Initial Incident Report definition
Initial Incident Report. Each initial incident report filed by a PASSE HCBS provider must contain the following information:
1. Date of the incident
2. Detailed description of the accident/injury
3. Time of the incident
4. Location of incident
5. Persons involved in the incident
6. Other agencies contacted regarding incident, and the name of the individual in the agency that was contacted
7. Whether the guardian was notified of the incident and time of notification,
8. Whether the police were involved, and if so, a detailed description of their involvement
9. Any action taken by Provider or staff of Provider, both at the time of the incident and subsequent to the incident
10. Any expected follow-up
11. Name of person that prepared the report When applicable, the PASSE HCBS provider shall notify the parent or legal guardian of the beneficiary any time an incident report is submitted.
Examples of Initial Incident Report in a sentence
The Initial Incident Response phase will be completed upon delivery of the Initial Incident Report.
Service Provider shall use good faith efforts to provide the Initial Incident Report within one business day after discovery (lithe Incident, and to provide a root cause analysis within one week after discovery of the Incident.