ࡱ> <>9:;#` $bjbj 8(m @@@T\\\\p,T0$h,` E@ Nggg@8@ggg(@g @E0\Lg<d0g]g@g@g   ^TTT8$TTT8TTT Department of Education Child care unit  INCLUDEPICTURE "http://www.communications.tas.gov.au/resources/tasgov_vert(m).jpg" \* MERGEFORMATINET  LODGING A COMPLAINT ABOUT A CHILD CARE SERVICE IN TASMANIA (for completion by person/s making complaint) The Child Care Unit (part of the Early Years branch of the Department of Education), holds the legislative responsibility under the Child Care Act 2001 to investigate child care services upon receipt of an allegation that there is a contravention of the Act, regulations, Standards or a condition of licence. If you believe that the service may be in contravention of the Child Care Act 2001, regulations, Standards or a condition of licence, please complete this form and return it to: Director, Early Years Department of Education GPO Box 169 HOBART TAS 7001 Name of child care service: Address: Suburb: Postcode: ___________________ What is your relationship with the service? eg, parent, staff member, visitor Date/s of alleged incident/s: Details of the allegation, nature of concerns: (Please include as much information as possible, eg when did it occur, what time of day, is it ongoing or once off, names of staff/other personnel involved, witnesses, how you know of the situation (seen/heard in person or second hand knowledge), ages/sex of children, location of incident, etc.) What attempts have been made to remedy the situation to date? (Have you spoken to staff, the Director/Person in charge, management of the service, others? What was the response?) What has been your overall general impression of the service? (Is this an unusual occurrence? Are other aspects of the service satisfactory?) If investigations require legal action, are you prepared to sign an % Yes % No affidavit or be available as a witness? Please provide any other information you believe is relevant For contact purposes, please provide your name and contact details. Name: Postal Address: Phone Number: Signature: Date: It is our responsibility to ensure that you realise that, although your name and personal details will not be released to the child care service, there is the potential that the service may guess your identity through the nature of the complaint. Please complete the attached acknowledgement proforma which states that you are prepared for your complaint to be investigated with the service even though there is the potential for your identity to become known. 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