Have there been similar near misses prior to this one? Section D How Can This Be Avoided in the future? What preventative measures can be practiced to avoid future occurrences? Discontinue Activity Train employees Train supervisors Redesign workstation Redesign task/process Routinely inspect for hazard Enforce existing policy Closer supervision Other:___________________ Section E Follow-up Training How will you go about conducting follow-up training to prevent this occurrence from happening again in the future? ____________________________ ___________________ Employee Signature: Date: ____________________________ ___________________ Supervisor Signature: Date: ____________________________ ___________________ Investigator Signature: Date: Attachments: Photos, drawing etc.
Have there been similar near misses prior to this one? Section D How Can This Be Avoided in the future? What preventative measures can be practiced to avoid future occurrences? Discontinue Activity Train employees Train supervisors Redesign workstation Redesign task/process Routinely inspect for hazard Enforce existing policy Closer supervision Other:___________________ Section E Follow-up Training How will you go about conducting follow-up training to prevent this occurrence from happening again in the future? ____________________________ ___________________ Employee Signature: Date: ____________________________ ___________________ Supervisor Signature: Date: ____________________________ ___________________ Investigator Signature: Date: Attachments: Photos, drawing etc.