CMR US Internal Audit - Accident/Incident Investigation

• CMR UK Internal Audit Report Form

• Conducted on

  Date

• Auditor

  Select P O'Donnell S Williams D McKeown W Moffatt L Kilburn P Anderson L Oliver S Taylor S Bond L Kilburn P Anderson

  • P O'Donnell
  • S Williams
  • D McKeown
  • W Moffatt
  • L Kilburn
  • P Anderson
  • L Oliver
  • S Taylor
  • S Bond
  • L Kilburn
  • P Anderson

• Auditee

  Select P O'Donnell S Williams D McKeown W Moffatt L Kilburn P Anderson L Oliver S Taylor S Bond L Kilburn P Anderson

  • P O'Donnell
  • S Williams
  • D McKeown
  • W Moffatt
  • L Kilburn
  • P Anderson
  • L Oliver
  • S Taylor
  • S Bond
  • L Kilburn
  • P Anderson
• Location
  Address

• Is there a defined accident and incident policy?

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

• Please gather evidence of a recent incident investigation. Is evidence of the below available?

  Select Accident records Clear responsibilities RIDDOR Reporting Witness statements Interviews Root cause analysis Risk assessment review Corrective and preventative actions Time frame of the investigation

  • Accident records
  • Clear responsibilities
  • RIDDOR Reporting
  • Witness statements
  • Interviews
  • Root cause analysis
  • Risk assessment review
  • Corrective and preventative actions
  • Time frame of the investigation

• Was corrective and preventative action effective?

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

• Were any changes effectively managed and implemented?

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

• Were the workforce consulted with regards any changes made? Please provide evidence

  Yes

  No

  N/A

• Are all actions complete?

  Yes

  No

  N/A

• How are incident investigation documents stored and controlled? Are they satisfactory?

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

Further Evidence

• Additional findings<br>

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

• Additional findings<br>

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

• Additional findings<br>

  Major Non-conformance

  Minor Non-conformance

  Opportunity for Improvement

  Meets Requirement

  Good Practice

Sign Off

• Auditor

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• Auditee

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