Free General Staff Incident Report Template

General Staff Incident Report


Incident Overview

  • Date of Incident: September 15, 2050

  • Time of Incident: 10:30 AM

  • Location: Main Office, 3rd Floor


Personnel Involved:

  • Michael Brown - Employee

  • Emily White - Witness

  • David Green - Supervisor


Details of the Incident

On September 15, 2050, at approximately 10:30 AM, a slip and fall incident occurred on the 3rd floor of the main office involving Michael Brown, an employee. The incident took place near the elevator area, where Michael slipped on a wet floor.

Immediate Actions Taken:

  1. Assistance Provided:

    Fellow employee Emily White, who witnessed the incident, promptly assisted Michael Brown.

  2. Area Secured:

    David Green, the supervisor on duty, immediately cordoned off the area with warning signs to prevent further incidents.

  3. First Aid Administered:

    First aid was administered to Michael Brown for minor injuries sustained during the fall. He reported discomfort but declined further medical attention at that time.

  4. Maintenance Notification:

    The Maintenance Department was notified to address the wet floor, ensuring it was cleaned and that appropriate measures were taken to prevent future occurrences.


Witness Statements:

Emily White, who was present during the incident, provided a statement indicating that there were no warning signs present to alert individuals of the wet floor conditions at the time of the incident. This lack of signage contributed to the accident, highlighting the need for improved safety measures.


Conclusion and Recommendations:

This incident underscores the importance of maintaining a safe working environment. To mitigate the risk of similar incidents in the future, the following recommendations are made:

  1. Proper Signage:
    Ensure that appropriate signage indicating wet floor conditions is maintained at all times, particularly in areas undergoing cleaning or where spills may occur.

  2. Regular Monitoring:
    Implement regular monitoring of high-traffic areas, especially during cleaning schedules, to promptly address any hazards.

  3. Training and Awareness:
    Conduct training sessions for all staff on safety protocols and reporting procedures for potential hazards.

  4. Incident Review:
    Establish a review process for all incidents to identify root causes and enhance safety measures.


Report Prepared By:
[Your Name]
HR Manager

Date of Report: September 16, 2050

Report Templates @ Template.net