Section Summary: An incident report is created detailing: Who the incident needs to be reported to, what type of incident is being reported and by whom, when and where it occurred, what occurred, who was present and what their role was along with any contact information, whether it reported to other organizations/agencies, and finally whether any follow-up occurred. Supporting Documents are uploaded as needed, and the report submitted to a Reviewer, or directly to a State Agency.
Provider Staff and State Agency Triage users have the ability to create new Incident Reports.
Click the + Icon in the upper right of the screen to create a new report.
For providers:
If you submit incidents to CYFD and/or BHSD, select the state agency you are reporting this incidient incident to.
If you only submit incidents to a single agency, the system will default the agency the incidient incident is being reported to in the background.
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The system will default the state agency you work for as the agency the incidient incident is being reported to in the background.
The Overview tab of the new Incident Report is displayed.
Required fields are indicated with a *.
Click the Title field and enter a short title for the report. (Do not include Client Names.)
Click the Occurred field calendar icon and click the date and time that the incident occurred.
Click the First Known field calendar and click the date and time that the provider was first aware of the incident.
Click the Type drop-down and click the incident type.
Click the Sub-type drop-down and click the incident sub-type. (This is filtered by the Type selected.)
Click the Service Context drop-down and click the location where the incident occurred. (If Other is selected. click the Other Contect field and enter details.)
Click the Source drop-down and click the source the incident is being reported by.
Click the Activity at Time of Incident field and enter a short description of the activity taking place when the incident occurred.
Click the I am completing this report on someone else's behalf checkbox if you are entering the incident report for someone else.
Click the Contributing Risk Factors drop-down and click each risk factor contributing to the incident.
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Click the At time of report creation, incident location is unknown checkbox if the actual location the incident occurred at is not known. (Example: Disclosure of past abuse/unclear on location details.)
Click the Location Name field and enter the name of the location where the incident occurred. (Required for reports from: Provider premises, Home, Other Private Residence, or Treatment Foster Care.
Tab to or click the Street field and enter the street address of the location where the incident occurred.
Tab to or click the City field and enter the city for where the incident occurred.
Tab to or click the State field and enter the state for where the incident occurred.
Tab to or click the Zip field field and enter the zip code for where the incident occurred.
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Click the Service Notified field and select the agency or emergency service that was also notified about the incident. If no other agencies were notified about the incident, select Not Applicable.
Tab to or click Date Reported calendar and select the date that agency was notified about the incident.
Tab to or click the Case Number field and enter that agencies case# for the incident.
Reported the steps above by clicking the + for each agency or emergency service also notified about the incident.
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Click the + to add a client to this incident report.
Click the First Name field and enter the client’s first name.
Tab to or click the Last Name field and enter the client’s last name.
Tab to or click the Gender drop-down and click the client’s gender.
Tab to or click the Date of Birth field and click the client’s DOB.
Tab to or Click Save to save the client’s record.
All other fields are Optional and can be entered/not entered as needed.
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Click the Involvement button for the createe client to explain their involvement in the incident.
Click the Role drop-down and click the role this client was in the incident.
Step 1 - Click the + Button
To begin filling out an Incident Report, click “Incidents” in the sidebar, then click the + button at the upper-right of the screen.
As you fill out the Incident Report, you can move sequentially through questions with the tab key or jump between questions using the mouse.
As you add information to the Incident Report, your changes will automatically be saved.
Based on your answers to some questions, you will see additional questions appear. For example, if you select an Incident Type, a new Incident Sub Type field wil display for selection.
Required fields are indicated with an *.
Step 2 - Complete the Report
Click the Contacts tab and add any contacts related to the incident.
Click the Documents tab and add any videos, photos, or documents related to the incident.
When all the fields have been filled out correctly, select the Finalize tab.
Step 3 - Abandon or Select a Submission Method
Select what should happen next with your report:
Abandon: If your report does not require submission to the LCA, you may abandon the report and it will be archived.
Submit for Review: This option should be selected for most reports so they can be reviewed for completeness.
Skip Review: This option should ONLY be selected in special circumstances, for example:
Submission of an urgent report occurs at night when no reviewer will be available at the provider location.
The report is exceptionally urgent and needs to reach the LCA immediately.
I believe I am a whistleblower and would like to submit the report anonymously, without review by supervisors.
If the only option you see is Abandon, this indicates you have a missing required field back on the Overview Tab.
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