Free Employee Critical Incident Report Template

Employee Critical Incident Report


I. Introduction

This Employee Critical Incident Report is prepared by the Emergency Response Coordinator, [YOUR NAME], following a significant emergency situation at [YOUR COMPANY NAME]. The report aims to document the incident thoroughly, outline the immediate and follow-up actions taken, and provide recommendations to prevent future occurrences.

II. Incident Details

Date: May 15, 2050
Time: 3:45 PM
Location: [YOUR COMPANY NAME] Warehouse, [YOUR COMPANY ADDRESS]

III. Description of Incident

On May 15, 2050, at approximately 3:45 PM, a fire broke out in the storage area of [YOUR COMPANY NAME] warehouse. The fire alarm was triggered, and all employees were evacuated promptly. The fire was contained by the sprinkler system and subsequently extinguished by the local fire department. There were no injuries reported.

IV. Individuals Involved

  • Maurice Lowe - Warehouse Manager

  • Saul Haynes - Employee (Witness)

  • Ed Potter - Firefighter

V. Witness Statements

Saul Haynes: "I noticed smoke coming from the storage area and immediately informed Maurice Lowe. We activated the fire alarm and began the evacuation procedure. Everyone exited the building safely."

VI. Immediate Actions Taken

  1. Fire alarm activated.

  2. Employees evacuated to the designated assembly point.

  3. Local fire department contacted and arrived on the scene within 10 minutes.

  4. Fire extinguished by the sprinkler system and fire department.

VII. Follow-Up Actions

  1. Conducted a thorough inspection of the affected area.

  2. Engaged a fire safety consultant to assess the cause of the fire.

  3. Reviewed and updated the emergency evacuation plan.

  4. Scheduled fire safety training for all employees.

VIII. Recommendations

  1. Enhance Fire Safety Measures: Install additional smoke detectors and fire extinguishers in key areas of the warehouse.

  2. Regular Safety Drills: Conduct bi-annual fire drills to ensure all employees are familiar with the evacuation procedures.

  3. Maintenance Checks: Perform regular maintenance checks on electrical equipment and storage practices to prevent future fire hazards.

IX. Signatures

Maurice Lowe
Warehouse Manager
Date: May 16, 2050

Saul Haynes
Employee (Witness)
Date: May 16, 2050

Ed Potter
Firefighter
Date: May 16, 2050


Table of Incident Summary

Date

Time

Location

Incident Type

Actions Taken

May 15, 2050

3:45 PM

[YOUR COMPANY NAME] Warehouse

Fire

Evacuation, Fire Extinguished

May 15, 2050

3:50 PM

[YOUR COMPANY NAME] Warehouse

Fire

Inspection, Safety Assessment

This Employee Critical Incident Report serves as a comprehensive record of the emergency situation, documenting all relevant details, actions, and recommendations to enhance future safety measures at [YOUR COMPANY NAME].

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