Free Safety Incident Rubric HR

In our commitment to fostering a safe workplace, this Safety Incident Rubric serves as a comprehensive guide for evaluating and addressing incidents. By utilizing standardized criteria, we aim to consistently assess the nature and severity of incidents, facilitating prompt and effective responses to ensure the well-being of our employees.

Category 1: Incident Severity

1.1 Severity Level

• Minor (No injuries or near misses, minimal property damage)

• Moderate (Minor injuries, moderate property damage)

• Major (Serious injuries, significant property damage)

• Critical (Life-threatening injuries, catastrophic property damage)

1.2 Impact on Operations

• No Impact (No disruption to operations)

• Low Impact (Minor disruption, easily manageable)

• Moderate Impact (Partial disruption, requires intervention)

• High Impact (Severe disruption, significant loss)

Category 2: Root Cause Analysis

2.1 Immediate Cause

• Human Error

• Equipment Failure

• Unsafe Conditions

• Unknown

2.2 Contributing Factors

• Lack of Training

• Inadequate Equipment Maintenance

• Inadequate Safety Procedures

• Communication Breakdown

• Other (Specify): _______________

Category 3: Incident Response

3.1 Initial Reporting

• Timely (Reported promptly)

• Delayed (Not reported immediately)

3.2 Documentation

• Comprehensive (Detailed incident report)

• Incomplete (Key details missing)

3.3 Corrective Actions

• Immediate Corrective Action Taken

• Corrective Action Planned

• No Corrective Action Taken

Category 4: Employee Involvement

4.1 Employee Compliance

• Employee followed safety procedures

• Employee violated safety procedures

• Employee not trained in safety procedures

4.2 Employee Reporting

• The employee reported the incident

• The employee did not report the incident

• Employees afraid to report the incident

Category 5: Communication and Follow-Up

5.1 Notification

• All relevant parties notified

• Incomplete notification

5.2 Follow-Up

• Investigation completed

• Investigation pending

Category 6: Preventive Measures

6.1 Preventive Actions

• Immediate preventive measures taken

• Preventive actions planned

6.2 Training and Awareness

• Additional training provided

• Training plan developed

Category 7: Compliance and Accountability

7.1 Compliance with Policies

• Incident handled in accordance with policies

• Policy violation identified

7.2 Accountability

• Accountability determined

• No accountability established

Category 8: Recommendations and Lessons Learned

8.1 Recommendations

• Recommendations for improvement made

• No recommendations provided

8.2 Lessons Learned

• Lessons learned documented

• No lessons learned identified

Overall Assessment:

• Incident Closed

• Incident Under Review

• Further Investigation Required

• Escalation to Legal/Authorities

Additional Comments:

Confidentiality Note:

The information contained in this Safety Incident Rubric is confidential and intended solely for internal use within [Your Company Name]. It is essential that all personnel reviewing this document adhere to strict confidentiality guidelines and not disclose any incident-related information to individuals or entities outside of the organization, except as required by law or authorized by the appropriate authorities.

Unauthorized distribution, sharing, or discussion of this information may compromise the integrity of our incident response process, infringe upon privacy rights, and violate applicable laws and regulations.

All HR professionals, managers, and employees entrusted with access to this document are expected to exercise the utmost discretion in handling and safeguarding this sensitive information.

By accessing or using this document, you acknowledge your understanding of the confidentiality requirements and your commitment to upholding the principles of confidentiality outlined herein.

[Your Company Name]

October 04, 2056

HR Templates @ Templates.net