Process alert discovered

What Shift?

What area?

Probable responsible associate (Where to begin investigation)

Process Discovered - Need details of the process alert.

Enter any pictures as verification and validation

Initial Investigation on the event - Ask the 5 Whys What was found, order number, plate number

responsible person to complete POST INVESTIGATION (team leader?)


Is there a controlled standard for this process (WI, Verbal instruction, process map etc...)

List details of investigation need details again, Why Why Why Why Why

Associate responsible

Enter pictures of incident if different from initial investigation

Deviation or variation discovered

If variation or deviation is revealed in post investigation, COMPLETE the following

In there own words, what will the associate do differently to avoid repeat? OWNERSHIP of INCIDENT

Associate signature
Team Leader signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.