International Development Fund: grant awards and management stages

Safeguarding incident reporting form

(please note that you may subsequently be required by the Scottish Government to provide additional information)

Safeguarding incidents should be reported to Scottish Government within 48 hours of the reporting organisation becoming aware at SafeguardingReportODA@gov.scot

1.1    SG project reference number:

1.2    Name of organisation reporting incident and details of named programme safeguarding lead:

1.2.1    Name of organisation dealing with incident (if different to response at 1.2 above) and details of named programme safeguarding lead:

1.3    Project/programme title:

1.4    Date of report: 

1.5    Type of incident – e.g. sexual or physical: exploitation, abuse and/or harassment

1.6    Summary of incident(s) - nature (and severity) of the incident - brief and factual (include details of impact on the victim/survivor and impact on the programme):

1.7    Where did the incident(s) take place?:

1.8    When did the incident(s) take place?:

1.9    When did you first become aware of the incident, and/or were notified of it?:

1.10    Was the survivor/victim involved in the project? (If yes were they (1) staff (2) partner staff (3) community member.) Include details of what support (if any) has been offered to the victim/survivor. Describe any vulnerabilities (disability, communication needs, lack of support) that the victim/survivor may have. Are they able to communicate their needs?

1.11    Was the alleged perpetrator involved in the project? (If yes were they (1) staff (2) partner staff (3) community member.) What action (if any) has been taken in relation to the alleged perpetrator?

1.12    Were any of the person(s) involved (victim and/or alleged perpetrator) in the incident a child (person under the age of 18 years?)

1.13    Action taken to date by you (please include timelines):

1.14    Please include details of any media releases or external communications circulated in relation to the incident.

1.15    Please outline any referral agencies involved to date (if applicable), e.g. regulatory authorities, police etc. If referral agencies have not been contacted please explain why.

1.16    Did the organisation have policies in place to deal with the incident and were these policies followed?

1.17    Have there been any learning outcomes arising from the incident and have they been actioned?