The DD-191-FF form, issued by the Arizona Department of Economic Security's Division of Developmental Disabilities, serves as a comprehensive incident report designed to capture all relevant details about occurrences involving individuals in care. It is a crucial document for both division staff and providers, ensuring accurate and complete recording of any incidents. This form requires the reporter to include information about the individual involved, such as their name, birthdate, and address, in addition to detailed accounts of the incident, including what happened before, during, and what could have potentially prevented the incident. The second page of the form focuses on the aftermath, documenting the type of medical intervention received, locations, and notifications to relevant parties including parents or guardians, support coordinators, and even law enforcement if necessary. Completion of this form is essential not just for immediate response and corrective actions but also for policy development and preventive measures. It's a tool to ensure transparency, accountability, and a commitment to the safety and well-being of those under the care of the Division of Developmental Disabilities, while also adhering to various legal and civil rights protections such as the Americans with Disabilities Act and the Civil Rights Act.
| Question | Answer |
|---|---|
| Form Name | Form DD 191 FF |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 46 |
| Avg. time to fill out | 10 min |
| Other names | DDD incident reporting AZ, AZ DDD clients incident report format, DD-191-FF |