LDSS-3123. Incident Report FTHA (DARC)(DAS)

Form FTHA (DARC)(DAS) is a New York State Office of Children and Family Services form used for incident reports.

The form consists of several sections that need to be filled out in order to provide information about the incident. These sections include the Incident Report Information Section, the Incident Report Narrative Section, and the Incident Report Closure Section. Additionally, there may be other sections that are present depending on the particular incident being reported.

Important fields in this form include the Date of Incident, the Location of Incident, the Name of Person Making Report, the Name of Person Involved in the Incident, and the Type of Incident. It is important to provide accurate information in these fields, as inaccurate information could lead to delays in the processing of the form or even an inability to process the form at all.

An example situation in which this form would be used would be when a caregiver at a daycare facility notices that a child has a bruise on their arm. In this scenario, the caregiver would need to fill out the FTHA (DARC)(DAS) form in order to provide information about the incident and report it to the Office of Children and Family Services. Specific instructions for completing the form can be found on the form itself and are important to follow in order to ensure that the form is filled out accurately and completely. The benefits of using the form are that it allows for the incident to be reported quickly and accurately, enabling the Office of Children and Family Services to take the appropriate action.

Related forms or alternatives to the FTHA (DARC)(DAS) form include the FTHA (DARC)(CFS) form, which is used to report an incident in a Child Protective Services setting. Additional documents that may need to be filled out in order to complete the FTHA (DARC)(DAS) form include any medical records or other records or documents related to the incident being reported.