Page 562

535

4. Forward Complaint Intake Form toCertifying/Approving Authority Once the Complaint Intake Form is deemed ready, the Designee, CCPO, or MOA licensing will forward the Complaint Intake Form by fax to the US Department of Defense or US Coast Guard Certified; Tribally Approved or Tribally Certified; or Nationally Accredited or Nationally Certified Day Camp or similar facility or program’s certifying, accrediting, or approving agency. A fax cover page with the subject line: “Complaint Received regarding a (Provider type) provider” is to be sent including the contact name and number of the sender in case there are additional questions and a request for a report back after an investigation or review has been completed.

Upon confirmation all documents were received and legible the documents are shredded.

5. Enter a Case Note The same day the Complaint Intake Form is forwarded a case note is entered, by the individual who completed the complaint intake form, in the provider’s ICCIS case using subject heading: Complaint Received (Date MM-DD-YYYY) and the body of the case note is to include: Complaint Received – forwarded to (Name of Certifying/Accrediting/Approving agency). No other information regarding the complaint is documented in ICCIS at this time.

4340-1 C. RECEIVING A COMPLAINT REGARDING AN APPROVED RELATIVE OR IN-HOME PROVIDER

The staff person receiving the health and safety complaint via telephone is to connect the complainant to the applicable Designee. If one of these individuals is not readily available, the call is to be transferred to the CCPO PAA II or CCPO main telephone number for an available CCPO Management Team member to take the call.

When a complaint is being made in person, the Designee will document the information pertaining to the health and/or safety issue in the Complaint Intake Form, using the questions on the left side of the form as a guide in obtaining the most information possible. All original notes taken and received, during the intake process including information handwritten or received via email and then transferred on the Complaint Intake Form must be retained.