In accordance with OAC 5101:2-9, Summit County Children Services' (SCCS) Internal Policies, and the SCCS Placement Service Agreement (please refer to the Agreement for full information), relative to children placed by SCCS, a typed Critical Incident Report must be filed for any incident listed in the SCCS Critical Incident Report.

SCCS must be notified by a call to the hotline at (330) 434-5437 within four (4) hours of the incident AND a typed Critical Incident Report must be sent via fax to the Director of Social Services by the end of the next business day. Fax (330) 379-9601.

This report is created in Microsoft Office Word 2010. (If you are using an earlier version of Word, please continue to use the paper form or download the Compatability Service Pack from Microsoft's website.) Below are the instructions for completing this form:

1. Click on the link to open the form in Microsoft Word. Critical Incident Report.

2. To complete the form, type in the shaded areas by the questions. Answer all of the questions.

3. Print the form. (For Microsoft Office Word 2007 and 2010, click on the File tab. select Print.)

4. Fax the completed form to the Director of Social Services at (330) 379-9601.

All Critical Incident Reports must be typed.