Incident and Hazard Report Form
v2.1
Purpose. This form is completed for every injury, near miss, hazard, security event, aggressive customer event, food safety event or property damage at any Marketplace site or in any vehicle.
1.When to use this form
Complete this form on the day the event occurs or the hazard is noticed. Use it for injuries to team members or customers, slips and spills, cuts, manual handling strains, theft and shoplifting, aggressive or abusive customers, food safety events, equipment failures and vehicle incidents. A near miss with the potential for injury is reported in the same way.
2.Who completes it
The team member involved or the person who saw the event completes the first sections. The supervisor completes the immediate action section and enters the report in the WHS and security incident register within two hours. The People, Safety and Loss Prevention Manager assigns the investigation and closes the record.
3.Customer injuries
Where a customer is injured, offer first aid, record their name and contact details with their consent, record what they say happened, preserve the area and any CCTV, and do not admit liability or discuss compensation. Refer the customer to the store manager.
4.Notifiable incidents
A death, serious injury or illness, or a dangerous incident must be reported to the regulator immediately by the store manager or the People, Safety and Loss Prevention Manager and the site preserved until the regulator advises otherwise.
5.Follow-up
Every report receives a risk rating, an investigation proportionate to the risk and corrective actions with an owner and due date. The supervisor will tell the reporter what action was taken. Trends are reviewed at the quarterly safety committee.