Next
Inform Incident
Inform Relavant Parties
*
Back
Next
Action Taken
First Aid Given / Related Information
*
Medical Treatment / Hospital / Clinic Visited
*
Other Comments
*
Back
Next
Photos
Incident related images
Back
Next
Final
Corrective Action Taken
*
Preventive Action
*
Back
Next
Acceptance
*
"I confirm that the details provided in this report are true and correct to the best of my knowledge."
Reported By (To Incident Reporting)
*
Please Select
Hirnya Chathurani
Rasmi Raveena
Warsha Rashmini
Sandali Naveendaya
Email of Reported by
*
example@example.com
Signature of Reported By
*
Continue
Continue
Should be Empty: