Incident and Improvement Report

Documents what happened, who was affected and which steps were taken once an incident occurred. It logs the issue category, injuries to up to two people, property damage, witnesses and the corrective actions with an owner and a deadline. Serves quality and workplace safety teams that follow each case through to closure.

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In the Claude connectors directory

Date

Reported by

First Name

Last Name

Client or Customer

Location

Category of issue

Description

Actions Taken

Cause and Recommendations

Was an injury sustained?

Injured person 1

First Name

Last Name

Person 1: position

Details of injury: person 1

Person 1: length of employment

Person 1: age

Injured person 2

First Name

Last Name

Details of injury: person 2

Person 2: position

Person 2: length of employment

Person 2: age

Actions taken at the scene

First aid was given The area was secured Emergency services were called The supervisor was notified Equipment was shut down Photographs were taken

Describe any property damage

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Witness 1

First Name

Last Name

Witness 1 phone

Witness 1 address

Street Address

City

State / Province

ZIP / Postal Code

Witness 2

First Name

Last Name

Witness 2 phone

Witness 2 address

Street Address

City

State / Province

ZIP / Postal Code

Further Action

Corrective and Preventative Actions

Person responsible

First Name

Last Name

Deadline

Results of action

Was the issue resolved?

Date resolved

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