Safeguarding Concern Log Template

[School Name]

Safeguarding Concern Log

STRICTLY CONFIDENTIAL — NOT PART OF PUPIL FILE

Important: This record must be passed to the Designated Safeguarding Lead immediately. Do not investigate the concern yourself. Record facts only — include the child's exact words where a disclosure has been made. Do not promise confidentiality to the child.

Section 1 — Child Details

Child's full name

Date of birth

Year group / class

Home address

Parent/carer name(s)

Parent/carer contact number

Is this child subject to a Child Protection Plan? ☐ Yes ☐ No ☐ Unknown

Section 3 — Factual Account

Describe what was seen, heard, or reported. Include child's exact words if a disclosure was made. Use factual, non-interpretive language.

Description of any physical signs observed (location on body, colour, size, shape)

Witnesses (names and roles)

Section 4 — Immediate Action Taken

What immediate steps were taken? (e.g. child made safe, parents not informed as disclosure relates to family member, medical attention sought)

Was the child's parent/carer informed? ☐ Yes ☐ No

If no, reason

Section 5 — Staff Recording Details

Name of staff member completing this form

Role

Date and time passed to DSL

Staff member signature

Date: _______________

Received by DSL (signature)

Date: _______________

Section 6 — DSL Action (to be completed by DSL)

Decision / action taken by DSL

Referred to Children's Social Care Referred to police (999 / 101) LADO referral (allegation against staff) CEOP report Monitor and review No further action at this stage

If referred: Agency name, contact name, telephone number, and reference number

Rationale / additional notes

DSL signature

Date: _______________

Review date (if monitoring)

Template provided by The Safeguard Hub (safeguard-hub.org) · Aligned with KCSIE 2025 and Working Together 2023 · Review before use with your DSL