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When a complaint is received in writing by the Designee, CCPO, or MOA licensing office a Complaint Intake Form is completed based on the information in the written report.

The following steps are to be followed by the Designee, CCPO or MOA licensing office: 1. Immediately Notify Supervisor Designee, CCPO, or MOA licensing office receiving the complaint will identify the Priority Level according to section 4310-2 Assigning a Complaint Priority Level and immediately notify their supervisor by email using subject heading: Complaint Received (name of provider). The body of the email will include the name of the provider, nature of the complaint, name of the complainant, if known, concerns reported and priority level and that the written intake form will follow.

If the complaint is a Priority Level 1 Staff are to notify their supervisor in person. If their supervisor is not available they will notify a member of the CCPO management team. Designee Staff will notify the CCPO Eligibility and Benefits Team PAA II or PC II when their supervisor is not available.

2. Document the Complaint Received The same or next day from receipt of the complaint, the Complaint Intake Form is to be completed by the staff who took the complaint and forwarded to their supervisor with all original notes for review, feedback, and guidance. If the complaint is alleging abuse, neglect, or mental injury the Designee, CCPO, or MOA licensing office will also forward the Complaint Intake Form to OCS andlocal police.

3. Review and Approve Complaint Intake Form The same or next day of the supervisor receiving the completed Complaint Intake Form, the Designee, CCPO, or MOA licensing staff and their supervisor meet to discuss any concerns or questions the supervisor may have regarding the Complaint Intake Form and confirm the priority level of the complaint. The supervisor will thoroughly review the intake for content, formatting, and grammar.

The Complaint Intake Form is returned to the Designee, CCPO, or MOA licensing Staff if corrections are needed or otherwise revised as applicable until it is deemed ready by the supervisor.