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Special Incident Reporting (SIR)

TCRC has developed a Provider COVID-19 Checklist for providers to assist them in taking all of the necessary steps to report the incident, and to help protect the health & safety of individuals and staffs.

TCRC has also developed two supplemental forms to the SIR for COVID-19 reporting:

Special Incident Report (SIR) Form in Word

Special Incident Report (SIR) Online Form with E-Signature   (instructions)

TCRC has created a streamline procedure for special incident reporting (SIR).  The purpose of this process is to more effectively carry out the mandates of Title 17, California Code of Regulations, Sec 54327, that are meant to protect the safety and rights of people with developmental disabilities.

Some of these forms and documents contain macros to simplify data entry. You may get a warning message regarding macros depending on your level of security. The macros have been tested and are safe to run.

Reporting SIRs

For all incident reports in SB/SLO Counties, fax to (805) 456-2197

For all incident reports in Ventura County, fax to (805) 456-0870

Reporting Regulations

Title 17:
Title 22:  link (Select Child Care, Residential, or Family Child Care from this page)

Risk Management Tools

Incident Response Checklist

Preventative Action Checklist

Additional Health and Safety Resources

Developmental Disabilities: Resources for Healthcare providers  link

The Safety Net  link

American Heart Association  link

American Diabetes Association  link

American Medical Association Health Information  link

California Childcare Health Program  link

HealthFinder: US Department of Health and Human Services Health Information  link

Healthtouch Online  link

National Cancer Institute  link

National Institutes of Health – Health Information  link