Referral to Islington's Local Authority Designated Officer form

This referral form must be completed when there is an allegation that any person who works with children has:

• behaved in a way that has harmed a child, or may have harmed a child,
• possibly committed a criminal offence against or related to a child,
• behaved towards a child or children in a way that indicates they may pose a risk of harm to children,
• behaved or may have behaved in a way that indicates they may not be suitable to work with children

This form must be completed by the person with lead responsibility for managing allegations in the setting.

For guidance, please see Chapter 7 of the London Child Protection Procedures.