Incident Investigation Template

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

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Health & Safety
Incident Investigation Template

Environment

Equipment/Materials

Work Systems

People

Environment

Equipment/Materials

Work Systems

People

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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.

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Incident Investigation Template

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

4. Are adequate controls implemented?

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

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

1. Are established procedures properly followed?

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

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

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

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

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

7. Is a lack of communication addressed?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

4. Are adequate controls implemented?

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

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

1. Are established procedures properly followed?

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

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

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

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

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

7. Is a lack of communication addressed?