General / Cross-sector 18 items
Workplace Incident & Accident Reporting
Ensures workplace incidents and injuries are reported, recorded, investigated, and escalated to OSHA when required.
29 CFR 190429 CFR 1904.39
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Immediate Response
- Was medical care provided and the scene made safe? *
- Date and time the incident occurred: *
- Was the area secured to preserve evidence for investigation? *
- Were affected personnel and supervisors notified? *
Incident Details
- Description of what happened: *
- Type of incident: *
- Were there injuries requiring medical treatment beyond first aid? *
- Names of persons involved and witnesses: *
OSHA Recording & Reporting
- Was the case evaluated for OSHA 300 Log recordability within 7 calendar days? *
- Did the event cause a fatality, in-patient hospitalization, amputation, or loss of an eye? *
- If a fatality, was OSHA notified within 8 hours? *
- If hospitalization/amputation/eye loss, was OSHA notified within 24 hours? *
Investigation & Root Cause
- Was a root cause analysis performed (not stopping at 'employee error')? *
- Were contributing factors (equipment, procedures, environment, training) identified? *
- Were similar hazards elsewhere in the operation checked? *
Corrective Action & Closure
- Are corrective actions defined with owners and due dates? *
- Have corrective actions been verified as effective? *
- Reviewer sign-off: *
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