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Daycare Incident Report Form Template

Effortlessly Document Incidents in Your Daycare

Accidents can happen unexpectedly in daycare settings, and being prepared is key to handling them correctly. This daycare incident report form helps you swiftly document and manage incidents, ensuring you capture all necessary details for future reference. Use this template to streamline communication with parents, maintain compliance with regulations, and enhance overall safety protocols in your facility-all while remaining transparent and accountable. You can easily customize this form to meet your specific needs and start managing incidents today.

Use this Template (FREE) Live Preview
Date of incident
Time of incident
Brief location notes (e.g., area or equipment)
Location of incident
Please Specify:
Child full name
Child date of birth
Primary educator on duty
Classroom or age group
Infant
Toddler
Preschool
Pre-K
School-age
Mixed-age
Other or not listed
Incident type (select all that apply)
Please Specify:
If other, describe
Activity at the time of the incident
Please Specify:
Brief description of events
Contributing factors (select all that apply)
Please Specify:
Was there an injury or illness?
Injury
Illness
No apparent injury or illness
Body part(s) affected
Please Specify:
Signs or symptoms observed
Please Specify:
Injury severity at the time of the incident
No apparent injury
Minor
Moderate
Severe
Unknown
First aid or care provided
Yes
No
Not applicable
Care actions taken (select all that apply)
Please Specify:
Who provided care
External services contacted
None
911 or EMS
Poison control
Doctor or clinic
Insurance provider
Licensing agency
Other
Please Specify:
Notes on response and child condition after care
Did the child return to normal activity?
Yes
Partially
No
Not applicable
Parent or guardian notified
Yes
No - unable to reach
No - not yet
Notification method
In person
Phone call
Text or message
Email
App notification
Written notice
Not applicable
Other
Please Specify:
Name of person notified
Supervisor or director notified
Yes
No
Licensing or other authority notified
Yes
No
Not applicable
Is follow-up required?
Yes
No
To be determined
Planned follow-up actions (select all that apply)
Please Specify:
Target date for follow-up
Person responsible for follow-up
Corrective or preventive actions taken immediately
Witness name(s)
Were there any witnesses?
Yes
No
Unknown
Report completed by (full name)
Role or title
Date completed
Parent or guardian acknowledgment name
Parent or guardian acknowledgment date
Supervisor review name
Supervisor review date
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Paper art illustration depicting a daycare incident report form for FormCreatorAI article

When to use this form

Use this template right after any injury, illness, behavior issue, or property damage involving a child at your center. Capture events like a fall on the playground, a bite during free play, an allergic reaction at snack, or a head bump from roughhousing. Teachers, directors, and parents benefit from a clear, consistent record that includes what happened, care provided, and who was notified. This helps you meet licensing rules, spot trends, and prevent repeat issues. If the event involves only a staff injury, use the Employee incident report form instead. If you called emergency services, attach the Fire call report sheet form to log call details. The result is a timely, traceable report you can share with families and file for audits or insurance.

Must Ask Daycare Incident Report Questions

  1. What happened, where, and when?

    These facts create a clear, time-stamped record and help you show due diligence. They also let parents and administrators understand context and risk.

  2. Who was involved (child, staff, and witnesses) and how can you contact them?

    Identifying everyone ensures accurate follow-up and communication. If a staff member was injured, also complete the Staff incident report form.

  3. What immediate care or first aid did you provide, by whom, and at what time?

    Documenting care shows timely action and supports any later medical review. It also highlights training needs for your team.

  4. Was a parent or guardian notified, how (call, SMS, email), and at what time?

    Notification proof builds trust and meets policy expectations. A clear timeline prevents disputes about who knew what and when.

  5. What factors contributed, and what corrective steps will you take to prevent a repeat?

    Root-cause notes guide fixes like removing broken equipment or adjusting supervision. Action items turn a report into prevention.

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