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INCIDENT INVESTIGATION CHECKLIST

COLLECTING THE EVIDENCE Observations Premises and place of work Access and egress Plant and substances in use Location and relationship of physical parts Any post-events, tests, checks, sampling or reconstruction Clinical evidence about injured person Sketches, photographs and measurements Documents Written instructions Safe operating procedures Risk assessments Policies Records of any earlier inspections by the department Tests Examinations Surveys Interviews Those involved in the incident Any witnesses Their line managers Those observing or involved before the event eg inspectors, maintenance staff or other
Tick if relevant Tick when complete

CR/cao/AI Checklist/8 April 2004

INCIDENT INVESTIGATION CHECKLIST

INCIDENT ANALYSIS Immediate Causes Premises Plant and substance Procedures People Underlying Causes Planning Risk assessment Organisation: control Organisation: co-operation Organisation: communication Organisation: competence Monitoring Reviewing Incident Report - Headings Summary Discussion Conclusions Recommendations Distribution
Tick if relevant Tick when complete

CR/cao/AI Checklist/8 April 2004

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