Unexplained Absence Report
When to use this formUse this form to report an unexplained absence of acare recipient from a residential aged care serviceas required under the Aged Care Act 1997 (the Act) (63-1 (1)(m)) and section 25 of the Accountability Principles 2014.
Note:Information provided in this form is not a substitute for independent legal advice.
What is an unexplainedSection 25 of the Accountability Principles 2014 defines an unexplained
absence?absenceas:
- a care recipient is absent from a residential care service;and
- the absence is unexplained; and
- the absence has been reported to the police.
Why do I have to reportUnder the Act, it is an approved provider’s responsibility to ensure care
unexplained absences torecipients live in a safe environment. Approved providers should report
the police and department?a missing care recipient to the police within a reasonable timeframe so that those care recipients affected receive timely help and support.
If an approved provider fails to report an unexplained absence to the department, the department may take compliance action.
When to reportWhen an approved provider reports an unexplained absence to the police,
unexplained absences toareport must be made to the department no later than 24 hoursafter
thepolice and department?the care recipient’s absence was reported to the police.
If the care recipient was returned to the service before the absence could be reported to the police, there is no requirement to tell the department about the absence.
However, if the care recipient was returned by the police, then the department must still be notified of the unexplained absence.
Reporting an unexplained absence to the department aims to ensure that the approved provider has put in place operational and organisational strategies to prevent the situation from occurring again.
For more informationGo to the Guide for reporting unexplained absences on
How to complete andThis form can be completed electronically or by hand.
return this form
- Please use black or blue pen and use BLOCK LETTERS.
- Mark boxes like this ☐with a 'x'
Check that you have answered all the questions in this form and send the completed form to:
Notice of Collection Australian Government agencies must comply with the Australian Privacy Principles (APPs) set out in the Privacy Act 1988 (the Privacy Act). The APPs cover the collection, storage, quality, use and disclosure of personal information about individuals. In this notice ‘personal information’ has the same meaning as in the Privacy Act.
You must read the Notice of Collectionbeforecompleting this form.
The purpose of the Notice of Collection is to inform you that personal information about you is being, or has been, collected by the department under the Aged Care Act and Aged Care Principles.
☐I have read and understood the Notice of Collection
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Unexplained Absence Report
This form is to be used to report an unexplained absence of a care recipient as required under s25 of the Accountability Principles 2014
Your contact details
- Mr ☐Mrs ☐Miss ☐Ms ☐
OtherClick to enter details.
- Surname
Click to enter surname.
- Given name
Click to enter given name.
- Position/role(e.g. CEO, key personnel, registered nurse, etc.)
- Work number(include area code)
Click to enter work number.
- Mobile number
Click to enter mobile number.
- Email address
Click to enter email address.
Note: A departmental officer may contact you to seek further information in relation to this report.
Approved provider and service details
- Name of the aged care service this report relates to:
- RACS ID: Click to enter text.
- Name of the approved provider this report relates to:
Unexplained Absence details
- Has the unexplained absence of the care recipient been reported to the police?
Yes☐provide details below
No☐go to question 12
Date reported to police Click to enter a date.
Time reported to policeUse 24hr time.
Police station reported to (if applicable)
Click to enter name of police station.
Incident number
Click to enter incident number.
- Has the care recipient returned to the service?
Yes☐ provide details below
No☐report unexplained absence to police
Date returnedClick to enter a date.
TimereturnedUse 24hr time.
NOTE: There is also no requirement to report to the department if the care recipientwas returned to the service before their absence was reported to the police.
However, you must report to the department if the police are aware of the care recipient’s absence because it was reported to the police or the care recipient was returned by the police.
- In relation to the circumstances resulting in the unexplained absence of this care recipient, what action has been takento manage or minimise the risk of the unexplained absence occurring again?
Click to enter details.
- If the care recipient is still missing from the service, what action is being taken to locate the care recipient?
- Statement
I declare thatthe information I have provided in this form is complete and correct.
YourName
Click to enter your name.
DateClick to enter a date.
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