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Setting up a Creche - Department for Communities

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Name of Child<br />

First name Surname<br />

Date and Time of Incident<br />

Incident / Accident Record Sheet<br />

Date Time<br />

Details of Incident / Accident<br />

Include names of any witnesses and adults/children involved.<br />

Details of any action taken<br />

Include any treatment provided, who provided treatment and outcome.<br />

Crèche Worker<br />

First name Surname<br />

Signature Date<br />

Parent of Child<br />

First name Surname<br />

Signature Date<br />

21

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