Conducting an Accident Investigation
Course 102
Safety Certified Supervisor Series

MODULE 7: WRITING THE REPORT

The Accident Report Form

• Section I. Background
• Section II. Description of the accident
• Section III. Findings
• Section IV. Recommendations
• Section V. Summary
• Section VI. Review and Follow-Up Actions
• Section VII. Attachment

Section III. Findings (continued)

• Sample primary surface cause finding statements
• Sample secondary surface cause finding statements
• Sample safety program implementation root cause finding statements
• Sample safety program design root cause finding statements

These findings describe one or more inadequate safety management system policies, programs, and processes in any of the seven element areas: commitment, accountability, involvement, identification/ control, incident/accident analysis, education/training, and evaluation. These "deep root causes" result in inadequate implementation of the safety management system.

• Conditions: Safety training policy statement does not exist. Safety training plan does not include policies and practices for employees working around high voltage line systems. The safety training plan does not include supervisor or manager level training on this subject.