Workplace Incident and Near-Miss Investigation Checklist
This workplace incident investigation checklist ensures compliance with OSHA 29 CFR 1904 Recordkeeping Requirements, ANSI/ASSP Z10.0-2019 Incident Investigation provisions, ISO 45001:2018 Clause 10.2 Incident Investigation, and NFPA 652 dust hazard investigation requirements. Designed for safety officers and EHS managers.
- Industry: General Industry / Security Services
- Frequency: Per Incident
- Estimated Time: 60-120 minutes
- Role: Safety Officer / EHS Manager / Incident Investigator
- Total Items: 9
- Compliance: OSHA 29 CFR 1904 Recordkeeping and Reporting, ANSI/ASSP Z10.0-2019 Incident Investigation, ISO 45001:2018 Clause 10.2 Incident, Nonconformity and Corrective Action, NFPA 652 Combustible Dust Investigation, OSHA 1904.39 Fatality and Severe Injury Reporting
Immediate Response and Scene Preservation
First aid, scene security, and initial documentation.
- First aid or emergency medical care rendered immediately?
- Incident scene preserved until investigation complete?
- Scene photographs taken from multiple angles before any changes?
- All witnesses identified and statements collected promptly?
Root Cause Analysis
Causal factor identification and systemic analysis.
- 5-Why or Fishbone root cause analysis completed?
- Immediate cause(s) identified (unsafe act and/or unsafe condition)?
- Root cause(s) identified (management system failures, training gaps, design issues)?
- OSHA recordability determination made and OSHA 300 log updated if applicable?
- Investigation Findings and Corrective Actions
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Why Use This Workplace Incident and Near-Miss Investigation Checklist?
This workplace incident and near-miss investigation checklist helps general industry / security services teams maintain compliance and operational excellence. Designed for safety officer / ehs manager / incident investigator professionals, this checklist covers 9 critical inspection points across 2 sections. Recommended frequency: per incident.
Ensures compliance with OSHA 29 CFR 1904 Recordkeeping and Reporting, ANSI/ASSP Z10.0-2019 Incident Investigation, ISO 45001:2018 Clause 10.2 Incident, Nonconformity and Corrective Action, NFPA 652 Combustible Dust Investigation, OSHA 1904.39 Fatality and Severe Injury Reporting. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Workplace Incident and Near-Miss Investigation Checklist cover?
This checklist covers 9 inspection items across 2 sections: Immediate Response and Scene Preservation, Root Cause Analysis. It is designed for general industry / security services operations and compliance.
How often should this checklist be completed?
This checklist should be completed per incident. Each completion takes approximately 60-120 minutes.
Who should use this Workplace Incident and Near-Miss Investigation Checklist?
This checklist is designed for Safety Officer / EHS Manager / Incident Investigator professionals in the general industry / security services industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.