POST-ACCIDENT CHECKLIST


YES NO
Immediately after an accident, have you:
Provided emergency medical assistance to anyone who is injured or ill?
_ _
Taken any necessary emergency action to prevent further injury or property damage?
_ _
Secured the scene to preserve the evidence for study?
_ _
Taken photos or measurements, if needed?
_ _
Interviewed witnesses to determine what happened?
_ _
Interviewed others with relevant information?
_ _
Determined the cause(s) of the accident?
_ _
Made recommendations and action plans?
_ _
Filed other required reports?
_ _
Does your record include the following information:
Name of injured employee(s)
_ _
Accident date and time?
_ _
Nature and extent of injury/illness?
_ _
Exact location of accident scene?
_ _
Witnesses and their activities at the time?
_ _
Others with relevant knowledge?
_ _
Description of accident?
_ _
Description of events preceding accident?
_ _
Task/activity engaged in at time of accident?
_ _
Employees normally assigned task?
_ _
Length of employment and assignment to current job?
_ _
Relevant training received by employee and training dates?
_ _
Equipment/materials involved in the accident?
_ _
Physical surroundings of accident?
_ _
Unsafe acts that could have led to accident?
_ _
Description and dates of similar or related accidents?
_ _
Cause(s) of accident?
_ _
Actions taken to prevent similar accidents?
_ _
Additional recommendations?
_ _


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