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tiered safety incident form
Tiered Safety Incident Form Checklist
Section 1: Initial Incident Response
Assess the immediate situation and ensure the safety of all individuals involved.
Contact emergency services if necessary.
Secure the area and prevent further harm or danger.
Section 2: Investigation and Documentation
Gather detailed information about the incident, including date, time, location, and individuals involved.
Interview witnesses and collect statements.
Take photographs of the scene and any relevant evidence.
Section 3: Analysis and Root Cause Identification
Review all available information and evidence to determine the root cause of the incident.
Identify any contributing factors or underlying issues.
Develop a plan to address and prevent similar incidents in the future.
Section 4: Corrective Actions and Follow-Up
Implement immediate corrective actions to prevent recurrence of the incident.
Assign responsibilities for follow-up tasks and monitor progress.
Conduct regular reviews and updates to ensure long-term effectiveness of corrective actions.
Section 5: Reporting and Communication
Complete the required incident report forms and documentation.
Communicate with relevant stakeholders, including management, employees, and regulatory agencies.
Provide regular updates on the incident investigation and corrective actions.
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