Incident Report

Incident Report

I. Incident Details

Field

Description

Date

May 15, 2054

Time

10:30 AM

Location

Main warehouse

Incident Type

Slip and fall

Description

The employee slipped on a wet floor near the loading dock, resulting in a fall and minor injuries.

Involved Parties

Neal Knight (Injured Employee), [YOUR NAME] (Supervisor), Mike Jones (Witness)

Witnesses

Mike Jones (Contact: mike@email.com)

II. Injury Details (If Applicable)

Field

Description

Injured Party

Neal Knight

Nature of Injury

Minor abrasions and bruising

Severity

Minor

Treatment Provided

Cleaned and bandaged on-site, no further medical attention is required

Medical Attention

None

III. Actions Taken

Action Taken

Description

Immediate Response

The employee was assisted to a safe area and the area was cordoned off for cleaning.

Investigation

The supervisor interviewed the employee, reviewed CCTV footage, and inspected the area for hazards.

Corrective Measures

Wet floor signs were placed and a reminder email was sent to all employees about safety procedures.

Follow-up

Scheduled additional training on workplace safety for all warehouse staff.

IV. Recommendations

Recommendation

Description

Safety Improvements

Consider installing anti-slip mats in high-risk areas and increase the frequency of floor inspections.

Training Needs

Conduct regular safety training sessions focusing on slip and fall prevention.

Policy Review

Review and update the company's safety policies regarding floor maintenance and signage.

V. Witness Statements (If Applicable)

Witness Name

Contact Information

Statement

Mike Jones

mike@email.com

"I saw Neal slip on the wet floor near the loading dock. It had just been cleaned, but there were no warning signs."

VI. Supervisor's Approval

I, [YOUR NAME], hereby approve this workplace incident report and confirm that the information provided is accurate to the best of my knowledge.

[YOUR NAME]

Company Supervisor, [YOUR COMPANY NAME]

Date: [DATE SIGNED]

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