Free Construction Incident Investigation Report Template
Construction Incident Investigation Report
I. Incident Information
Section |
Details |
---|---|
Reported By: |
[Your Name] |
Date of Incident: |
May 30, 2050 |
Time of Incident: |
10:00 AM |
Location: |
Construction Site |
II. Incident Description
On May 30, 2050, at approximately 10:00 AM, a construction incident occurred at the construction site.
This report is being submitted by [Your Name], the site supervisor for [Your Company Name]. The incident involved a worker, [Worker Name], who fell from a height due to improper scaffolding.
III. Detailed Account of the Incident
The incident occurred during the routine inspection of the scaffolding structures. The worker, [Worker Name], was performing his duties on the scaffolding when it unexpectedly gave way, causing him to fall approximately 15 feet to the ground. The scaffolding was later inspected and found to be improperly secured. The failure likely arose from insufficient bracing, which led to unstable support.
IV. Immediate Actions Taken
Following the incident, the immediate area was secured, and all work in the vicinity was halted. Medical assistance was promptly requested, and [Worker Name] was transported to [Hospital Name] for medical examination and treatment. Emergency contacts were notified, and a preliminary investigation began on-site to gather evidence and interview witnesses.
V. Witness Statements
Witness statements were collected from on-site personnel, including [Witness 1 Name] and [Witness 2 Name]. Both witnesses corroborated the sequence of events, highlighting the sudden collapse of the scaffolding. They also confirmed that safety harnesses were being worn, but the structural failure was unexpected.
VI. Investigation Findings
Our preliminary investigation indicates that the scaffolding failure was due to insufficient bracing, which resulted in unstable support.
Further analysis is being performed to confirm these findings and deduce any other implicit contributory factors.
VII. Corrective Actions
Corrective actions to prevent recurrence include immediate inspection and reinforcement of all scaffolding structures, retraining workers on proper scaffolding usage and safety protocols, and re-evaluating risk assessment procedures.
Additionally, a thorough audit will be conducted to ensure compliance with all safety regulations.
VIII. Recommendations
It is recommended that [Your Company Name] invests in more frequent and comprehensive safety checks, updates safety policies regarding scaffolding use, and institutes a mandatory safety equipment check before each shift.
The appointment of a dedicated scaffolding safety officer should also be considered.
IX. Report Authorization
This incident report is authorized and submitted by:
Name: [Your Name]
Position: Site Supervisor
Date: May 30, 2050