Special Incident Report. 6 CONTRACTOR shall complete a Special Incident Report, in the event 7 there are any incidents of unusual, aggressive, or high-risk behavior by a 8 Participant and/or a Participant’s Family member(s); there are any serious 9 injuries or death suffered by any party during delivery of services; any time
10 a Participant’s and/or Participant’s Family member’s confidentiality is 11 compromised; and/or if Participant and/or a Participant’s Family member 12 exhibit inappropriate behavior. In such event(s), CONTRACTOR shall:
13 14.8.1 Use the Special Incident Report form provided by 14 ADMINISTRATOR and follow all applicable instructions;
15 14.8.2 Immediately notify ADMINISTRATOR, or designee, by 16 telephone in the event of a death or serious injury, in the event there may be 17 media coverage, and/or if the Special Incident Report will be delayed beyond 18 the required twenty-four (24)-hour notification requirement;
19 14.8.3 Submit Special Incident Report to ADMINISTATOR, or 20 designee, within twenty-four (24) hours of the special incident;
21 14.8.4 Immediately report any and all threats of violence by 22 Participant and/or Participant’s family member(s) to the ADMINISTRATOR, 23 assigned Probation Officer and/or SSA SSW and/or the referring HCA clinician;
24 14.8.5 Report all details of the incident clearly and completely, 25 including any action(s) taken.
Special Incident Report. 8.10.1 CONTRACTOR shall complete a Special Incident Report in 26 the event of any incidents of unusual, aggressive, and/or high-risk behavior 27 exhibited by a Participant and/or a Participant’s family member(s); any 28 serious injuries or death suffered by any party during any Participant’s WCB0418 Page 38 of 00 00-00-00 1 and/or Participant’s family’s participation in Wrap OC; breach in Participant 2 and/or Participant’s family member’s confidentiality; and/or a Participant 3 and/or a Participant’s family member(s) exhibit inappropriate behavior. In 4 such event(s), CONTRACTOR shall:
5 8.10.1.1 Use the Special Incident Report form provided 6 by ADMINISTRATOR and state all details of the incident clearly and completely, 7 including actions taken;
8 8.10.1.2 Notify ADMINISTRATOR, or designee, by 9 telephone, immediately after learning of the occurrence;
10 8.10.1.3 Submit Special Incident Report to 11 ADMINISTRATOR, or designee, within twenty-four (24) hours of the special 12 incident; and
13 8.10.1.4 Report any and all threats of violence by the 14 Participant and/or Participant’s family member(s) to ADMINISTRATOR, or 15 assigned designee, including the assigned DPO and/or SSW and/or MH clinician, 16 immediately after learning of the occurrence.
Special Incident Report.
6.1 CONTRACTOR shall complete ADMINISTRATOR’s Special Incident Report, in the event there is any incident of unusual, aggressive, or high-risk behavior by a CLIENT, or there are any injuries suffered by any party during the service delivery, provided CONTRACTOR observes or is made aware of any incidents of unusual, aggressive, or high-risk behavior by a CLIENT, or CONTRACTOR observes or is made aware of any injuries suffered by any party during the service delivery.
6.2 CONTRACTOR shall use the Special Incident Report form provided by ADMINISTRATOR to report incidents described in Subparagraph 6.1 of Exhibit A.
6.3 CONTRACTOR shall contact the CLIENT’s assigned SSW or the CFS Officer of the Day by telephone within one (1) business day and complete a Special Incident Report, in the event there is any incident of unusual, aggressive, or high-risk behavior by a CLIENT, or if there are any injuries suffered by any party during the service delivery. CONTRACTOR shall use the Special Incident Report form provided by SSA and submit the form to SSA within one (1) business day. A copy of the Special Incident Report must be retained in the CLIENT’s file.
6.4 CONTRACTOR shall ensure reports are prepared in a format approved by ADMINISTRATOR. ADMINISTRATOR and CONTRACTOR may mutually agree in writing to add, delete, waive, or otherwise modify reporting requirements as stated in this Paragraph.
Special Incident Report. 10 4.5.1 CONTRACTOR must make contact with assigned SSW immediately in the 11 event of any incident of unusual, aggressive or high-risk behavior by a CLIENT, or if there are 12 any injuries suffered by any party (CLIENT, CONTRACTOR’s staff, or others) in the delivery of 13 services. If SSW is not available and a voice mail is made, CONTRACTOR shall follow up by 14 contacting the Officer of the Day via phone call, in addition to ADMINISTRATOR. RDM shall 15 be notified if attempts to contact the SSW and ADMINISTRATOR have been unsuccessful.
16 4.5.2 CONTRACTOR will document the incident by completing the Special 17 Incident Report form provided by ADMINISTRATOR. CONTRACTOR must submit the Special 18 Incident Report to the assigned SSW and ADMINISTRATOR within one (1) business day of the 19 incident via SCMS.
Special Incident Report. 12.10.1 CONTRACTOR shall complete a Special Incident Report as instructed by ADMINISTRATOR or in the event of any incidents of unusual, aggressive, and/or high-risk behavior exhibited by Participant and/or a Participant’s family member(s); any serious injuries or death suffered by any party during Participant’s and/or Participant’s family’s participation in Wrap OC; breach in Participant and/or Participant’s family member’s confidentiality; and/or when Participant and/or a Participant’s family member(s) exhibit inappropriate behavior. In such event(s), CONTRACTOR shall: Use the Special Incident Report form provided by
Special Incident Report. 12.10.1 CONTRACTOR shall complete a Special Incident Report as instructed by ADMINISTRATOR or in the event of any incidents of unusual, aggressive, and/or high-risk behavior exhibited by Participant and/or a Participant’s family member(s); any serious injuries or death suffered by any party during Participant’s and/or Participant’s family’s participation in Wrap OC; breach in Participant and/or Participant’s family member’s confidentiality; and/or when Participant and/or a Participant’s family member(s) exhibit inappropriate behavior. In such event(s), CONTRACTOR shall: Use the Special Incident Report form provided by ADMINISTRATOR and state all details of the incident clearly and completely, including actions taken; Notify ADMINISTRATOR, or designee, by telephone, immediately after learning of the occurrence; Submit Special Incident Report to ADMINISTRATOR, or designee, within twenty-four (24) hours of the special incident; and Report threats of violence by Participant and/or Participant’s family member(s) to ADMINISTRATOR, or assigned designee, including the assigned DPO and/or SSW and/or MH clinician, within one (1) hour upon learning of the occurrence. Follow-up with ADMINISTRATOR, or designee, with any updated information related to Special Incident Report within twenty-four (24) hours of special incident report submission.
Special Incident Report. 24 8.5.1 Child Care Provider must make contact with ADMINISTRATOR’s 25 TDM staff immediately (voice mail is acceptable) in the event of any incident 26 of unusual, aggressive or high-risk behavior by a child/family, or if there 27 are any injuries suffered by any party (child/family, CONTRACTOR’s staff, or 28 others) in the delivery of services.
1 8.5.2 The Child Care Provider will document the incident by 2 completing the Special Incident Report form provided by ADMINISTRATOR. 3 Provider must submit the Special Incident Report to the ADMINISTRATOR’s TDM 4 staff and Contact Administrator within one (1) business day of the incident.
Special Incident Report. 4.18.4.1 In addition to the Community Care Licensing (CCL)CCLD Unusual Incident/Injury Report procedures, CONTRACTOR shall immediately contact (voice mail is acceptable) RDM staff in the event of any incident of unusual, aggressive, or high-risk behavior by a child/family, or if there are any injuries suffered by any party (child/family, CONTRACTOR's staff, or others) in the delivery of services.
Special Incident Report. 8 CONTRACTOR shall complete a Special Incident Report (SIR), in the 9 event there is any incident of unusual, aggressive, or high-risk behavior by x 10 Participant and/or Participant’s Family member(s); there are any injuries or 11 death suffered by any party or loss of property during delivery of services; 12 any time Participant’s and/or Participant’s Family member’s confidentiality is 13 compromised; or if services are terminated early due to the Participant and/or 14 Participant’s Family member(s) refusing to participate or exhibiting 15 inappropriate behavior. In such event(s), CONTRACTOR shall:
16 8.4.1 Immediately notify ADMINISTRATOR, assigned Probation 17 Officer, Mental Health Worker or SSA Social worker, and direct services agency 18 of the incident by telephone,
19 8.4.2 Comply with established CONTRACTOR’s established procedures 20 for such events, 21 8.4.3 Complete SIR form provided by ADMINISTRATOR and follow 22 applicable instructions, clearly identifying the specific information 23 regarding the incident, and 24 8.4.4 Submit SIR to ADMINISTRATOR within twenty-four (24) hours 25 of the special incident.
Special Incident Report. 8.10.1 CONTRACTOR shall complete a Special Incident Report in 25 the event of any incidents of unusual, aggressive, and/or high-risk behavior 26 exhibited by a Participant and/or a Participant’s family member(s); any 27 serious injuries or death suffered by any party during any Participant’s 28 and/or Participant’s family’s participation in Wrap OC; breach in Participant WCB0418 Page 41 of 75 4-23-18 1 and/or Participant’s family member’s confidentiality; and/or a Participant 2 and/or a Participant’s family member(s) exhibit inappropriate behavior. In 3 such event(s), CONTRACTOR shall:
4 8.10.1.1 Use the Special Incident Report form provided 5 by ADMINISTRATOR and state all details of the incident clearly and completely, 6 including actions taken;
7 8.10.1.2 Immediately notifyNotify ADMINISTRATOR, or 8 designee, by telephone within ten (10) minutes after learning of the
