Incident Investigation Checklist
Are there any written procedures for the task to be accomplished?
Was the employee provided with training or informed about the procedure?
Is the employee physically and mentally capable of carrying out the tasks?
Was the employee provided with the personal protective equipment (PPE) and was he/she correctly wearing them?
Was enough time provided for the employee to accomplish their tasks?
Was there any equipment involved in the incident?
How did the equipment contribute to the incident?
Through a failure
Lack of feature
Lack of maintenance
Which of the following environmental factors has contributed to the incident?
Is the role of management clearly defined and assigned in hazard recognition and corrective action?
Is management trained in hazard recognition?
Was management aware of a potential deviation that might occur from safety procedures?
Please explain the main cause of the incident and what measures could have been taken to prevent it?
Please assign a task for each key issue in order to prevent further incident
Repair/Replacement of Equipment
Should be Empty: