Incident Investigation Form Template for Ireland

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Key Requirements PROMPT example:

Incident Investigation Form

"I need an Incident Investigation Form for our manufacturing facility that complies with Irish HSA requirements for chemical handling incidents, including specific sections for hazardous material exposure and environmental impact assessment, with capability for digital signature collection."

Document background
The Incident Investigation Form is a crucial document required under Irish health and safety legislation, specifically designed to support organizations in conducting thorough investigations of workplace incidents, accidents, and near-misses. It aligns with the requirements of the Safety, Health and Welfare at Work Act 2005 and related regulations, providing a structured approach to gathering evidence, analyzing root causes, and determining corrective actions. This document should be used whenever an incident occurs that requires investigation, ranging from minor near-misses to serious accidents. The form ensures consistent documentation of key information including incident details, witness statements, environmental conditions, and follow-up actions, while maintaining compliance with data protection requirements. It serves as an essential tool for preventing future incidents and demonstrating regulatory compliance.
Suggested Sections

1. Incident Details: Basic information including date, time, location, and type of incident

2. Affected Persons: Information about all individuals involved in or affected by the incident, including employees, contractors, visitors, or members of the public

3. Incident Description: Detailed narrative of what happened, including sequence of events and immediate actions taken

4. Witness Information: Details of witnesses and their initial statements regarding the incident

5. Environmental Conditions: Description of workplace conditions, weather, lighting, etc. at the time of incident

6. Equipment/Materials Involved: Details of any equipment, machinery, tools, or materials involved in the incident

7. Immediate Causes: Identification of direct causes that led to the incident

8. Root Cause Analysis: Investigation of underlying systemic causes and contributing factors

9. Corrective Actions: Immediate and long-term actions to prevent recurrence

10. Investigation Team: Details of personnel conducting the investigation

11. Sign-off and Verification: Signatures of investigators, relevant managers, and health & safety representatives

Optional Sections

1. Medical Response: Details of first aid or medical treatment provided, used when injuries occurred

2. Environmental Impact: Assessment of environmental effects, used when incident involves spills or environmental hazards

3. Property Damage Assessment: Detailed evaluation of damage to property or equipment, used when physical damage occurred

4. Regulatory Reporting: Details of notifications to authorities, used when incident meets reporting thresholds

5. Union Representative Input: Comments from union representatives, used when incident involves unionized workers

6. Risk Assessment Review: Review of existing risk assessments, used when incident suggests need for risk assessment updates

7. Training Review: Analysis of training records and requirements, used when incident suggests training deficiencies

Suggested Schedules

1. Appendix A - Photographic Evidence: Photographs, diagrams, or sketches of the incident scene and relevant details

2. Appendix B - Witness Statement Forms: Detailed written statements from witnesses

3. Appendix C - Risk Assessment Templates: Standard forms for conducting post-incident risk assessments

4. Appendix D - Equipment Inspection Records: Relevant maintenance and inspection records for involved equipment

5. Appendix E - Training Records: Copies of relevant training certificates and records

6. Appendix F - Reference Documents: Relevant procedures, policies, or regulations referenced during investigation

7. Appendix G - Investigation Methodology: Description of investigation methods and techniques used

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions
Relevant Industries

Manufacturing

Construction

Healthcare

Transportation and Logistics

Retail

Education

Hospitality

Mining and Resources

Agriculture

Warehousing

Chemical Processing

Pharmaceutical

Food Processing

Public Sector

Energy and Utilities

Technology

Financial Services

Relevant Teams

Health and Safety

Operations

Human Resources

Risk Management

Quality Assurance

Compliance

Facilities Management

Production

Maintenance

Environmental Health

Security

Legal

Senior Management

Relevant Roles

Health and Safety Manager

Facility Manager

Operations Director

Production Supervisor

Human Resources Manager

Risk Manager

Department Head

Site Manager

Safety Officer

Quality Assurance Manager

Environmental Health and Safety Coordinator

Compliance Officer

Operations Manager

Plant Manager

Line Supervisor

Maintenance Manager

Project Manager

Senior Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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