SCS Risk Management Guides for Schools Incident Investigation Reference Guide
Incident
Investigations
SCS Risk Management – Safety/Loss Control Services - (909) 433-0841 Rev: 09-0930 Page 2 of 6
SCS Risk Management Guides for Schools Incident Investigation Reference Guide
Some may not remember, but Jack Webb played “Sergeant Joe Friday” (LAPD badge number 714) along with “Officer Bill Gannon” (played by Harry Morgan) in the police detective television series, Dragnet. My all-time favorite line from the show was when Sergeant Joe was interviewing a female witness or victim he’d tell her when she began sharing opinions, “Just the facts, mam, just the facts.”
While your investigation need not take on the proportions of these fictional characters, proper incident investigation techniques are vitally important and significant to any current or future claims made against your district.
Our Risk Control Assistant and colleague, Daniel Mellon, put this resource together for your use. We are providing it to help you collect and organize facts from incidents at your district whenever people are injured or property is damaged.
We recommend that you always investigate incidents, collect factual information, and record it for current and future use. Doing this may help you reduce risk to your district and will help you improve district safety. An electronic version of the Supervisor’s Incident Investigation Report is available upon request.
Sincerely,
Safety Bill
SCS Risk Management – Safety/Loss Control Services - (909) 433-0841 Rev: 09-0930 Page 3 of 6
SCS Risk Management Guides for Schools Incident Investigation Reference Guide
Despite our best efforts, there are times when people are injured or property is damaged. When these events occur the excitement may cause even the most experienced person to forget the importance of preserving and gathering the required information. This documentation is vital if we are to: • Determine the root cause of the incident • Properly assign responsibility for the incident • Avoid repeating similar incidents in the future • Minimize financial exposure
This guide is provided for Members of the Southern California Schools Risk Management JPA and is intended to aid them in preparing to conduct a thorough incident investigation.
Who is responsible for conducting an investigation? When possible, the manager with responsibility for the area or for the person (or people) involved in the incident, should conduct the initial investigation. If not available, then another manager may accept the responsibility. Most importantly, someone needs to take charge and complete the investigation.
Incident investigation is often done in “layers.” Your investigation may not be the final one. Elements of your documentation may be included in a more in-depth investigation conducted by the district’s Risk Manager, your SCSRM JPA, an insurance carrier, or even the police. Regardless of who might investigate the incident, it is vital that the manager closest to the occurrence gather and preserve the initial information and evidence.
When do I need to perform an investigation? • When any individual reports an injury or illness. • When property is damaged. • When the unsafe act of a person (whether or not an employee) puts themselves or others at risk. • When someone tells you about a condition or practice that may create a liability for the Member (alleged harassment, molestation, etc.). • Near misses. If we can learn from our “almost” mishaps, we can help prevent them from becoming reality.
What do I do? Be calm and be prepared. Call “911” if appropriate. Assess the scene to make sure that you or others will not be placed at risk by entering the area. If it is safe to enter the area, attend to the medical needs of injured parties. Protect others from further danger, including exposure to blood borne pathogens. Have an investigation kit at the ready (see attached) including an investigation form and blank paper, pens, digital or disposable camera, etc. Take control of the situation. Calm others by demonstrating that you are in charge.
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SCS Risk Management Guides for Schools Incident Investigation Reference Guide
Preserve evidence: Make certain that the incident scene is not disturbed or contaminated. A well meaning employee may attempt to put things back in proper order, before you complete your investigation. Notify senior staff of the incident. Follow other district protocol as indicated. (If your district has defined protocol, it supersedes this document.) Interview witnesses: o If an injury is involved, interview the injured party as soon as possible. o Be meticulous in having them take you through even the most minor details. What may seem unimportant to them may well turn out to be the root cause. o Interview others who might have either witnessed the incident or can offer other helpful information. o Interviews should be conducted individually, not in groups. Avoid having others influence or intimidate your witness. o Workers sometimes “jump” to incorrect conclusions. Record their explanation of events, being careful to avoid opinions, searching only for facts. o Protect the privacy of those involved. Don’t discuss details of your interviews or the case in general with anyone without a legitimate need-to-know. Physical environment: o Take photographs generously and from several angles. o Note the time of day, unusual weather or other environmental conditions (e.g. humidity, cloudiness, or extreme heat). o Note other factors affecting equipment and facility conditions (e.g. grease spill on floor, a malfunctioning piece of equipment).
Once I’ve gathered the information, what do I do? • Complete the Incident Investigation form. Use the form provided by your district. Absent a district form, use the SCSRM JPA form. • Say it with pictures! Your narrative description is important, but photographs, diagrams, and other visual media help paint a clearer picture. • At its conclusion, attempt to clearly identify the most significant underlying (root) cause of the incident, not just the obvious one. Sometimes investigators accept the first answer they encounter. If that were the case in the following example (a, b or c), the more significant answers (d, e and f) might have been missed.
An example of determining root cause. An employee was ejected from a utility vehicle after colliding with a dumpster. The results of the investigation yielded the following: a. A witness reported the driver was driving carelessly. (Behavior) b. The driver was driving too fast. (Violation of Safety Rule) c. The driver wasn’t wearing a safety belt. (Violation of Safety Rule) d. The utility cart had a broken safety belt. (Equipment) e. The dumpster was improperly located in a traffic lane. (Engineering) f. The driver hadn’t been trained and certified to operate the equipment. (Training, Violation of Safety Rule)
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SCS Risk Management Guides for Schools Incident Investigation Reference Guide
Items a through e might all be true, and as part of the corrective action should all be addressed. Regardless, an untrained and non-certified operator (f) had no business operating the vehicle. Had he been trained properly, he may have avoided a through d, and probably would have recognized e. Lack of training is the underlying (root) cause. Additionally, if determined that the employee knowingly and willfully disregarded his unauthorized use of the vehicle, disciplinary action may be considered.
What do I do with the report when I’m finished? • Have it reviewed and approved by the site principal. • Provide one completed copy to the site principal. • Provide one completed copy to the person in the district who is responsible for submitting and managing claims.
Incident investigation is a vital component of a comprehensive safety program. If you have questions or concerns about the process, contact your district’s Risk Manager or the SCSRM JPA office at 909-433-0841.
Incident Investigation Toolkit
The following items are suggested contents for an Incident Investigation Toolkit. Time is of the essence in starting your investigation. Having these tools assembled in advance will aid you in quickly starting the process, and help you avoid having to search for them.
The Basics • Clip board • Incident Investigation forms • Extra paper (with grid background) • Pens and pencils • A camera: digital (preferred), disposable, or Polaroid • Tape measure
Optional (but helpful) • Flashlight • Gloves (surgical and work gloves) • Safety glasses • Dust mask • Yellow Lumber Crayon • Rolo-Tape • Yellow and black “Caution” tape • A ruler for drawings
SCS Risk Management – Safety/Loss Control Services - (909) 433-0841 Rev: 09-0930 Page 6 of 6
SCS Risk Management Guides for Schools Incident Investigation Reference Guide
SCS Risk Management – Safety/Loss Control Services - (909) 433-0841 Rev: 09-0930
Supervisor’s Incident Investigation Report
District:______Location / Site:
Supervisors name: Title:______
Address where incident occurred: ______
______
Name of injured employee:
Occupation:
Date of injury or illness: Time: AM PM
Was Nurse on Call contacted? Yes_____ No _____ Date and Time: ______
Was medical treatment recommended? Yes No Was treatment refused? Yes No
Was employee given a claim form (California form DWC 1)? Yes No
What type of medical treatment was given?
First Aid______Clinic______Emergency Room______Paramedics______Hospitalization______
Date last Was employee required to leave work due to this injury or illness? Yes No worked: Date Has employee returned to work? Yes returned: No, still off work
Name of person to whom the injury or illness was reported: _
Timeliness of reporting: If the accident was not reported immediately, why not?
Specific location: (e.g. northwest corner of Building G) where accident or exposure occurred:
_
WITNESS INFORMATION (use separate sheet for additional witnesses)
Name: Name:
Address: Address:
City/State/Zip: City/State/Zip:
Telephone: Telephone:
List property damage, if any:
______
(Continued on reverse)
SCSRM-301 Supervisor’s Incident Investigation Report Rev 07-0319
Body part injured (check all that apply and indicate left and/or right): Head Upper back Finger (which?) Ankle Face Lower back Upper leg Foot Eye Arm Lower leg Toe (which?) Neck Wrist Knee Other
Nature of injury or illness: Scrape Burn Fracture Cold-related problem Cut Sprain/strain Skin problem Loss of consciousness Puncture Foreign body Chemical-related problem Respiratory problem Bruise Poisoning Heat-related problem Other
What was employee doing at the time of injury or exposure?
Person, object or substance that directly injured employee:
Check any of the following possible causes which apply:
Haste/unsafe speed Improper procedure Unsafe lifting Not authorized Unsafe equipment usage Unsafe position Disregard of instructions Defective equipment/tools Running/jumping Lack of knowledge/skill/training Inattention Poor housekeeping Failure to use proper equipment Assault Act of other Inadequate protective gear Horseplay Physical disability Carelessness Alcohol/drugs Other
I know the injury occurred on duty. I have no specific knowledge that the injury occurred on duty.
What steps have been taken or recommended to prevent a recurrence?
Comments:
Supervisor's signature: Date:
Site Administrator’s signature:______Date:______
Fax This Document To The District Workers’ Compensation Representative Immediately SCSRM-301 Supervisor’s Incident Investigation Report Rev 07-0319