Injury Report Form

It is important that all child care programs record any injury that requires first aid, such as a bandage or a cold compress. Planning for injuries, reporting injuries and eliminating hazards or conditions that cause injuries should be part of the overall plan to keep children safe while they are in child care. And by tracking injuries that happen, programs can look for patterns caused by hazardous conditions and identify problem areas before they cause serious injury. This form is to be used to ensure accurate tracking and appropriate follow-up of all serious incidents that occur in child care.

This form was developed by CCHP staff and is excerpted from Health and Safety in the Child Care Setting: Prevention of Injuries, A Curriculum for the Training of Child Care Providers, 2nd Ed. If you discover a child's injury, such as bruising, cuts or burns, and suspect child abuse, you are required to file a report with your local child protective services agency.

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