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CMS-07-021/023 - Los Angeles County Department of Children and ...

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1. BEHAVIOR INCIDENTS<br />

3<br />

EXHIBIT A-VIII<br />

(Any incidents that threaten the physical health, emotional health, or continued<br />

safety <strong>of</strong> any child, e.g. substance abuse, physical violence, physical restraints,<br />

seclusion, suicide attempts, sexually related incidents, school incidents, police<br />

contacts, <strong>and</strong> disruptive behavior by parents or other visitor)<br />

“OHCMDM” in the tables below means the <strong>Los</strong> <strong>Angeles</strong> <strong>County</strong> DCFS Out-<strong>of</strong>-<br />

Home Management Division Monitor.<br />

“DMH” in the tables below means the <strong>Los</strong> <strong>Angeles</strong> <strong>County</strong> DCFS <strong>Department</strong> <strong>of</strong><br />

Mental Health.<br />

HOW TO WHOM WHEN<br />

Fax only if I- Phone admitting parent(s)/conservator Immediately or the next workday<br />

Track is down (DMH children only)<br />

except for DMH <strong>County</strong> Placement Worker (DCFS) Immediately or the next workday<br />

children.<br />

OHCMDM/Probation Monitors Immediately or the next workday<br />

Community Care Licensing (CCL) Immediately or the next workday<br />

Written File copy in clinical file (DMH children only) Immediately or the next workday<br />

2. OTHER SIGNIFICANT INCIDENTS (Child not enrolled in school; child not regularly<br />

attending school)<br />

HOW TO WHOM WHEN<br />

Telephone <strong>County</strong> Placement Worker Within 3 school days<br />

3. ILLNESS (E.g. common cold or flu that may or may not require medical treatment by<br />

physician)<br />

HOW TO WHOM WHEN<br />

Telephone Admitting Parent(s)/Conservator (DMH Immediately or the next workday<br />

Written<br />

children only)<br />

Parent/Guardian Within 7 calendar days<br />

Copy in clinical file (DMH children only) Within 7 calendar days<br />

4. INJURY OR ACCIDENT (Includes, but is not limited to, incidents requiring treatment<br />

by a medical physician. If in doubt, report to or call the required agency for<br />

clarification.)<br />

HOW TO WHOM WHEN<br />

Fax only if I- Phone admitting parent(s)/conservator Immediately or the next workday<br />

Track is down (DMH children only)<br />

except for DMH OHCMDM/Probation Monitors Immediately or the next workday<br />

children. Community Care Licensing Immediately or the next workday<br />

Written<br />

Copy in clinical file (DMH children only) Within 7 calendar days<br />

Send copy to parent/guardian Within 7 calendar days

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