Licensing form LIC 624, Unusual Incident/Injury Report
English form: https://www.cdss.ca.gov/cdssweb/entres/forms/English/LIC624.PDF
Spanish form: https://www.cdss.ca.gov/cdssweb/entres/forms/spanish/lic624sp.pdf
English form: https://www.cdss.ca.gov/cdssweb/entres/forms/English/LIC624.PDF
Spanish form: https://www.cdss.ca.gov/cdssweb/entres/forms/spanish/lic624sp.pdf