Get the free Supervisor's Incident Investigation Report - njsda

This document is used to report and investigate incidents that occur on project sites managed by the New Jersey Schools Development Authority, detailing the incident, primary causes, and corrective

How to fill out supervisors incident investigation report

How to fill out Supervisor's Incident Investigation Report

1. Obtain a blank Supervisor's Incident Investigation Report form from your organization's resources.
2. Start by filling in the date and time of the incident at the top of the form.
3. Provide a detailed description of the incident, including what happened, where it happened, and any relevant environmental conditions.
4. List the names and contact information of all individuals involved in the incident.
5. Document any witnesses, including their names and contact details.
6. Note any injuries sustained by individuals during the incident, and provide a brief description of these injuries.
7. Describe the immediate actions taken following the incident to ensure safety and mitigate further risk.
8. Identify the root cause of the incident if known, and list any contributing factors.
9. Include any relevant photographs or diagrams if applicable.
10. Review the report for accuracy and completeness before submitting it to the appropriate personnel.

Who needs Supervisor's Incident Investigation Report?

1. Supervisors who oversee operations in various work environments need the Supervisor's Incident Investigation Report to document incidents.
2. Human Resources departments require the report to manage safety compliance and employee relations.
3. Safety officers or committees need the report to identify patterns in incidents for safety training purposes.
4. Insurance companies may also require the report for claims related to workplace incidents.

For pdfFiller’s FAQs

What is Supervisor's Incident Investigation Report?

The Supervisor's Incident Investigation Report is a document used to formally record details about an incident or accident that occurs in the workplace. It aims to analyze the cause of the incident and recommend preventive measures.

Who is required to file Supervisor's Incident Investigation Report?

Typically, supervisors or managers who witness or are informed of an incident are required to file the Supervisor's Incident Investigation Report.

How to fill out Supervisor's Incident Investigation Report?

To fill out the report, gather all relevant information about the incident, including date, time, location, individuals involved, a description of the event, witness statements, and any immediate actions taken. Then complete the report form based on the collected information.

What is the purpose of Supervisor's Incident Investigation Report?

The purpose of the Supervisor's Incident Investigation Report is to document incidents thoroughly, understand their causes, and develop preventive measures to enhance workplace safety.

What information must be reported on Supervisor's Incident Investigation Report?

The report must include information such as the date and time of the incident, location, names of those involved, a detailed description of the incident, witness accounts, and any immediate corrective actions taken, along with recommendations for future prevention.