Incident Report
School District of Manawa
Complete this report under any of the following situations:
A. A child becomes ill or receives an injury that requires First Aid or medical treatment while in your care;
B. A child receives a bump or blow to the head or other visible injury regardless of treatment;
C. A child is transported by ambulance from your facility;
D. An unusual or unexpected incident occurs that jeopardizes the safety of a child, such as a child left unattended there is a vehicle accident (with or without injuries), or a child is exposed to a threatening person or situation;
E. There is an allegation or reasonable suspicion of abuse of a child.
Complete this report in its entirety.
Use fact-based statements only. Submit this form no later than 24 hours after the incident.
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