School Accident Investigation Report

School Accident Report

• School Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Incident Date

• Incident date & time

  Date

Reported By

• Name of person who initially reported the accident?

Incident Detail

• Injured persons name

• Person type

  Staff

  Contractor

  Student

  Visitor

• Incident location

• Immediate medical treatment given

• Further medical treatment required

  Yes

  No

• Details of further treatment received.

Incident Description

• Describe how the accident happened?

• Was the incident foreseeable?

  Yes

  No

• How was the incident foreseeable?

Photographs of the Scene

• Add media

  Media

Accident Causation

• What was the immediate cause of the accident?

• What were the underlying causes of the accident?

Corrective and Preventative Actions

• Actions taken at the scene?

• Actions taken to prevent recurrence?

• Who took these actions and when were they taken?

• What further corrective actions need to be taken?

Reporting Actions

• Is the incident/accident reportable under RIDDOR?

  Yes

  No

• Under what grounds is a RIDDOR report required?

• Has the RIDDOR report been made?

  Yes

  No

Investigation Sign Off

• Signed

  Sign

• Date

  Date