Form LIC624 Unusual Incident / Injury Report - California

LIC Unusual Incident Report

A licensed child care provider is required to submit current and accurate reports to Community Care Licensing in a timely fashion. An unusual incident report (namely, Form LIC 624 for child care centers and Form LIC 624B for family child care homes) is one type of these mandatory reports. Below are some examples of unusual incidents to be reported:

• Outbreaks of communicable diseases (e.g. mumps or measles);
• Suspected child abuse or any incidents that put children in danger, may it be them wandering away from the facility unattended or injuries requiring medical intervention.

Unusual incident reports, thanks to their nature, can be filed both by phone and in writing. Phone reports are made no later than the next working day after the event occurs. A detailed written report must be filed within 7 days of the event. Personnel changes reports are made within 10 days of the change.

Some events must be reported not only to the Community Care Licensing but to more than one government agency. Here are some examples:

1. Events involving a public health risk (e.g. outbreak of a communicable disease) are to be reported to the Department of Public Health.
2. Reports of any kind of criminal violation are to be filed to local law enforcement authorities.
3. And suspected child abuse cases must also be reported to a child protective agency.

Not what you were looking for? Check out these publications related to Form LIC 624:

• LIC 624A, Death Report, submitted by the licensee within 7 days of the death of a client regardless of the cause and the location of the death;
• LIC 624B, Unusual Incident/Injury Report - Family Child Care Home, a written report in the event of a death or injury occurred in a child care facility;
• LIC 624-LE, Law Enforcement Contact Report, used to report every incident involving a law enforcement contact, even if the child is not is alleged to have committed a crime.