For Providers
Mother and Daughter

Special Incident Reporting (SIR) Requirements

Special Incident Report Form click here

The following information to be included on each report

  • The date, time, and location of the special incident
  • The name(s) and date(s) of birth of the client involved;
  • A description of the incident
  • Treatment provided to the client, if any
  • Type of medications and dosages for any medication errors/reactions
  • The action(s) taken by the vendor, the client, or any other agency(ies) or individual(s) in response to the special incident;
  • The law enforcement, licensing, protective services, and/or other agencies or individuals notified of the special incident or involved in the special incident
  • All other information required by Title 17

Timelines for Special Incident Reports

Vendor timelines per Title 17 §54327:

Special Incidents… shall be submitted to the regional center by telephone or FAX immediately, but not more than 24 hours after learning of the occurrence of the special incident. The vendor or long-term health care facility shall submit a written report of the special incident to the regional center within 48 hours after the occurrence of the special incident. Vendors and Long Term Care facilities are accountable for adhering to timelines.

Vendor Training on Special Incident Reports – August 2021  Link

RCRC Timelines

The regional center shall submit an initial report to the Department of any special incident, as defined in Welfare and Institutions Code Section 54327(b) within two working days following receipt of the report pursuant to Welfare and Institutions Code Section 54327(b).

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