Safeguarding Concern Log
Complete one form per concern. Record contemporaneously: as soon as possible after the incident or disclosure. Use the child's own words where relevant. Never investigate or ask leading questions.
PART A: Child Details
| Child's full name | |
|---|---|
| Date of birth | |
| Year group / class | |
| Any SEND / communication needs | |
| Looked after / CIN / CP plan? | |
| Siblings at school (names, year groups) |
PART B: Nature of Concern
| Date and time of concern / disclosure | |
|---|---|
| Where did this occur? | |
| Type of concern (tick all that apply) |
☐ Physical abuse ☐ Emotional abuse ☐ Sexual abuse ☐ Neglect
☐ Peer-on-peer abuse ☐ AI-generated intimate imagery / deepfakes ☐ Online safety ☐ Domestic abuse ☐ CSE / CCE ☐ Radicalisation / Prevent ☐ Missing / unexplained absence ☐ FGM / HBA ☐ Self-harm ☐ Other: _______________ |
|
Description of concern
Where the child made a disclosure, record their exact words in quotation marks. Do not paraphrase, summarise, or tidy up the child's grammar. The child's own words are evidence. |
|
|
Any physical indicators observed?
(describe location and appearance, do not photograph) |
|
| Behaviour / emotional indicators observed | |
| Who else was present? (names and roles, includes anyone present during the incident or during any disclosure) |
PART C: Person Raising the Concern
| Name and job title | |
|---|---|
| Date and time of this record | |
| Did you respond to a disclosure? | ☐ Yes ☐ No. Concern was observed or reported by a third party |
| If yes, what did you say to the child? | |
| What did you do immediately after? (e.g. ended the conversation, reassured the child, went to find DSL), include date and time | |
| Who did you report this to, and at what time? | |
| Child's wishes or views (if expressed) |
PART D: DSL Actions (completed by DSL)
| DSL informed (name, date, time) | |
|---|---|
| DSL decision |
☐ Monitor and review (reason: ______________________________)
☐ Early Help referral ☐ Consult MASH (no formal referral at this stage) ☐ s.17 referral. Child in Need ☐ s.47 referral. Child Protection ☐ NRM referral pathway initiated. Concern referred to police or local authority children's services (the school is not a First Responder and cannot make the NRM referral directly) ☐ LADO referral (concern about staff member) ☐ 999 called |
| Referral made to | |
| Date and time of referral | |
| Name of person spoken to at MASH / agency | |
| Written confirmation sent within 1 working day? | ☐ Yes, date sent: _________ ☐ N/A |
| Parents / carers informed? | ☐ Yes, date: _________ ☐ No, reason: _______________________________ |
| Next review / follow-up date | |
| Further actions / notes |
PART E: Signatures
| Person raising concern | Signature: Date: ___________ |
|---|---|
| DSL | Signature: Date: ___________ |
Storage:
File in the child's secure safeguarding file (not educational file). Retain until the child is 25, or 75 years in cases involving abuse (IRMS guidance). Do not leave on a shared drive.
Statutory references:
KCSIE 2026 (Record-keeping) · Working Together 2026 · Children Act 1989 s.17 and s.47
Free template from The Safeguard Hub (safeguard-hub.org). Customise for your school's context before adoption. This is general information and not legal advice. Where anything here differs from your local safeguarding children partnership procedures, follow your local procedures. Last reviewed July 2026.