Incident investigation report

The incident report captures what happened on the day; the investigation report is the follow-up that finds WHY and fixes it. Use this form to reconstruct the sequence, gather evidence, get past the immediate cause to the root cause, and assign corrective actions that actually prevent a repeat. Blaming a worker is not a root cause.

CompanyJobsiteDate

Incident investigation report

Company: ____________

Jobsite: ____________

Date: ____________

Incident summary

	Date/time of incident and of this investigation: ____________	N/A · Action
	Location and project: ____________	N/A · Action
	People involved and their roles: ____________	N/A · Action
	Reference to the first-response incident report / case number: ____________	N/A · Action
	Investigation team (not just the supervisor of the area): ____________	N/A · Action

What happened (the sequence)

	Step-by-step timeline leading up to the incident	N/A · Action
	The task being performed and whether it followed the JHA or safe work procedure	N/A · Action
	What was different about this day (people, equipment, conditions, time pressure)	N/A · Action

Evidence gathered

	Photos of the scene and equipment	N/A · Action
	Witness statements collected (separately, promptly)	N/A · Action
	Documents: JHA, training records, inspection logs, SDS, maintenance records	N/A · Action
	Physical evidence preserved	N/A · Action

Contributing factors

	Task/procedure: was there a safe procedure and was it usable and followed?	N/A · Action
	Equipment/materials: condition, guarding, maintenance, right tool for the job	N/A · Action
	Environment: weather, lighting, housekeeping, other trades	N/A · Action
	People/training: competent, trained, fit for the task, adequately supervised	N/A · Action
	Management systems: was the hazard identified, controlled, and checked?	N/A · Action

Root cause

	Ask "why" repeatedly past the immediate cause to the underlying system gap	N/A · Action
	Immediate cause (the unsafe act or condition): ____________	N/A · Action
	Root cause (the system that allowed it): ____________	N/A · Action
	Note: "employee was careless" is not a root cause; ask why the system let it happen	N/A · Action

Corrective actions (in the hierarchy of controls)

	Elimination or substitution where possible	N/A · Action
	Engineering controls (guards, ventilation, barriers)	N/A · Action
	Administrative controls (procedure, training, supervision)	N/A · Action
	PPE where still needed	N/A · Action
	Each action: owner, due date, and how completion will be verified: ____________	N/A · Action

Follow-up and sign-off

	JHA / safe work procedure updated to reflect the findings	N/A · Action
	Lessons shared with the crew (toolbox talk) and other sites where relevant	N/A · Action
	Recordable/reportable status confirmed (OSHA 300 log; 8h/24h reporting if applicable)	N/A · Action
	Investigation reviewed and signed by management: ____________ date ____________	N/A · Action

Completed by: ____________________

Signature: ____________________

tailgatedocs.com · Free printable form. Not legal advice; adapt to your jobsite.

Common questions

▸What is the difference between an incident report and an investigation report?

The incident report is the immediate record: what happened, injuries, whether it must be reported to OSHA, and first actions. The investigation report is the follow-up that determines the root cause and assigns corrective actions so it does not recur. You do the report first, the investigation right after.

▸Which incidents should be investigated?

All recordable injuries and significant near misses at a minimum. A serious near miss is worth the same investigation as an injury, because the only difference was luck. Match the depth of the investigation to the potential severity, not just the actual outcome.

▸What makes a good root cause?

A root cause points to a system that can be fixed: a missing procedure, an unguarded machine, inadequate training, a hazard never assessed. "The worker was careless" stops the investigation too early. Keep asking why until the answer is something the organization controls.

A finding that a JHA was missing or wrong is common. Generate a corrected, task-specific JHA in minutes.

Forms record what happened on the job; the JHA, safety plan, or written program is what a GC, prequal portal, or inspector asks to see. Generate a verified, job-specific one in minutes.

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