Information to Collect From Complainant

5010.1 - Information to Collect From Complainant (Rev. 18, Issued: 03-17-06; Effective/Implementation Dates: 03-17-06) The SA collects information necessary to make important decisions about the allegations. In instances where written or verbal allegations are received, subsequent communication may be necessary to obtain additional information. Comprehensive information should be collected during the intake process to allow for proper prioritization, including the following: • Information about the complainant (e.g., name, address, telephone, etc.); • Individuals involved and affected; • Narrative/specifics of the complainant’s concerns including the date, and time of the allegation; • The complainant’s views about the frequency and pervasiveness of the allegation; • Name of the provider/supplier including location (e.g., unit, room, floor) of the allegation, if applicable; • How/why the complainant believes the alleged event occurred; • Whether the complainant initiated other courses of action, such as reporting to other agencies, discussing issues with the provider, and obtaining a response/resolution; and • The complainant’s expectation/desire for resolution/remedy, if appropriate.