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Add Incident
Main Centre - Archer Daycare
Children Involved
Donald Barnes
Jessica Barnes
June Ramirez
Jane Ramirez
Kenneth Reed
Sherry Roberts
William Roberts
April Roberts
Roxanne Leavitt
Alda Waldron
Mark Hardwick
Andre Irvine
Abigail Brown
Maryellen Holm
Date
Time of injury
Time guardians notified
Attending caregiver
aleah joshana
Frank Archer
Helen Archer
Selena Garcia
Tana Kelly
Short Description
Describe the injury
Child Outline
How and where did the injury occur
Was first aid administered?
No
Yes
(If yes, specify)
Who administered first aid
aleah joshana
Frank Archer
Helen Archer
Selena Garcia
Tana Kelly
Was any further action taken? (e.g. child sent to hospital, to physician)
If yes, complete and submit Injuries/Unusual Occurrence Report
(Saskatchewan Form 7796)
If the child remained at the facility, what was the childs level of participation?
Other comments
What corrective action has been taken to prevent further injuries of this type
Names of staff who witnessed the injury
aleah joshana
Frank Archer
Helen Archer
Selena Garcia
Tana Kelly
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