Child Protection – Risk Management Breach Report

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Child Protection – Risk Management Breach Report

 

Date breach occurred ______________________         Time breach occurred __________________

Location of breach __________________________________________________________________

 

Name of person(s) involved in the breach

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Description of the breach

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Immediate action taken

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If no action taken – reason

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___________________________ ___________________________
Name of person completing form Signature of person completing form
Date __________ Time __________ AM/PM
___________________________ ___________________________
Authority breach reported to (if relevant) Name of person reported to

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