HR Incident Report
I. Incident Overview
Date of Incident: May 15, 2050
Time of Incident: 10:30 AM
Location: [Your Company Address]
Incident Report Number: HRIR-2024-0515
II. Employee Information
III. Injury Details
Nature of Injury: Laceration to left forearm, requiring stitches
IV. Description of Incident
While operating machinery, [Employee's Name]'s left forearm came into contact with a sharp edge, resulting in a deep laceration.
V. Immediate Actions Taken
First aid was administered by the onsite nurse.
The production supervisor was notified immediately and secured the area.
[Employee's Name] was transported to the nearby clinic for further medical evaluation and treatment.
VI. Medical Treatment
VII. Safety Recommendations
Implement additional safety protocols regarding the use of protective gear, especially gloves, during machine operation.
Conduct a thorough review of machinery to ensure all safety guards are in place and functional.
VIII. Supervisor's Comments
The incident occurred due to a momentary lapse in attention. We will reinforce safety training for all operators.
IX. HR Coordinator's Remarks
Follow-up meeting scheduled with [Employee's Name] to discuss return-to-work arrangements and any needed support.
Submitted By:
Name: [Your Name]
Position: HR Coordinator
Date: May 16, 2050
Approved By:
Incident Report Templates @ Template.net
