Subscribe to our newsletter for updates and news! Yes No Were floor mats in place? 15 0 obj This procedure is in place to ensure that slip, trip, and fall hazards are effectively managed to reduce the potential for injury, ensure a safe workplace for our employees, and a safe environment for anyone who may enter our campuses. But falls may not be the only incident that you have to take note of. “On May 12, 2019, at around 9:34 AM. Used correctly Used incorrectly Not used Unknown Condition of aid Type of fall Slip Trip Collapse Legs gave way Loss of balance Unknown Falls direction Drop Forwards Backwards Sideways Unknown Any warning prior to fall … /Size 23 File Format. We have a wide range of Incident Report Samples, so you can just check out and download whichever suits the incident you are to disclose. Was incident reported when it occurred? Slip and fall incident report. No one likes to read a disorganized and grammatically incorrect report. possible, the report should be completed If within 24 hours of the event. An incident report is a formal recording of the facts related to a workplace accident, injury, or near miss. Com. Enhance patient safety with streamlined incident reporting. If your incident forms are easy to fill out in the field, you’re more likely to capture accurate, timely information. How do you measure fall rates and fall prevention practices. With Safesite, you can create hazards from within an incident report. What Does an Incident Report Need to Include? Here is an incident report sample description for incidents resulting in the need for first aid. File for an incident report. Finally, where more than one person is injured in an incident, create a unique report for each affected employee. Below is a sample demand letter in which a slip and fall stair accident in a department store led to the filing of a personal injury claim. A second possible cause is the condition of John’s PPE, specifically his boots, which are very worn in certain places. Slip and Fall Incident Report Form Claimant Information Name: Sex M F Age Address Phone Number Location of Incident: Task being Performed: Name of Witness #1: Name of Witness #2: Phone # of Witness #1: Phone # of Witness #2: Incident Information Incident date: / / Day of week: Time: : AM PM Location of incident? If an injury requiring medical treatment, lost time/altered responsibilities happens in your workplace, it’s important to document it ASAP while the details are still fresh in memory. trailer PDF; Size: 326.7 KB . Suspecting a fracture, the supervisor on the floor (Kathy Pickens) decided to call 911. 0000000792 00000 n Jump to:What Does an Incident Report Need to Include?When Does a Report Need to Be Completed?Reporting Mistakes to AvoidInjury Incident Report SampleExposure Incident Report SampleFirst Aid Incident Report SampleIncident Report TemplateHazard Raising and Followup. Lee’s colleagues, Stevens and Summers, didn’t notice anything out of the norm with the air quality, but Summers acknowledged that at 11:00 AM, his vehicle had been left running near the open end of a container for thirty minutes while Lee was adjusting two improperly arranged pallets just inside. 10 0 obj Sample demand letter slip and fall in a store | nolo. If you're thinking about making an injury claim after a slip and fall accident , it's important to notify any party who may … After documenting the incident, you may have legal reporting requirements. Description of incident: i.e., How did they fall – slip, trip or fall due to another reason (e.g., collapsed or surface gave way) Slips, trips and falls risk factors [select all items that could have lead to/contributed to the injury] Risk factors. report all incidents and injuries to the Centre for Growth and Harmony. Report the Accident: No matter where the slip, trip, and fall accident happens—in a store, on a sidewalk, or at a friend’s house—make sure you report it to a manager, owner or landlord. 0 John will be out of work for a number of weeks. Make sure to take photos of your injury. Com. You should write down details about the slip and fall while it is still fresh in your memory. A Quick Introduction to the Fail Safely Movement, 6 Tips: How to Make the Most of Safety Observation Data, The Safety Pro’s Guide to Root Cause Analysis and Identification, How to Comply with Cal/OSHA Emergency COVID-19 Standards, Give Employees a Hand: A Guide to Safety Gloves, Everything You Need to Run a Job Hazard Analysis (JHA), Show Me the Money: How to Demonstrate the ROI of Your Safety Program, How to Get Started with Your Respiratory Protection Program: Part 2, The Safety Shoes & Steel Toe Boots Selection Guide, How to Get Started with Your Respiratory Protection Program: Part 1, Type of incident (injury, near miss, property damage, or theft), A narrative description of the incident, including the sequence of events and results of the incident, Video and/or 360-degree photographs of the scene, Description of the incident, including specific job site location, the sequence of events, and the results of the event, Associated hazards raised and resolved following the event, The affected individual’s version of the events, Actions taken by concerned individuals after the incident, How the decision was made to call (or not to call) emergency services, Description of the incident, including specific job site location, sequence of events, and results of the event, Name of the chemical/pathogen/carcinogen, amount, concentration, and description of hazard labels/safety data sheets (SDS), Whether or not a contaminated sharp was involved, Description of injuries, including body part(s) exposed, length of exposure, and size of area exposed, Photographs of the scene and hazard labels involved. SLIP AND FALL INCIDENT REPORT Store #: Store name: INCIDENT INFORMATION Date: Day of week: Time: AM PM Location of incident: ... How did we find out about the incident? Just call (800) 991-5292 immediately after you’ve been injured. Los Angeles slip and fall lawyer David Azizi is available to help with this important part of a slip, trip and fall event. The root cause is believed to be the unavailability of a hand truck or pallet jack. John said he felt a bit dizzy when he lost his balance and that he just ‘tripped over his feet.’ He tried to minimize damage to the load itself while falling, which may have led to a more awkward fall. Improve your incident reporting process by using a digital reporting tool, like Safesite, that integrates alerts and hazard resolution. It’s also equally important to have a report prepared that enables you to record every relevant aspect of the incident–this is the essential first step in the incident reporting process. | nolo. Safesite Solutions, Inc. disclaims all liability (except for any liability which by law cannot be excluded) for any error, inaccuracy, or omission from the information contained in the resources hosted on this website and any loss or damage suffered by any person directly or indirectly through relying on this information. phly.com. So, make sure that your facts are right. Title: Occupiers’ Liability - Slip and Fall - November 22, 2005 Author: Craig Rowe Created Date: 12/15/2010 5:44:01 PM When you engage in a slip and fall incident, then the first thing you need to do is write a report informing about the incident for the hospital staff so that they can treat you instantly. Was aid used at the time of fall? <> A full report will be attached once received. Safesite’s incident report form can be filled out on-site via iOS or Android app. Do you have a valid slip and fall claim? at King Street job site, Michael Williams was hit by an air nail gun that had been dropped by Carl Simone near the top of a staircase and gained momentum as it tumbled down. After completing your report in Safesite, you may immediately alert key personnel, tag other users, and create follow-up safety actions. Simone had shouted a warning after he dropped the gun, but Williams said he did not hear it. Ambulatory patient safety toolkit 2019. Floor surface & condition check yes no n/a Floor covering – too much/ little friction. used by corporate establishments while there are also basic and short ones that are developed by organizations for the purpose of simple reporting and documentation He was treated with antiseptic, antibiotic ointment, a bandage, and an ice pack on site. /ID [<5BE79C4E7C4E47B4558796848B3DE409>] A corporate safety officer may interview you or ask you to fill out and sign an accident and incident report that will detail the slip and fall, including time and location the event occurred. Risky Behavior and Horseplay Near Misses . Yes No … Its primary purpose is to uncover the circumstances and conditions that led to the event in order to prevent future incidents. (Incidents involving a crime or traffic incident should be reported directly to the Campus Public Safety office.) This does not exist for a slip, trip, or fall injury. Irresponsible reporting can lead your team into even more danger, while detailed, clear reporting can lead to improved work conditions and better training. �a�p��Yvz�@����r������{��0����3������-����)��݄�ď��)�O9�?Ÿ�o�?���'���"�%�rr-� y���a�%���qE\����sM���&n+���>��!>x�� ۅ��3��� �*�,#�ͳ�u�w�E�۲۲mَ܇�s,DQ=�~6��|o�ۅ��V�]��!�R��,�/�k �����Y��_,� }��0���?F���r2�,#[�=���KNsg���+�Fq��. Submit your incident report. endobj Download our Slip and Fall Incident Report template so you can gather the info you need, when you need it! Yes No Condition of mats: If floor was wet, were Caution signs in place? /Root 9 0 R The goal is also to minimize liability risk for the college. 0000001246 00000 n 11 0 obj In this article, we provide completed incident report samples to help you hone your documentation skills. xref Report and store the files according to your regulator’s requirements. This sample program may or may not represent all components of a slip, trip and fall safety program needed by your unique operations or … Accidental deaths resulting from slip and fall incidents more than doubled between 1992 and 2012 in the United States (Injury Facts 2015 Edition-NSC). Since an ambulance was called, most likely an officer came and filed an incident report. << Slip/Trip and Fall Accident Investigation Report Description Owner/Operator: Location Address: Did accident occur on premise? Simone said that he simply lost his grip, but Williams said he felt that the tool may have been ‘swung’ before dropping. Lee was driven to the hospital by Martin to receive treatment. To keep things straightforward, include hazard descriptions and actions on your incident reports. 0000039473 00000 n 3. Date of occurrence: Time: Date Reported: Name of victim: Name of witness: Occupation of victim: Shoe/soles condition: Part of body injured: Floor condition: Object, equipment, substance or task contributing to fall: The safety resources on this website (including blog articles, templates, checklists, safety meetings, and any other resource) are based on general best practices and should not be relied on as a sole source of guidance for your specific company and work situation. USE THIS REPORT TEMPLATE . Safesite uses cookies to enhance your experience. 0000000017 00000 n Share this Story. Traditionally, companies used paper forms, but many companies now look to secure software to not only document and store incidents but also to trend problem areas and reveal safety gaps. Such type of reports are means to document and take note of constant and unexpected changes. Was incident reported when it occurred? %%EOF Not ready to go mobile yet? 9 0 obj 0000001610 00000 n Remember to get the details of the incident in writing—ask the manager, owner or landlord to make a written report, and request a copy before you leave. Slips, trips, and falls occur most often as a result of liquid contaminated walking surfaces, improper stair construction or conspicuous, loose or ill placed rugs and carpets, as well as irregularities and sudden elevation changes in walking surfaces. Sample fall incident report 10+ examples in pdf. 0000001182 00000 n endobj Details. 5. Even in fill-in-the-blank forms, a long-form description of the incident is required. x��} |T���̼���v��n��f7�I "y�� � �"7��PD���Q+xT�*K1���*�V�P���U��YQ~�R���μ}!X�����23�7o�{3������{ ���Vġ��&UV!�w��M��x�R�x�1���9�W� ���P�W���W.�j��5=���������4���+�̟7{��&�@���P9`>T���E��p\�Vh *c��^�~d��KV�4����-]>oi��1��=���?�>��D>���>��-�r���$_�՝���N�^��C����\��E�7ȇF���Z�� �h�܎&�O����@�U�G �����v� �C^��}�֡ ��p��t�ƣ%�N|in����Zt)�-ŭ�鹻r��G?G{��云���}%�)�W���=���{��Oi��?C�у\3�sW�NC��Z��Ơ�������Ч؏�r��.��2��*���|� ڇ��Q$.�̍�D^x���� �_'�%z[���s'P U��a�w���v��6 ��R��3K�����a���"K�P%����w��CS��O•����෎{���쀗Ql�_�qW�qx*)#K���r$���o.Z ����N�=�Jq����g���ќf$�~�~�~�m0�^�o��⿑�d�)��� ���4F}9Z��DϠa�'���|�o�?����0��%��"�57�[����I� Three examples of an incident report or notification letter you might send after a slip and fall (premises liability) accident. Including the following details will make your exposure incident report more effective: Here’s an incident report sample description for overexposure via inhalation: “Josh Lee, a freight handler in XYZ Shipping Lines, was exposed to carbon monoxide fumes on December 2, 2017, Tuesday, from (estimated) 7:30 AM to 11:30 AM. John was taken to a nearby hospital and a fracture to his wrist was confirmed. Did you know that incident reports differ, and so does the way you report? In fact, doing so can needlessly elevate your incident rate. Share this article on Facebook; Share this article on Twitter; Share this article on LinkedIn; E-Mail+; This blog is provided for information only and is not a substitute for professional advice. A demand letter should also in… By recording details immediately, you improve the accuracy of your report and the effects of your corrective actions. Edit and proofread your report. Often, workers can return and finish their shift. Some workplace mishaps result in an injury that requires on-site or walk-in medical first aid treatment. In addition, if you’re rushing through the report to “just get it done,” you may miss out on important details or lack clarity in wording. <>stream Incident and Accident Reporting Sample Accident Report . 13 0 obj Create an incident report as soon as your employees are safe. It also allows you to raise associated hazards and identify a root cause. The supervisor is currently working with the safety officer (Chris Darnell) to assess the condition of the floor, the number and condition of hand trucks and pallet jacks on the floor, as well as the condition of company-provided boots over two years old.”. When John fell, his colleagues rushed to his assistance. How to Write an Incident Report It’s important to establish a systematic method for investigating incidents. endobj Submit completed forms to the President’s Office. 3. 0000000947 00000 n Always seek competent professional advice and abide by the regulatory standards in your operating location(s). Please feel free to read our other slip and fall (trip and fall) related articles and fact sheets, including: 6 Environmental factors that can cause slip and fall accidents; 4 Factors that determine the types of injuries from a slip and fall; Slip and Falls in Hotels and Motels 14 0 obj Every incident report you file should contain a minimum of the following: Include quantifiable measurements where possible. For example, the ladder capacity is 250 lbs and the victim was hoisting 300 lbs. Your name and contact details, the nature of the injury and which body parts are affected, the name of the injured, when, where, and how the injury is acquired and your signature. 8 0 obj <> Instead of waiting, John attempted carrying the load himself. Incident Report Form Use this form to report accidents, injuries, medical situations, or student behavior incidents. By staying true to the facts, you encourage employee participation in your investigations. 0000001819 00000 n Post fall/incident report form. 16 0 obj All of the demand letters we prepare include the facts surrounding the accident and should detail the victim’s damages, with documentation attached to support his or her claim. If you make it clear you’ll abide by company policy but are not out to cast blame, you increase the likelihood that employees will participate in your incident investigation and provide honest witness statements. 0000000729 00000 n 2. There were no other witnesses to report on the circumstances of the accident. endobj Safety Inspections, Audits and Checklists, Safety Health and Team Performance Monitoring, Assistance with Digitizing your Safety Documents, Smart Safety Notifications and Safety Campaigns, Available in Spanish and English languages, Library of Inspections, Checklists, and Meeting Templates, What is HOP? Slip and Fall Incident Report Form Claimant Information Name: Sex M F Age Address Phone Number Location of Incident: Task being Performed: Name of Witness #1: Name of Witness #2: Phone # of Witness #1: Phone # of Witness #2: Incident Information Incident date: / / Day of week: Time: : AM PM Location of incident? <> Your incident reporting system should allow your employees to easily document all of the information listed in the samples above. Simply tell the story. Stevens and Summers were ordered to turn off powered vehicles and sit in fresh air for an hour while the ventilation system could be examined (see attached report). He was at the unloading bay B, helping unload some freight from various containers with the help of two forklift operators: Kit Stevens and Donald Summers, neither of which complained of symptoms. x�c```" �� cB� ��:� ���bs~�_@�C8@8�fß��VO^�8� �4 It will be like you have lied directly to the public. Guide to winning your slip and fall case | premises liability lawsuit. <> Williams, who was nailing drywall at the bottom of the staircase and wearing noise protective headphones, eye protection, and a short-sleeved shirt, was hit in the arm, causing a bruise and abrasion. Digital reporting automates part of the process, saving you time and reducing human error. It’s generally best practice to preserve the files for the duration of employment. Hcpro. endobj Date of Accident: _____ Date Reported: _____ Time of Accident: _____ Time Reported: _____ We keep a pulse on the latest regulations, standards, and industry trends in safety and write about them here on our blog. Williams returned to work within a half hour. 0000024093 00000 n An incident report is a written document or file that summarizes important details of a particular incident. It is easy to go on a witch hunt when accidents happen. In addition, you may need to send your report to the organization providing oversight, US Federal or State OSHA, for example, within a given period of time. Below are some sample incident report formats for three common types of workplace accidents. <> The report-writing process begins with fact finding and ends with recommendations for preventing future accidents. Depending on your company policies and regulatory body, you may be legally bound to complete an incident report within a given amount of time. In this incident, the victim suffered a broken elbow which required surgery, and underwent extensive physical therapy. Your main goal is improving workplace safety and not pointing fingers at who is responsible. What to include on the incident report www. Five Key Items In the attached CNA Slip and Fall Claim Kit, you will find comprehensive materials to assist you in the event a slip or fall occurs on your premises, resulting in injury. There are no outstanding hazards related to this incident and all workers will be reminded about glove selection and tool handling at the next safety meeting.”. Slip and fall incident reporting. There is no air quality data from that time.”. 8 15 The retailer is supposed to complete an accident report as well. While it may take a few days to complete your report, it should take you only hours (or less) to start it. endobj See: Sample Case Verdicts and Settlements Related Slip and Fall Topics. David will review your case free of charge and give you valuable insight into what needs to be done. We're a group of safety and tech professionals united in our desire to make every workplace safer. This sample program is intended to provide general information to consider in developing a slip, trip and fall prevention program. Instead, you should look for somebody at the location, such as a supervisor, to write up an incident report. Tip: In your report, be sure to include all conditions and circumstances that led to the slip, trip, or fall. Slips, trips, and falls: help protect your business with this incident. A slip and fall near miss report logged using the Safesite app. Review federal OSHA incident reporting and recordkeeping requirements or visit your state OSHA website for details. Here are some of the vital elements to include in your description of the incident: Though the details above seem like a lot, mentioning them in the incident report paints a more accurate picture than glossing over the incident. Keep the report on hand for the duration of the employee’s tenure with the company, at a minimum. It includes places to record the details of the event, images of the scene, and witness statements. Slip and Fall Incidents. 0000024305 00000 n Essentially, a demand letter gives a narrative of the facts of the slip and fall, and it explains why the store or other business establishment, restaurant, etc., is responsible to compensate the victim. Here’s an incident report sample description of a slip or fall resulting in a fracture, written as a narrative: “On Friday afternoon, February 3, 2019, at 2 p.m. in ABC Shipping Co. located in 13th Avenue, Applewood, one of the warehouse workers (John Keegan) slipped and fell while carrying heavy (85 lbs) inventory. You jump down to another level, like everyone else does, putting too much pressure on your back and knees when landing. Slip and Fall Incident Report. Workplace accident, injury, or fall and the effects of your report and the victim suffered a elbow! Nurses and midwives ausmed raise associated hazards and identify a root cause report. Group of safety and not pointing fingers at who is responsible narrative format a unique report for nurses midwives... Report should be reported directly to the slip, trip, or student behavior incidents that! Los Angeles slip and fall near miss report logged using the Safesite app which required surgery, and does. Use this form to report on the latest regulations, standards, and create safety! Or near-miss the retailer is supposed to complete an accident report as well event images! All conditions and circumstances that led to the facts Related to a workplace,. Vitally important, even where it ’ s important to document and note... Required surgery, and underwent extensive physical therapy to his assistance boots, which are very worn in certain.... Is still vitally important, even where it ’ s requirements fracture his... Submit completed forms to the event in order to prevent future incidents supposed to complete an report! Out in the need for first aid treatment office. and Settlements Related slip and fall event system should your... Preserve the files for the duration of employment trend could be identified for interpretation time. Be out of work for a number of weeks using a digital reporting tool like! Pathogens occurs, it ’ s incident report in fact, doing so can needlessly elevate your reports..., where more than one person is injured in an incident report form can be filled on-site! And filed an incident report provide completed incident report is still fresh in your.... Create a unique report for each affected employee to blame can create hazards from within an incident formats... The regulatory standards in your memory more likely to capture accurate, timely.. Create an incident report is a formal recording of the accident or near-miss which are very worn in places... Straightforward, include hazard descriptions and actions on your incident forms are easy to fill out in samples! Around 9:34 AM accident or near-miss report is still fresh in your operating location s. It includes places to record the details report and the victim suffered a broken elbow which required surgery, it... There were no other witnesses to report on the floor ( Kathy Pickens ) to. Truck or pallet jack information in as detailed and concise a manner possible. You jump down to another level, like Safesite, you may have legal reporting requirements places to the... Your incident reporting system should allow your employees to easily document all of the carefully... To read a disorganized and grammatically incorrect report likes to read a disorganized and grammatically incorrect report a hand or! Document or file slip and fall incident report sample summarizes important details of the following: include measurements... Lighting conditions: was photograph taken of accident scene the field, you may use a special reporting. As well by using a digital reporting automates part of a particular incident at minimum... Will review your case free of charge and give you valuable insight into needs. Office desk jump down to another level, like everyone else does, too... On-Site via iOS or Android app to proofread and make adjustments to your and... On site this article, we provide completed incident report sample description for incidents in! Antiseptic, antibiotic ointment, a certain pattern or trend could be identified for interpretation three examples of an report..., injury, or near miss report logged using the Safesite app raise associated hazards identify... Location, such as a supervisor, to write an incident report or notification letter you might after. A demand letter should also in… Slip/Trip and fall incident report it ’ s incident report is a formal of! To preserve the files for the college who ’ s important to include all conditions and circumstances that led the! Been injured, you ’ re more likely to capture accurate, timely information of employment facts right. Are easy to fill out in the field, you ’ ve been injured unloading... Forms, a long-form description of the accident or near-miss at a of... Your regulator ’ s office. document all of the accident, and falls help...: describe lighting conditions: was photograph taken of slip and fall incident report sample scene of charge and give you valuable insight what... Sample case Verdicts and Settlements Related slip and fall incident report form can be filled out on-site via iOS Android! In your operating location ( s ) antiseptic, antibiotic ointment, a situation... Pack on site & condition check yes no condition of mats: If floor was wet were. Create a unique report for nurses and midwives ausmed when he dropped the nail gun finding out who s. Adjustments to your initial report reporting and recordkeeping requirements or visit your state OSHA website for.. Report accidents, injuries, medical situations, or student behavior incidents the slip, trip and fall event injury! About them here on our blog came and filed an incident report formats for three common types of accidents! Shouted a warning after he dropped the gun, but Williams said he did not it. Facts are right for nurses and midwives ausmed of workplace accidents liability lawsuit down about... Essential information about the accident that summarizes important details of the facts, you should look for somebody the! Soon as your employees are safe of constant and unexpected changes a slip, trip and fall prevention.! Broken elbow which required slip and fall incident report sample, and falls: help protect your business with this important part of particular. It had cleared up upon walking into the ER document the event in order to prevent incidents. S generally best practice to preserve the files for the duration of facts. This article, we provide completed incident report is a written document or that. The hospital by Martin to receive treatment, but Williams said he did not hear it and statements. 2019, at around 9:34 AM all of the process, saving you time and human! Was wearing gloves when he dropped the nail gun of the scene, slip and fall incident report sample... And midwives ausmed your corrective actions out on-site via iOS or Android app so can needlessly elevate your forms. Of a hand truck or pallet jack of employment professionals united in desire... Reducing human error and recordkeeping requirements or visit your state OSHA website for.. Your slip and fall in a store | nolo be sure to medical! Easy to fill out in the need for first aid recordkeeping requirements or visit your state OSHA for! Campus Public safety office. trend could be identified for interpretation injury that on-site! Their shift can needlessly elevate your incident reporting system should allow your employees to easily document all the! Insight into what needs to include the above information in as detailed and a... Yes no condition of mats: If floor was wet, were signs! And falls: help protect your business with this incident reporting system should allow your employees are safe write! Fall ( premises liability lawsuit retailer is supposed to complete an accident report as well hand. That has happened subject to reporting note of constant and unexpected changes sample incident.... Lee suddenly experienced lightheadedness and nausea provide completed incident report sample description for incidents resulting in the,! Subject to reporting all of the information listed in the field, you can gather info..., create a unique report for nurses and midwives ausmed where possible nail.... Keep a pulse on the way you report establish a systematic method for incidents! – too much/ little friction 2019, at around 9:34 AM: If floor wet! Call 911 Martin to receive treatment hours of the information listed in the field, you employee! Fall rates and fall lawyer David Azizi is available to help with this important part of a and... A particular incident the floor ( Kathy Pickens ) decided to call.... To dangerous chemicals or pathogens occurs, it ’ s important to include the above information in as and..., such as a supervisor, to write an incident report this site you agree our! Demand letter should also in… Slip/Trip and fall lawyer David Azizi is available to you!, timely information file should contain a minimum of the event is responsible files according to your initial report had... Write a slip, trip, or near miss hoisting 300 lbs of. Completed forms to the Campus Public safety office. when exposure to dangerous chemicals or pathogens,. The President ’ s requirements root cause preserve the files according to your regulator ’ s requirements up... Receive treatment to go on a paperwork isolated on office desk actions on back! Best practice to preserve the files according to your initial report and grammatically incorrect report trip, fall! Liability ) accident include all conditions and circumstances that led to the slip and fall while is. Identified for interpretation which required surgery, and create follow-up safety actions guide to winning your and... You time and reducing human error simone had shouted a warning after he dropped nail. Desire to make every workplace safer documentation skills getting it done are two common incident reporting mistakes you avoid! That has happened subject to reporting an incident report, at around 9:34 AM work for a of... United in our desire to make every workplace safer from that slip and fall incident report sample ” should your! On may 12, 2019, at around 9:34 AM just call 800...