Reference

Revision
Effective Date
Revision Date

Conduct Audit Checklist

It is recommended that the following checklist be used to review the incident investigation, and to ensure
everything has been done. You may want to use this checklist to assess your investigations at the
workplace.
NO
QUESTION YES NO
.

Were the incident report forms completed at the time of the incident?
1

Were the incident compensation report forms completed at the time of the
2 incident?

Was the CEO/GM advised of the incident when it was first reported?
3

Was the health and safety representative advised of the incident when it
4 was first reported?

5 Has a documented investigation been initiated?

6 Has the investigation been completed?

Who conducted the investigation? Name:

7 ...................................................................

Who was responsible for the investigation? Name:

8 .....................................................

Did the investigation assess the organisation’s legal (non- compliance)

9 exposures?

What was the duration of the investigation from the date of the incident? days hours
10

Was a Remedial Action Plan (RAP) developed from the investigation

11 findings? Was the RAP in writing?

12 Did the RAP assign responsibilities to the actions required?

Did the RAP consider time parameters for completion of the actions
13 required?

Did the RAP allocate and approve resources to develop and complete actions
14 required?

15 Did management approve the RAP?

 Reference
Revision
Effective Date
Revision Date

16
Has the RAP been completed as proposed?

17
Have any modifications been made to the approved RAP?

18 Has the RAP been assessed to ensure it is suitable as first

planned?

19 Has senior management signed off the RAP when

completed?

20
Has the RAP been dated to show when it was completed?

21 Did the RAP fully address the incident’s remedial actions that were
required?

22 Did the RAP ensure we now comply legally with our

responsibilities?

23 Was the completed incident investigation form seen and signed off by
the CEO/GM?

24 Were the incident report forms completed at the time of the

incident?

25
Was the completed incident investigation form circulated to:

 involved personnel

 health and safety representative(s)

 the health and safety committee

 the team leader/front line manager

 CEO/GM?

26 List the actions still required to complete the investigation and the
RAP.


27
Is a further review required (evaluation) of this incident?

28
By when is this review required?