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DACYP Form for Reporting Safeguarding Incident
For use by Team member who initially reports the concern/incident
TIME AND DATE OF INCIDENT
CHILD’S NAME
SUMMARY OF INCIDENT/CONCERN:
Include context of disclosure or concern; what was said (using the words, as far as possible, used by the child); where; when; who was present; who else is aware of the disclosure/concern.
Signed: ……………………………………………………. Date ………………………….
Thank you for recording this incident/concern and for the part you have played in endeavouring to keep children safe. Please seek support from our Safeguarding Coordinator.
Dunbar Area Christian Youth Project Scottish Charity Number SC036138
November 2023