Special Incident Reporting

New Fax number for all Special Incident Reports - The regional center must be notified of an incident within 24 hours of occurrence and written report received within 48 hours of incident. All Special Incident Reports (SIRs) must be faxed to:

310-258-4222

Forms:

SIR Tip Sheet (New Updated Laws Included – Effective January 1, 2013 – PLEASE READ CAREFULLY)

WRC Special Incident Report form -Vendors and Long-term Care (LTC) Providers

Instructions for Vendors and Long-term Care providers completing Special Incident Report (SIR)

Suspected Adult/ Elder abuse Reporting form (SOC341)

Suspected Child Abuse Reporting (S.C.A.R.) Form

Vendor SIR Reporting Title 17 Regulations

Links:

Adult Protective Services (APS) - State mandated Title XX service program which mandates the prompt investigation of all situations involving elders (age 65 or older) and dependent adults (physically or mentally impaired 18-64 year old) who are reported to be endangered by physical, sexual or financial abuse, abandonment, isolation, abduction, neglect or self-neglect or hazardous living conditions.

California Poison Control System (CPCS) is the statewide provider of immediate, free and expert treatment advice and assistance over the telephone in case of exposure to poisonous, hazardous or toxic substances. Call us toll-free - 1-800-222-1222, 24 hours a day, 7 days a week, 365 days a year.

Department of Child and Family Services (DCFS) - Mandated reporters may now complete Child Abuse Reporting online.. It is necessary to make a phone report firstand receive a reference number that will allow you to log in to the Mandated Reporters site to complete the written report.

Long Term Care Ombudsman - An Ombudsman is an individual who is trained and State-certified to objectively investigate and resolve complaints made by individuals against abuses. The Long Term Care OMBUDSMAN Program is a free and confidential service that maintains and improves the quality of life for resident in long-term care facilities.

Official California Legislative Information - Site is maintained by the Legislative Counsel of California and contains up-to-date information on law, legislative sessions, and bill information.

Restraints and Seclusion - This is the Senate Bill regarding use of restraints and seclusion in final version in H&S Code section 1180.3. (a)This section shall apply to psychiatric units of general acute care hospitals, acute psychiatric hospitals, psychiatric health facilities, crisis stabilization units, community treatment facilities, group homes, skilled nursing facilities, intermediate care facilities, community care facilities, and mental health rehabilitation centers. It is considered a "Best Practice" for all consumers.

Risk Management Tools:

Incident Response Card

Incident Response Checklist

Preventative Action Checklist

Risk Assessment Evaluation & Planning

Risk Assessment Evaluation & Planning Worksheet

Risk Assessment Inventory: Falls

Risk Assessment Inventory: Major Depression

Risk Assessment Inventory: Osteoporosis

Risk Assessment Inventory: Physical & Nutritional Management

Risk Assessment Inventory: Skin Breakdown

Risk Assessment Inventory: Substance Abuse