Incident Investigation Template

Use the Incident Investigation Template for a systematic approach to safety, with thorough analysis and corrective actions to avoid future incidents.​

Incident Investigation Template



Environment

1. Have noise-related hazards been assessed and addressed?


Photo Comment

2. Has the layout/design been evaluated for safety considerations?


Photo Comment

3. Have lighting-related hazards been identified and rectified?


Photo Comment

4. Are dust/fume hazards adequately managed in the work environment?


Photo Comment

5. Have vibration-related risks been evaluated and mitigated?


Photo Comment

6. Have slip/trip hazards been identified and addressed?


Photo Comment

7. Have damaged/unstable floors been identified, and corrective actions taken?


Photo Comment
Equipment/Materials

1. Is the equipment suitable for the job, and have any instances of wrong equipment usage been identified?


Photo Comment

2. Has equipment failure been assessed, and preventive measures put in place?


Photo Comment

3. Has maintenance been carried out adequately to prevent any hazards?


Photo Comment

4. Have measures been taken to address material/equipment that is too heavy or awkward?


Photo Comment

5. Is there adequate guarding in place to prevent accidents?


Photo Comment

6. Has proper training been provided to address any gaps in knowledge or skills?


Photo Comment
Work Systems

1. Have all hazards been identified within the work systems?


Photo Comment

2. Has a risk assessment been conducted, and are controls implemented appropriately?


Photo Comment

3. Are safe work procedures in place, and are they adequate for the tasks at hand?


Photo Comment

4. Are adequate controls implemented?


Photo Comment

5. Is there a mechanism for reporting hazards, and has it been utilized?


Photo Comment

6. Have employees been adequately trained and supervised to perform their tasks safely?


Photo Comment
People

1. Are established procedures properly followed?


Photo Comment

2. Have drugs/alcohol-related risks been assessed and managed?


Photo Comment

3. Is fatigue considered in the work environment, and preventive measures implemented?


Photo Comment

4. Are time/production pressures evaluated for their impact on safety?


Photo Comment

5. Is there a plan in place to address changes in routine that might impact safety?


Photo Comment

6. Are distractions, personal issues, or stressors monitored and managed to maintain a safe working environment?


Photo Comment

7. Is a lack of communication addressed?


Photo Comment

Is this sample what you are looking for?
Sign up to use & customise this template, or create your own custom checklist:

Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

Seeing is Believing

Get a live demo customized to your unique needs, or get started with a 14-day FREE trial.