Confidential Report of Accident Investigation

State:
Multi-State
Control #:
US-AHI-277
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is a confidential accident investigation that is performed by the company once an injury has occurred.

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FAQ

California Car Accident Reporting Requirements If the crash involved any injuries or deaths, you will need to report the accident to law enforcement within 24 hours.The crash resulted in damage to property worth more than $1,000.

What is the purpose of an accident report? The purpose of the report is to record the findings of the accident investigation, the cause or causes of the accident, and recommendations for corrective action.

An investigation will involve an analysis of all the information available, physical (the scene of the incident), verbal (the accounts of witnesses) and written (risk assessments, procedures, instructions, job guides etc), to identify what went wrong and determine what steps must be taken to prevent the adverse event

Checklist for Accident/Incident Reports make sure your report contains as much of the following:Description of the job duty that was being performed at the time of the incident/accident. Detailed description of the event. Parts of body injured and/or parts of equipment damaged (in an injury occurred)

The date and time on which it occurred. The person who was injured. Any witnesses. The type and nature of the injuries sustained. The cause and full circumstances of the accident.

Accident Investigation & Reporting Finding the causes of an accident and taking steps to control or eliminate it can help prevent similar accidents from happening in the future.Investigators can then determine accident conditions by examining physical evidence and interviewing witnesses.

The incident should be described on the report in sufficient detail that any reader can clearly picture what happened. You might consider creating a diagram to show, in a simple and visually effective manner, the sequence of events related to the incident and include this in your incident report.

Date, time and specific location of incident. Names, job titles and department of employees involved and immediate supervisors. Names and accounts of witnesses. Events leading up to incident. Specifically what the employee was doing at the moment of the accident.

The incident report for an accident or injury such as a fall should include the following information: Circumstances of the incident. Date, time, and location of fall, and during which shift and on what unit the fall occurred. Witnesses', staff members', and resident's accounts of the incident.

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Confidential Report of Accident Investigation