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Message Hope Human Services’ INCIDENT RESPONSE MANUAL For Staff & Managers Date Updated: 5/21/2025 ALWAYS call CRU if you have reason to suspect abuse, neglect, or exploitation. ALWAYS call Police/Emergency Services if you believe your life or personal safety is in danger and/or if the supported individual, guardian, or legal representative requests that you call

Page 2 of 62 Table of Contents Death Unexpected ........................................................................................................... 4 Death Expected ............................................................................................................. 5 Life Threatening Medical Emergency ............................................................................... 6 Non-Life-Threatening Medical Emergency (ER/UC) .......................................................... 7 Natural Disaster ............................................................................................................. 8 Missing Client ................................................................................................................ 9 Types of Abuse, Neglect, and Exploitation ..................................................................... 10 Alleged or Suspected Sexual Abuse/Assault .................................................................. 13 Abuse/Neglect/Exploitation.......................................................................................... 15 Abuse/Neglect/Exploitation with Hospital Admission .................................................... 16 Alleged Abuse/Neglect/Exploitation.............................................................................. 17 Abuse/Neglect/Physical Assault with Injury .................................................................. 18 Injury of Unknown Origin .............................................................................................. 19 Injury of Unknown Origin with Hospital Admission ......................................................... 20 Fire .............................................................................................................................. 21 Car Accident ................................................................................................................ 22 Hospital Admission ...................................................................................................... 24 Police Response to House or Client .............................................................................. 25 Client Arrested ............................................................................................................. 26 Client Detained for Mental Health Eval ......................................................................... 27 Client to Client Abuse with Injury .................................................................................. 28 Client to Client Abuse without Injury ............................................................................. 29 Suicide or Attempt Requiring Medical/Psych Attention .................................................. 30 Choking Requiring Physical Intervention ....................................................................... 31 Moderate to Severe Client Injury (Beyond First Aid) ........................................................ 32

Page 3 of 62 Moderate to Severe Property Damage ($1,000+ in Damage) ........................................... 34 Alleged Criminal Activity Against Client ......................................................................... 35 Serious Treatment Violations ........................................................................................ 36 Med/Nurse Delegation Error that Causes Injury or Harm or is a Pattern (Same Client or Same Sta) .................................................................................................................. 37 Immediate Concern from Parent/Family/Guardian ........................................................ 38 Client or Legal Rep Contemplating Permanent Sterilization Procedures ......................... 39 Missing Money ($) or Property (Client or Company) ........................................................ 40 New Challenging Behavior ............................................................................................ 41 Minor Client Injury (First Aid or No Treatment) ............................................................... 42 Employee Injury (Fill out Employee Injury Form) ............................................................ 43 Company/Sta Vehicle Damage on Shift ....................................................................... 44 Known Media Interest or Litigation ................................................................................ 46 Minor Property Damage (less than $1,000) .................................................................... 47 Service Impacting Conict w/ Sta/Co-Worker ............................................................. 48 Employee Misconduct (Leaving Early, Arriving Late, Not Punching In/Out) ...................... 49 Drug Testing ................................................................................................................. 50 Extreme Weather Response ......................................................................................... 52 Investigation Process ................................................................................................... 53 Positive Respiratory Virus/COVID Procedures ............................................................... 55 CRU Notication/Posting ............................................................................................. 57 Addendum/Notes ........................................................................................................ 62

Page 4 of 62 Death Unexpected Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU – Somemes a. If there are any signs of Abuse, Neglect, or Exploitaon 3. Nofy Police 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU – Somemes a. If there are any signs of Abuse, Neglect, or Exploitaon and sta have not already called, or if new informaon was found 5. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days Related Documents: 1. DDA Mortality Review Provider Report 10-331

Page 5 of 62 Death Expected Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Police – Somemes a. 3. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Email DDA Case Resource Manager within 1 Business Day 5. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days Related Documents: 2. DDA Mortality Review Provider Report 10-331

Page 6 of 62 Life Threatening Medical Emergency Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy DDA Resource Manager (RM) 5. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 7 of 62 Non-Life-Threatening Medical Emergency (ER/UC) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Email DDA Case Resource Manager within 1 Business Day – Somemes a. 5. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a.

Page 8 of 62 Natural Disaster Descripon: A natural disaster can include snowstorms, earthquakes, oods, volcanic erupons, tornados, power outages, etc. On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call 3. Nofy HR 4. Nofy Maintenance/Designee Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Guardian or Legal Representave 3. Nofy Other - HR 4. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 7. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. Extreme Weather Response

Page 9 of 62 Missing Client Descripon: A client is considered missing if they are 1. A Support Level 4 or higher (i.e. most clients with 24/7 stang) and have not been located/contacted in 2 hours, unless a dierent meframe is listed in their PCSP 2. A Support Level 1-3 (i.e. most clients without 24/7 stang) and the client is out of contact with sta for more me than is expected based on their typical roune, or if a dierent meframe is listed in their PCSP 3. A rst responder, police ocer, or community member locates the client, and HHS was unaware that the client was gone On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police – Somemes a. If the client was located by someone outside of HHS without HHS aware of missing client 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU

Page 10 of 62 Types of Abuse, Neglect, and Exploitation For more information/examples go to DDA Policy 6.12 Examples (including, but not limited to): • Sexual Abuse o Any sexual contact between sta or volunteer of a facility and a client, whether or not it is consensual o Inappropriate or unwanted sexual touching including but not limited to: Fondling, Intercourse, Oral Sex, Rape, Sodomy o Sexual coercion/Sexual harassment o Sexually explicit photographing, lming, or videotaping o Unsolicited showing, selling, or otherwise distribung pornographic materials. An adult client has the right to purchase or access legal pornography. • Physical Abuse o Bing, Choking, Kicking, Pinching, Pushing, Shaking, Shoving, Prodding, Slapping, Striking or hing with or without an object, Twisng limbs (joint torsion) o Causing or willfully allowing the person to do bodily harm to themselves o Causing or willfully allowing another client to physically harm them, o Retaliaon following a physical aack, verbal abuse or other unwelcome acon by a client • Mental Abuse o Coercion/Harassment o Inappropriately isolang a vulnerable adult from family, friends, or regular acvity o Making derogatory or disparaging remarks about a person and the person’s family in front of the person or within hearing distance of any client • Verbal Abuse o Oral, wrien or gestural language threatening harm or intended to frighten clients o Verbal assault such as ridicule, inmidaon, yelling, or swearing • Neglect o A paern of conduct or inacon by a person or enty with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult o An act or omission by a person or enty with a duty of care that demonstrates a serious disregard of consequences of such a magnitude as to constute a clear

Page 11 of 62 and present danger to the vulnerable adult's health, welfare, or safety, which may include but not limited to: ▪ Abandoning a client in situaons where other persons, objects or the environment may injure the client ▪ Failing to report to DDA or take acon when the physical environment deteriorates to the point that a client is subject to hazardous situaons, such as electrical, water, and structural hazards ▪ Failure to promptly respond to known or idened medical emergencies or requests for medical treatment, Failure to follow prescribed treatments ▪ Failure to respond to, or seek assistance for clients in dangerous situaons ▪ Failure to supervise which leads to a client wandering/missing/running away ▪ Willful failure to protect the client from physical abuse by a client/sta ▪ Willful failure to protect a child from sexual contact with another child • Self-Neglect o Vulnerable adults who neglect themselves are unwilling or unable to do needed self-care. This can include such things as: ▪ Not eang enough food to the point of malnourishment ▪ Living in lthy, unsanitary, or hazardous condions ▪ Refusing urgent medical care/a paern of declining necessary medical care ▪ Refusing to pay for necessary or essenal expenses, such as rent or ulies, resulng in the loss of these services • Personal Exploitaon o An act of forcing, compelling, or exerng undue inuence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior • Financial Exploitaon o Using clients to perform work that should be done by paid employees o Using client nancial resources for personal gain or for acvies not related to client care • Improper Use of Restraint o Using excessive force when restraining an agitated client o Liming a person’s freedom of movement with physical devices such as waist belts, restraining vests, or hand mis o Restricng a person’s free access to the places or things in their environment, such as locking up a room or keeping an item in an inaccessible locaon

Page 12 of 62 • Chemical Restraint o Use of medicaons to moderate behavior ▪ This could look like a sta giving a vulnerable adult a PRN when it is not needed/they are at baseline just to make their shi “easier” DDA Policy 6.12 Attachment C

Page 13 of 62 Alleged or Suspected Sexual Abuse/Assault Descripon: Some examples include • Any sexual contact between sta or volunteer of a facility and a client, whether or not it is consensual • Inappropriate or unwanted sexual touching including but not limited to: Aempted Groping, Groping Fondling, Intercourse, Oral Sex, Rape, Sodomy • Sexual coercion/Sexual harassment On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police a. You must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police a. If sta have not called, you must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 14 of 62 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. DDA Policy 6.12 – Incident Management and Reporng

Page 15 of 62 Abuse/Neglect/Exploitation Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police a. You must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police a. If sta have not called, you must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. DDA Policy 6.12 – Incident Management and Reporng

Page 16 of 62 Abuse/Neglect/Exploitation with Hospital Admission Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police a. You must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police a. If sta have not called, you must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. DDA Policy 6.12 – Incident Management and Reporng

Page 17 of 62 Alleged Abuse/Neglect/Exploitation Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police a. You must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police a. If sta have not called, you must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 8. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. DDA Policy 6.12 – Incident Management and Reporng

Page 18 of 62 Abuse/Neglect/Physical Assault with Injury Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police a. You must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police a. If sta have not called, you must call the police if there is a suspected case of abuse/neglect/exploitaon, even if the Client does not request it 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU Related Documents: 1. DDA Policy 6.12 – Incident Management and Reporng

Page 19 of 62 Injury of Unknown Origin Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Quickly invesgate to see if the injury has a known/explained origin. If it does, you do not need to connue these steps. 2. Complete a GER 3. Nofy CRU 4. Nofy Police – Somemes a. 5. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. If sta have not already, quickly invesgate to see if the injury has a known/explained origin. If it does, you do not need to connue these steps 2. Nofy Regional Director/Assistant Regional Director 3. Nofy Administrator (Cheryl/Designee) 4. Nofy Guardian or Legal Representave 5. Verify and/or Report to CRU 6. Nofy Police – Somemes a. 7. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 8. Email DDA Case Resource Manager within 1 Business Day 9. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 10. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU

Page 20 of 62 Injury of Unknown Origin with Hospital Admission Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police – Somemes a. 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police – Somemes a. 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU

Page 21 of 62 Fire Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave

Page 22 of 62 Car Accident Descripon: • A car accident is an incident where a vehicle collides with another object. This can include other vehicles, pedestrians, animals, staonary objects like trees or buildings, or even other moving objects like cyclists. On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Police 3. Nofy Program Manager/On-Call 4. Nofy Maintenance/Designee Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other - Maintenance Related Documents: • HHS’s Vehicle Accident Reporng Acon Items (see below)

Page 23 of 62

Page 24 of 62 Hospital Admission Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other – Billing/Finance 5. Nofy DDA Resource Manager (RM) 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours – Somemes a. 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU – Somemes a.

Page 25 of 62 Police Response to House or Client Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU – Somemes a. 3. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU – Somemes a. 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 7. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU - Somemes a.

Page 26 of 62 Client Arrested Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other – Billing/Finance 5. Nofy DDA Resource Manager (RM) – Somemes a. 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 27 of 62 Client Detained for Mental Health Eval Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other – Billing/Finance 5. Nofy DDA Resource Manager (RM) – Somemes a. 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 28 of 62 Client to Client Abuse with Injury Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police – Somemes a. If the injury (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buock, genital, or anal areas; is a fracture; is a choking aempt; is a paern; or if it has caused fear of imminent harm 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police – Somemes a. If Police have not already been called b. Contact Police if the injury (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buock, genital, or anal areas; is a fracture; is a choking aempt; is a paern; or if it has caused fear of imminent harm 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 8. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU

Page 29 of 62 Client to Client Abuse without Injury Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU 3. Nofy Police – Somemes a. Contact Police if the injury (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buock, genital, or anal areas; is a fracture; is a choking aempt; is a paern; or if it has caused fear of imminent harm 4. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU 5. Nofy Police – Somemes a. If Police have not already been called b. Contact Police if the injury (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buock, genital, or anal areas; is a fracture; is a choking aempt; is a paern; or if it has caused fear of imminent harm 6. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU

Page 30 of 62 Suicide or Attempt Requiring Medical/Psych Attention Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 31 of 62 Choking Requiring Physical Intervention Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 32 of 62 Moderate to Severe Client Injury (Beyond First Aid) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director – Somemes a. If there is an i. Injury from a restricve procedure ii. Injury from a physical intervenon iii. Injury that requires professional medical aenon iv. Injury of unknown origin when it raises suspicions of possible abuse or neglect due to: 1. Extent of the injury 2. Locaon of the injury (in an area not generally vulnerable to trauma) 3. Presence of mulple injuries 4. Repeated injuries of unknown origin 5. Injury inconsistent with the clients’ condion 6. Paern of behavior 7. Roune injury 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a. If there is an i. Injury from a restricve procedure ii. Injury from a physical intervenon iii. Injury that requires professional medical aenon

Page 33 of 62 iv. Injury of unknown origin when it raises suspicions of possible abuse or neglect due to: 1. Extent of the injury 2. Locaon of the injury (in an area not generally vulnerable to trauma) 3. Presence of mulple injuries 4. Repeated injuries of unknown origin 5. Injury inconsistent with the clients’ condion 6. Paern of behavior 7. Roune injury

Page 34 of 62 Moderate to Severe Property Damage ($1,000+ in Damage) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call 3. Nofy Maintenance/Designee Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other – Billing/Finance 5. Nofy Other - Maintenance 6. Nofy DDA Resource Manager (RM) 7. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee 8. Email DDA Case Resource Manager within 1 Business Day 9. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 35 of 62 Alleged Criminal Activity Against Client Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Police – Somemes a. 5. Nofy DDA Resource Manager (RM) – Somemes a. 6. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours – Somemes a. 7. Email DDA Case Resource Manager within 1 Business Day 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU – Somemes a.

Page 36 of 62 Serious Treatment Violations Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Nofy Other – SOTP (Sex Oender Treatment Provider) 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 7. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU - Somemes a.

Page 37 of 62 Med/Nurse Delegation Error that Causes Injury or Harm or is a Pattern (Same Client or Same Sta) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy CRU – Somemes a. 3. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave 4. Verify and/or Report to CRU – Somemes a. 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days 7. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU - Somemes a.

Page 38 of 62 Immediate Concern from Parent/Family/Guardian Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Police – Somemes a. 4. Nofy DDA Resource Manager (RM) – Somemes a. 5. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours – Somemes a. 6. Email DDA Case Resource Manager within 1 Business Day - Somemes a. 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a. 8. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU - Somemes a.

Page 39 of 62 Client or Legal Rep Contemplating Permanent Sterilization Procedures Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave – Somemes a. 4. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 5. Email DDA Case Resource Manager within 1 Business Day 6. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 40 of 62 Missing Money ($) or Property (Client or Company) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call 3. Nofy Maintenance/Designee Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Guardian or Legal Representave – Somemes a. 4. Nofy Other – Billing/Finance 5. Nofy Police – Somemes a. 6. Nofy DDA Resource Manager (RM) – Somemes a. 7. Email DDA Case Resource Manager within 1 Business Day - Somemes a. 8. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a. 9. Send a GER (Therap Incident Report) to the DDA CRM (no specic meframe) & follow up with CRU - Somemes a.

Page 41 of 62 New Challenging Behavior Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director – Somemes 2. Nofy Other – Clinical

Page 42 of 62 Minor Client Injury (First Aid or No Treatment) ****Contact RD/CRM if there is an injury from a restrictive procedure or physical intervention; requires professional medical attention; or is of unknown origin when it raises suspicions of possible abuse or neglect due to: extent of injury, location (in an area not generally vulnerable to trauma), presence of multiple injuries, repeated injuries of unknown origin, or inconsistent w/ clients condition, pattern of behavior, or routine Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER – Somemes a. 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director – Somemes a. 2. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 3. Email DDA Case Resource Manager within 1 Business Day - Somemes a. 4. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a.

Page 43 of 62 Employee Injury (Fill out Employee Injury Form) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER – Somemes a. 2. Nofy Police – Somemes a. 3. Nofy Program Manager/On-Call 4. Nofy HR Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Other - HR 3. Nofy Police – Somemes a. Related Documents: 1. Online Work Injury Report

Page 44 of 62 Company/Sta Vehicle Damage on Shift Descripon: See the next page for details On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call 3. Nofy Maintenance/Designee Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) 3. Nofy Other - Maintenance

Page 45 of 62

Page 46 of 62 Known Media Interest or Litigation Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Administrator (Cheryl/Designee) – Somemes a. 3. Nofy Guardian or Legal Representave 4. Nofy DDA Resource Manager (RM) 5. Nofy DDA within 1 Hour including the Case Resource Manager (CRM), RM/Designee or Aer Hours 6. Email DDA Case Resource Manager within 1 Business Day 7. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days

Page 47 of 62 Minor Property Damage (less than $1,000) Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Complete a GER 2. Nofy Program Manager/On-Call 3. Nofy Maintenance/Designee – Somemes a. Manager/On-Call Responsibilies: Acons 1. Nofy Other – Billing/Finance 2. Nofy Other – Maintenance 3. Nofy DDA Resource Manager (RM) – Somemes a. 4. Send a GER (Therap Incident Report) to the DDA CRM within 3 Days – Somemes a.

Page 48 of 62 Service Impacting Conict w/ Sta/Co-Worker Descripon: On Duty Sta/Reporter Responsibilies: Acons 1. Nofy Program Manager/On-Call 2. Nofy HR Manager/On-Call Responsibilies: Acons 1. Nofy Other - HR

Page 49 of 62 Employee Misconduct Descripon: • Leaving Early • Arriving Late • Not Punching In/Out • Not Compleng Shi Change, etc. On Duty Sta/Reporter Responsibilies: Acons 1. Nofy Program Manager/On-Call 2. Nofy HR Manager/On-Call Responsibilies: Acons 1. Nofy Regional Director/Assistant Regional Director 2. Nofy Other - HR

Page 50 of 62 Drug Testing Within Business Hours:

Page 51 of 62 Outside of Business Hours: Updated 4/11/2025

Page 52 of 62 Extreme Weather Response Updated 4/11/2025

Page 53 of 62 Investigation Process Updated 5/20/2025

Page 54 of 62 Related Documents: 1. HHS’s Incident Invesgaon Form 2. HHS’s Incident Invesgaon Follow Up Form 3. HHS’s Witness Statement First Page 4. HHS’s Witness Statement Connued

Page 55 of 62 Positive Respiratory Virus/COVID Procedures

Page 56 of 62 Updated 4/11/2025

Page 57 of 62 Contact Information (Option 1) HR • Tacoma – Josie Lobo-Dennill, (253) 831-4675, josiel@hopehumansvcs.com • Vancouver – Emma Risne, 360-207-4020, emmar@hopehumansvcs.com • Spokane – Monica Wolf, (509) 852-5553, monicaw@hopehumansvcs.com Maintenance • Tacoma o Within Business Hours – Bryce Miller, (253) 219-0354, brycem@hopehumansvcs.com o Outside of Business Hours – Darin Borden, (206) 396-0478, darinb@hopehumansvcs.com • Vancouver – Jacob Bilings, (360) 772-9955, jacobb@hopehumansvcs.com • Spokane – Mitch Hartman, (509) 957-8767, mitchh@hopehumansvcs.com Billing/Finance • All Oces – Kody Hernandez, (253) 252-2406, kodyh@hopehumansvcs.com Clinical • Tacoma o If Green Zone or Pilot - Briana Kluza, (253) 831-4865, briannak@hopehumansvcs.com o If NOT Green Zone/Pilot - Debra Ash, (253) 392-2452, debraa@hopehumansvcs.com • Vancouver – Nikki Armstrong, (661) 644-2968, nikkia@hopehumansvcs.com • Spokane – Ken Weed, (509) 816-1025, kenw@hopehumansvcs.com SOTP (Sex Oender Treatment Provider) • All Oces – Varies for each client. Look at their CP Treatment Plan for contact info On-Call Manager • Tacoma (if unsure which group, contact A, then if no response C, and then D) o Group A – (253) 406-6053 o Group C – (253) 961-8463 o Group D (Diversion) – (253) 388-7975

Page 58 of 62 • Vancouver – (360) 324-2533 • Spokane – (509) 270-2126 Regional Director • Tacoma (if unsure which group, contact A, then if no response C, and then D) o Group A – Arden Borden, (253) 579-8979, ardenb@hopehumansvcs.com o Group C – Chrisan Haines, (253) 878-5819, chrisanc@hopehumansvcs.com o Group D (Diversion) - Celeste Turner, (253) 252-6002, celesnet@hopehumansvcs.com • Vancouver – Nikki Armstrong, (661) 644-2968, nikkia@hopehumansvcs.com • Spokane (contact Regional rst, then Assistant Regional if no response) o Regional – Allison Hurt, (509) 998-1434, allisonh@hopehumansvcs.com o Assistant Regional – Mike Cady, (509) 216-3427, mikec@hopehumansvcs.com Administrator/CEO • All Oces – Cheryl Borden, (253) 442-9964, cherylb@hopehumansvcs.com Guardian/Legal Representative • All Oces – Varies for each client. Look at their Guardianship leers or PCSP (Person Centered Service Plan) for contact informaon

Page 59 of 62 Contact Information (Option 2) Tacoma/Lakewood 1. HR – Josie Lobo-Dennill, (253) 831-4675, josiel@hopehumansvcs.com 2. Maintenance o Within Business Hours – Bryce Miller, (253) 219-0354, brycem@hopehumansvcs.com o Outside of Business Hours – Darin Borden, (206) 396-0478, darinb@hopehumansvcs.com 3. Billing/Finance – Kody Hernandez, (253) 252-2406, kodyh@hopehumansvcs.com 4. Clinical o If Green Zone or Pilot – Briana Kluza, (253) 831-4865, briannak@hopehumansvcs.com o If NOT Green Zone or Pilot - Debra Ash, (253) 392-2452, debraa@hopehumansvcs.com 5. SOTP – Varies for each client. Look at their CP Treatment Plan for contact informaon 6. On-Call Manager o Group A – (253) 406-6053 o Group C – (253) 961-8463 o Group D (Diversion) – (253) 388-7975 7. Regional Directors - (if unsure which group, contact A, then if no response C, and then D) o Group A – Arden Borden, (253) 579-8979, ardenb@hopehumansvcs.com o Group C – Chrisan Haines, (253) 878-5819, chrisanc@hopehumansvcs.com o Group D (Diversion) - Celeste Turner, (253) 252-6002, celesnet@hopehumansvcs.com 8. Administrator – Cheryl Borden, (253) 442-9964, cherylb@hopehumansvcs.com Vancouver 1. HR – Emma Risne, 360-207-4020, emmar@hopehumansvcs.com 2. Maintenance – Jacob Bilings, (360) 772-9955, jacobb@hopehumansvcs.com 3. Billing/Finance – Kody Hernandez, (253) 252-2406, kodyh@hopehumansvcs.com 4. Clinical – Nikki Armstrong, (661) 644-2968, nikkia@hopehumansvcs.com 5. SOTP – Varies for each client. Look at their CP Treatment Plan for contact informaon 6. On-Call Manager – (360) 324-2533 7. Regional Director – Nikki Armstrong, (661) 644-2968, nikkia@hopehumansvcs.com 8. Administrator – Cheryl Borden, (253) 442-9964, cherylb@hopehumansvcs.com

Page 60 of 62 Spokane 1. HR – Monica Wolf, (509) 852-5553, monicaw@hopehumansvcs.com 2. Maintenance – Mitch Hartman, (509) 957-8767, mitchh@hopehumansvcs.com 3. Billing/Finance – Kody Hernandez, (253) 252-2406, kodyh@hopehumansvcs.com 4. Clinical – Ken Weed, (509) 816-1025, kenw@hopehumansvcs.com 5. SOTP – Varies for each client. Look at their CP Treatment Plan for contact informaon 6. On-Call Manager – (509) 270-2126 7. Regional Director/Assistant Regional (contact Regional rst, then Assistant Regional) o Regional – Allison Hurt, (509) 998-1434, allisonh@hopehumansvcs.com o Assistant Regional – Mike Cady, (509) 216-3427, mikec@hopehumansvcs.com 8. Administrator – Cheryl Borden, (253) 442-9964, cherylb@hopehumansvcs.com

Page 61 of 62 CRU Notication/Posting Scan with Your Phone Click Here or Call 1-800-562-6078 To Report to CRU Once you log on it will ask for HHS Cercaon Number and City. Use the informaon below to complete your report Locaon Tacoma/Lakewood Vancouver Spokane Cercaon Number 2011160 2011174 2011209 City Lakewood Vancouver Spokane On-Call Manager Group A: (253) 406-6053 Group C: (253) 961-8463 (360) 324-2533 509-270-2126 For a crime, physical or sexual abuse, or a life-threatening situaon: call 911. Try to write down or save the conrmaon number Other Emergency Phone Numbers Emergency Services 911 Poison Control 1-800-222-1222 WARM Crisis Line 1-877-500-9276 Mental Health Crisis 988 Non-Emergency Police (253) 287-4455 On Call Pharmacy 253-722-6099

Page 62 of 62 Addendum/Notes • CRU Posng? • Incident Reporng for Sta Quick Guide • Incident Reporng to Managers Quick Guide • Change Client to Individual? • Add “Related/Applicable” Forms? ALWAYS call CRU if you have reason to suspect abuse, neglect, or exploitation. ALWAYS call Police/Emergency Services if you believe your life or personal safety is in danger and/or if client, guardian, or legal representative requests that you call Details (Old Co Manual Layout) Who Scope Who/ What/ How Procedure When / How Often Documentation Oversight Applicable Forms Applicable Regulations Exceptions

Date Updated: 5/21/2025 Incident Reporting Guidelines for Staff 
R = Required S = Sometimes (Depending on Severity or Situation) 
Incidents:  GER NotifyCRU NotifyPolice NotifyProgramManager/ On-Call* NotifyHR NotifyMaintenance/ Designee  
 
   Death Unexpected RSRR

Death Expected R
SR

Life Threatening Medical Emergency R

R

Non-Life-Threatening Medical Emergency (ER/UC) R

R

Natural Disaster R

RRRMissing Client** RRRR

Alleged or Suspected Sexual Abuse/Assault RRR+R

Abuse/Neglect/Exploitation RRR+R

Abuse/Neglect/Exploitation with HospitalAdmission R  RR+R    Alleged Abuse/Neglect/Exploitation RRR+R

Abuse/Neglect/Physical Assault with Injury RRR+R

Injury of Unknown Origin  RRSR

Injury of Unknown Origin with Hospital Admission RRSR

Fire R

R
RCar Accident R
RR
RHospital Admission R

R

Police Response to House or Client RS
R

Client Arrested R

R

Client Detained for Mental Health Eval R

R

Client to Client Abuse with Injury RRS***R

Client to Client Abuse without Injury RRS***R

Suicide Gestures or Attempts R

R

Choking Requiring Physical Intervention R

R

Moderate to Severe Client Injury (Beyond First Aid) R

R

Moderate to Severe Property Damage  ($1,000+ in Damage) R  
R    RAlleged Criminal Activity Against Client R

R

Serious Treatment Violations R

R

Med/Nurse Delegation Error that Causes Injury or Harm or is a Pattern (Same Client or Same Staff) R  S
R    Immediate Concern from Parent/Family/Guardian 


R

Client or Legal Rep Contemplating PermanentSterilization Procedures R  
R    Missing $ or Property (Client or Company) R

R
RNew Challenging Behavior R

R

Minor Client Injury (First Aid or No Treatment) S

R

Employee Injury (Fill Out Employee Injury Form) S
SRR
Company/Staff Vehicle Damage on Shift R

R
RKnown Media Interest or Litigation R

R

Minor Property Damage (less than $1,000) R

R
SService Impacting Conflict w/ Staff/Co-Worker 


RR
Employee Misconduct  (Leaving Early, Arriving Late, Not Punching In/Out)  
R  R  +You must call the police if there is a suspected case of abuse/neglect/exploitation, even if the Client does not request it * IF UNABLE TO REACH PROGRAM MANAGER OR ON-CALL, NOTIFY REGIONAL DIRECTOR. IF UNABLE TO NOTIFYREGIONAL DIRECTOR, NOTIFY THE ADMINISTRATOR. ** Missing Client = Level 4+ after 2 hours, Level 1-3 outside of normal routine, as defined in PCSP, or located by someone outside of HHS without HHS aware of missing client ***Contact Police if the injury (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buttock, genital, or anal areas; is a fracture; is a choking attempt; is a pattern; or if it has caused fear of imminent harm ALWAYS call CRU if you have reason to suspect abuse, neglect, or exploitation. ALWAYS call Police/Emergency Services if you believe your life or personal safety is in danger and/or if client, guardian, or legal representativerequests that you call 

Date Updated: 5/21/2025 Incident Reporting Quick Guide for Managers R = Required S = Sometimes (Depending on Severity, Situation or if Not Notified by Staff) Manager/Admin Notification Manager Follow Up Incidents: Notify Regional Director (RD) Notify Ad min Notify Guardian or Legal Rep Other Verify and/or Report to CRU Notify Police Notify Resource Manager (RM) Notify DDA Within 1 Hour (CRM, Regional Designee, or After Hours) Email to CRM within 1 business day* IR/ GER to CRM in 3 days IR/ GER & Follow Up to CRU Death Unexpected R R R S R R R Death Expected R R R R R Life Threatening Medical Emergency R R R R R R Non-Life-Threatening Medical Emergency (ER/UC) R R R S S Natural Disaster R R HR R R R R Missing Client** R R R R S R R R R Alleged or Suspected Sexual Abuse/Assault R R R R R+ R R R R Abuse/Neglect/Exploitation R R R R R+ R R R Abuse/Neglect/Exploitation with Hospital Admission R R R R R+ R R R R Alleged Abuse/Neglect/Exploitation R R R R R+ R R R Abuse/Neglect/Physical Assault with Injury R R R R R+ R R R R Injury of Unknown Origin R R R R S S**** R R Injury of Unknown Origin with Hospital Admission R R R R S R R R R Fire R R R Car Accident R R R Maint. Hospital Admission R R R Billing R S R R S Police Response to House or Client R R R S R R S Client Arrested R R R Billing R R R R Client Detained for Mental Health Eval R R R Billing S R R Client to Client Abuse with Injury R R R R S*** R R R Client to Client Abuse without Injury R R R R S*** R Suicide or Attempt Req. Medical/Psych Attention R R R R R R Choking Requiring Physical Intervention R R R R R R Moderate to Severe Client Injury (Beyond First Aid) R R R S**** S**** Moderate to Severe Property Damage ($1,000+ in Damage) R R R Billing Maint. R R R Alleged Criminal Activity Against Client R R R S S S R R S Serious Treatment Violations R R R SOTP R R S Med/Nurse Delegation Error that Causes Injury or Harm or is a Pattern (Same Client or Same Staff) R R R S R R S Immediate Concern from Parent/Family/Guardian R R S S S S S S Client or Legal Rep Contemplating Permanent Sterilization Procedures R R S R R Missing $ or Property (Client or Company) R R S Billing S S S S S New Challenging Behavior S Clinical Minor Client Injury (First Aid or No Treatment) S**** S**** S**** Employee Injury (Fill out Employee Injury Form) R HR S Company/Staff Vehicle Damage on Shift R R Maint. Known Media Interest or Litigation R S R R, RA R R Minor Property Damage (less than $1,000) Billing Maint. S S Service Impacting Conflict w/ Staff/Co-Worker HR Employee Misconduct (Leaving Early, Arriving Late, Not Punching In/Out) R HR +You must call the police if there is a suspected case of abuse/neglect/exploitation, even if the Client does not request it *Written notification to Case Manager (CRM) is based on the provider’s immediate knowledge and must include: • Who was involved in the incident; • Where the incident occurred; • The time and date of the incident; • A description of the incident; and • Initial actions taken to keep the client safe. ** Missing Client = Level 4+ within 2 hours, Level 1-3 outside of normal routine, as defined in PCSP, or located by someone outside of HHS without HHS aware of missing client ***Contact Police & CRM if the injury from client to client abuse (bruising, scratches, etc.) appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buttock, genital, or anal areas; is a fracture; is a choking attempt; is a pattern; or if it has caused fear of imminent harm ****Contact RD/CRM if there is an injury from a restrictive procedure or physical intervention; requires professional medical attention; or is of unknown origin when it raises suspicions of possible abuse or neglect due to: extent of injury, location (in an area not generally vulnerable to trauma), presence of multiple injuries, repeated injuries of unknown origin, or inconsistent w/ clients condition, pattern of behavior, or routine ALWAYS call CRU if you have reason to suspect abuse, neglect, or exploitation. ALWAYS call Police/Emergency Services if you believe your life or personal safety is in danger and/or if client, guardian, or legal representative requests that you call Relevant Links: DDA Policy 6.12 WAC 388-101-4150 WAC 388-101-4160 RCW 74.34