Free Restaurant Employee Incident Report Template

Restaurant Employee Incident Report


I. Incident Details

Date of Incident:

[Incident Date]

Time of Incident:

[Incident Time]

Location of Incident:

Kitchen area

Description:

The employee slipped on a wet floor and fell while carrying a tray of dishes.

II. Employee Information

Name of the employee(s) involved:

[Employee Name]

Job position/title:

Cook

Location of Incident:

Kitchen area

Employee ID/Number::

EMP12345

III. Witness Statements

  • Witness Name: [Witness Name]

  • Description of what the witness observed: [Witness Name] witnessed [Employee Name] slipping on the wet floor and falling, causing the dishes to break.

IV. Investigation Findings

  • Summary of investigation: [Employee Name] slipped on a spilled liquid due to a leaking pipe in the kitchen.

  • Root cause analysis: The incident was caused by negligence in promptly addressing maintenance issues.

V. Recommendations and Actions Taken

  • Preventive measures: Implement regular checks for maintenance issues and immediate clean-up of spills.

  • Disciplinary actions: None, as the incident was due to a maintenance issue.

VI. Follow-up Actions

Schedule maintenance to repair the leaking pipe and conduct staff training on safety procedures.

VII. Reporting Personnel

Name:

[Your Name]

Position:

Safety Coordinator

Email:

[Your Email]

Company Name:

[Your Company Name]

Company Address:

[Your Company Address]

Date:

[Date]

VIII. Conclusion

The Restaurant Employee Incident Report emphasizes the need for a safe and respectful work environment. Prompt documentation and resolution of incidents help mitigate risks and promote a culture of accountability and professionalism. Implementing preventive measures like training and communication strategies is crucial to reduce future incidents. Management will keep a close watch and support employees to maintain our conduct and safety standards.

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