Critical Incidents are classified as Category I or Category II. Please use this form to complete Category I incidents. This form must be completed in addition to calling the 24-hour automated phone system.

Category I Incidents

• Any suspected or confirmed suicide or homicide, or any unexpected death that occurs onsite in a facility or site-based program or within the vicinity of the program they were connected to;
• Any sexual assault that occurs onsite in a facility or site-based program;
• Anything that causes more than 24 hours in an interruption to normal operations including temporary relocation, such as flooding, fire, unsafe conditions, etc.;
• Any suspected sexual exploitation or trafficking of a child while enrolled in a facility or site-based program;
• Any event causing media attention or has led to media attention. Anything you suspect will be or may be in the news;
• Any physical assault leading to hospitalization (staff or client) that occurs onsite or within the vicinity of the program they were connected to, or while conducting outreach;
• Any credible threats to persons or property, that led to calling for outside intervention such as crisis responders, police, or other emergency responders;
• Any bias incident from program staff (i.e., acts of prejudice that are not criminal in nature and do not involve violence, threats, or property damage) including those targeting LGBTQ community members, global majority, and/or gender-based violence (i.e., trans, two-spirit, etc.);
• Hate crimes as defined by state and federal law (acts of prejudice that are criminal in nature and involve actions such as violence, threats, or property damage).

Report Category I incidents within 24 to 48 hours of incident—as soon as the situation is confirmed, stable, and any immediate risks to clients or staff are resolved.

Note: Report Category II incidents on a quarterly basis via the required Quarterly Narrative Report in the contract management system, FLUXX/Salesforce. If an incident has already been reported as Category I, and in this Smartsheet Form, it does not need to be reported again.

Notice to the KCRHA does not change or replace your responsibility for appropriate action immediately to address an incident. You are responsible for safe, effective, appropriate, and person-centered program management for your clients, staff, and facilities.

PLEASE NOTE: Information provided on this form will be a public record subject to free and open examination by any person under the Washington State Public Records Act (RCW 42.56.250). Any personal or contact information will be redacted.