Lara incident report: Fill out & sign online

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Click ‘Get Form’ to open the bcal 4605 incident report in the editor.
Begin by indicating whether the incident was phoned to licensing. Select 'Yes' or 'No' and provide the date and time if applicable.
Fill in the TYPE OF REPORT section by selecting one of the options: Incident, Accident, Illness, or Death.
Complete the FACILITY section with your License Number, Facility Type, Phone Number, and Address details.
In the CHILD(REN) IN CARE INVOLVED section, enter each child's name, birthdate, sex, home address, and parent information.
Document CAREGIVER(S) / OTHER PERSON(S) INVOLVED / WITNESS(ES) by providing their names and contact details.
Detail the INCIDENT DETAILS including date, time, location, and a specific description of what occurred.
Indicate if First Aid was given and provide additional medical treatment information if applicable.
List any PERSON(S) NOTIFIED regarding the incident along with their notification dates and times.
Finally, sign off on the report by entering your title and date before submitting it through our platform.

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