---
title: Childcare Center Near Miss Report Form Template | Paperform
description: Document near misses, close calls, and safety hazards at your childcare center. Track playground incidents, choking hazards, and supervision gaps to maintain licensing compliance and prevent injuries.
url: "https://paperform.co/templates/childcare-center-near-miss-report"
type: static
generatedAt: "2026-03-28T00:43:17.891Z"
---

[← Back to free form templates](/templates/)    ![Childcare Center Near Miss Report](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/childcare-center-near-miss-report.png)
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A near miss report is one of the most valuable tools a childcare center can use to prevent serious injuries before they happen. This **Childcare Center Near Miss Report** template helps daycare centers, preschools, and early learning facilities document close calls, potential hazards, and safety concerns in a structured, licensing-compliant way.

Whether it's a child who nearly accessed a choking hazard, a supervision gap on the playground, or a trip hazard that was caught just in time, reporting near misses allows your team to identify patterns, improve protocols, and create a safer environment for every child in your care.

### Why near miss reporting matters in childcare

Childcare licensing agencies across most jurisdictions expect centers to maintain detailed incident and near miss documentation. Beyond compliance, tracking near misses helps you spot systemic issues—like a gate that's frequently left unlocked, a toy that's breaking down, or a transition time when supervision ratios slip.

This template is designed specifically for the childcare environment, with fields for playground supervision details, choking hazard identification, child information, staff involved, corrective actions taken, and follow-up plans. It's perfect for daycare directors, educators, and safety coordinators who want to stay ahead of risks and meet licensing standards with confidence.

### Automate follow-up and reporting workflows

Once a near miss is submitted, you can use **Stepper** to automate what happens next. Route serious incidents to your director or safety officer immediately, log every report in a central Airtable or Google Sheet for quarterly review, send a summary email to the staff member involved, or trigger a safety checklist for the area where the near miss occurred.

You can also connect submissions to your existing childcare management software, notify your licensing coordinator, or create tasks in tools like Asana or Monday to ensure corrective actions are completed on time. With Paperform's conditional logic, you can tailor confirmation messages and workflows based on the type of near miss reported—ensuring the right people are notified and the right actions are taken, every time.

### A safer center starts with better reporting

This template is trusted by childcare centers that prioritize proactive safety, transparent communication with families, and continuous improvement. It's mobile-friendly, so staff can submit reports right from the playground or classroom, and it's fully customizable to match your center's branding, policies, and reporting requirements.

Start using the Childcare Center Near Miss Report template today and build a culture of safety that protects children, supports staff, and keeps your center in full compliance.
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