Worksite Incident Report Checklist

Worksite Incident Report is a document used to record details about accidents, injuries, near misses, or other incidents that occur at a workplace.

The Worksite Incident report is crucial for maintaining workplace safety, complying with legal requirements, and implementing corrective actions to prevent future incidents.

Immediate Actions:

1. Ensure Safety
   • Secure the area to prevent further injury or damage.
   • Provide first aid or medical assistance if needed.
   • Evacuate the area if necessary.
2. Notify Authorities
   • Inform the site supervisor or manager immediately.
   • Contact emergency services if the situation is severe.

Incident Details:

3. Incident Information
   • Date and time of the incident.
   • Exact location of the incident on the worksite.
   • Type of incident (e.g., injury, property damage, near miss).
4. Persons Involved
   • Names and contact details of all individuals involved.
   • Job titles and roles of the persons involved.
   • Nature of injuries sustained, if any.
   • Actions taken by the individuals involved immediately after the incident.

Witness Information:

5. Witnesses
   • Names and contact details of any witnesses.
   • Statements from witnesses describing what they saw.
   • Record the exact location of witnesses during the incident.

Incident Description:

6. Detailed Account
   • A detailed narrative of what happened, including the sequence of events.
   • Activities being performed at the time of the incident.
   • Environmental conditions (weather, lighting, noise levels).
   • Equipment or machinery involved.
7. Photos and Diagrams
   • Take photographs of the incident scene, including any relevant equipment or hazards.
   • Create diagrams or sketches of the incident scene.

Equipment and Materials:

8. Equipment Details
   • Description and identification numbers of any equipment involved.
   • Condition of the equipment before and after the incident.
   • Maintenance records of the equipment.
9. Materials Involved
   • List of materials involved in the incident.
   • Safety Data Sheets (SDS) for any hazardous materials.

Response Actions:

10. Immediate Response
    • Actions taken to address the incident immediately.
    • Individuals responsible for each action.
11. Follow-up Actions
    • Corrective actions taken to prevent recurrence.
    • Timeline for implementing corrective actions.
    • Person(s) responsible for follow-up.

Reporting and Documentation:

12. Incident Report Form
    • Fill out the formal incident report form with all gathered information.
    • Ensure the form is signed by the person reporting and any witnesses.
13. Submission and Filing
    • Submit the incident report to the appropriate personnel or department.
    • File a copy of the report in the incident log.

Review and Analysis:

14. Incident Review
    • Conduct a review meeting with relevant stakeholders.
    • Analyze the causes of the incident (immediate and root causes).
15. Recommendations
    • Develop recommendations to prevent future incidents.
    • Document and communicate the recommendations to all relevant personnel.
16. Training
    • Update training programs based on the incident analysis and recommendations.
    • Ensure all workers are trained on new procedures or policies.

Additional Considerations:

• Legal Compliance: Ensure the report meets all regulatory requirements.
• Confidentiality: Maintain confidentiality of sensitive information.
• Insurance Reporting: If applicable, report the incident to the insurance company.
• Continuous Improvement: Use incident data to improve safety practices continuously.

Worksite Incident Report Checklist Using eAuditor Audits & Inspections

Creating a comprehensive Worksite Incident Report using eAuditor can help streamline the reporting process and ensure all necessary details are captured efficiently. Here’s a step-by-step guide to setting up and using eAuditor for a Worksite Incident Report:

Step-by-Step Guide

1. Create an eAuditor Account

• Sign up for an eAuditor account on their website or download the app on your mobile device.

2. Set Up Your Incident Report Template

• Use eAuditor’s template editor to create a custom Worksite Incident Report template. You can start from scratch or use a pre-existing template from the eAuditor public library.

3. Design the Incident Report Template

• General Information:
  • Incident report number
  • Date and time of the incident
  • Location of the incident (worksite address, specific area)
• Incident Details:
  • Description of the incident
  • Type of incident (e.g., injury, near miss, property damage)
  • Persons involved (names, contact details, roles)
  • Witnesses (names, contact details)
• Injury Details (if applicable):
  • Nature of the injury (e.g., cut, fracture, burn)
  • Body part(s) affected
  • Immediate actions taken (first aid, medical treatment)
• Cause of Incident:
  • Root cause analysis
  • Contributing factors (e.g., equipment failure, human error, environmental conditions)
• Corrective Actions:
  • Immediate actions taken to secure the area and prevent further incidents
  • Long-term corrective actions to prevent recurrence
  • Responsible persons for implementing corrective actions
• Photos and Evidence:
  • Attach photos, videos, and other evidence of the incident scene
• Witness Statements:
  • Sections for written statements from witnesses
• Reporter Details:
  • Name and contact details of the person reporting the incident
  • Signature of the reporter

4. Share the Template

• Share the incident report template with relevant personnel through eAuditor. They can access the template via the app or web portal.

5. Complete the Incident Report

• When an incident occurs, designated personnel can complete the report using the eAuditor app.
• They can capture photos and videos, add detailed descriptions, and attach any relevant documents.

6. Review and Submit the Report

• Review the completed incident report to ensure all details are accurate and complete.
• Submit the report for review and further action by supervisors or safety officers.

7. Analyze and Take Action

• Use eAuditor’s analytics tools to review incident trends and identify areas for improvement.
• Implement and track corrective actions to prevent future incidents.

8. Maintain Records

• Store all incident reports and related documents in eAuditor’s cloud storage.
• Ensure records are easily accessible for future reference and compliance purposes.

Benefits of Using eAuditor for Incident Reporting

• • • Efficiency: Quickly and easily report incidents using mobile devices.
    • Consistency: Standardize the reporting process with custom templates.
    • Documentation: Capture and store evidence with photos, videos, and notes.
    • Real-Time Reporting: Generate and share reports instantly.
    • Tracking and Analytics: Monitor incident trends and track corrective actions.

Features to Use in the eAuditor Audits & Inspections:

• Notifications and Reminders: Set up automatic reminders for follow-up actions and reviews.
• QR Code Scanning: Use QR codes on equipment to quickly access maintenance history and incident reports.
• Checklists and Forms: Utilize built-in checklists and forms for structured incident reporting.
• Data Analytics: Analyze incident data over time to identify trends and potential issues.
• Cloud Storage: Ensure all data is backed up to the cloud for easy access and retrieval.
• Reporting: Generate and share detailed incident reports directly from the eAuditor Audits & Inspections.