2012 District of Columbia Child Care Market Rates ... - osse - DC.gov-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Part I – Reported By. Fill in your name, facility name, title/position, and contact information including home and cell numbers.
3. Proceed to Part II – Incident Information. Enter the date and time of the incident, type of incident, and whether Child Protective Services was contacted if suspected abuse or neglect is indicated.
4. In this section, provide details about individuals involved in the incident. Include names, ages, and contact numbers for each person listed.
5. Complete Part III by describing the incident thoroughly. Use clear language to explain who was involved, what happened, where it occurred, and how it transpired.
6. Finally, in Part IV, document any actions taken following the incident along with your signature and date before submitting the form via fax or email as instructed.

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