HR Incident Report

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

  • Name: [Employee's Name]

  • Employee ID: 123456

  • Job Title: Machine Operator

  • Department: Production

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

  • Medical Provider: City Clinic

  • Treatment Provided: John received stitches and was prescribed antibiotics for the wound.

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:

  • Name: [Production Manager Name]

  • Position: Production Manager

  • Date: May 17, 2050


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