DETAILS OF THE SAFEGUARDING INCIDENTDate the incident happened: *Time the incident happened: *Location of Incident: *Alleged victim(s): *Alleged perpetrator(s): *Is the victim under the age of 18? (If so it is mandatory to report the disclosure.) *YesNoIs the victim 18 or above? (Under the Care Act 2014, if an adult is at risk of serious harm, others are at risk, or a crime has been committed, you still have a duty to report, even without the person’s consent.) *YesNoWitnesses: Name of the person who made the safeguarding disclosure: *What Happened: (Write your report with a clear, factual account of what you saw or heard, using the person’s own words where possible and avoiding personal opinions.) *Who the safeguarding issue was disclosed to if different form the person completing this form: REPORTING OF THE INCIDENTDate the incident was reported after the disclosure was made: *Time the incident was reported after the disclosure was made: *Name of the event lead or team leader the disclosure was reported to: *The safeguarding leads at All Saints' Church are: Rev Paul Walker (Designated Safeguarding Lead) - 07825 372527 Jackie Wiggins (Safeguarding Officer) - 07952 807107 You must contact a safeguarding lead without delay if there is an immediate risk of harm. (Eg. the risk is urgent or ongoing.) If someone is in immediate danger, then contact the emergency services by calling 999, and then let the safeguarding lead know.Has a Safeguarding Lead been informed?: *Yes: Paul Walker (Vicar and Designated Safeguarding Lead)Yes: Jackie Wiggins (Parish Safeguarding Officer)Were the emergency services or any other agencies informed or contacted? (Eg. the social services or the diocesan out of hours safeguarding team.) *YesNoIf yes, who was contacted? Date reported: Time reported Were any reference numbers given when you reported and/or the name of the person you spoke with: DETAILS ABOUT THOSE COMPLETING THE REPORTThe name of the person completing this form: *Role (if any): Email Please provide your email address if you are ablePhone Number provide a phone number where you can be reachedDate form completed: *Time form completed: EmailSubmit
