Get Fl Fdacs-01510 2016-2026

The FL FDACS-01510 is an essential form used for documenting incidents or accidents within the Florida Department of Agriculture and Consumer Services. This guide will provide clear, step-by-step instructions to help users complete the form online efficiently and accurately.

Follow the steps to complete the form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully enter the accident date in the designated field, ensuring the format is correct.
3. Record the reporting date, which should correlate with when you are completing the form.
4. Input the full name of the employee involved in the incident, starting with the last name followed by the first name.
5. Specify the job title of the employee to provide context about their role.
6. In the space provided, detail how the incident or accident occurred. Use additional sheets if necessary to fully articulate the events.
7. Indicate the county where the incident took place, ensuring accurate geographical identification.
8. Record the county of domicile for the involved employee.
9. Answer whether medical treatment was required for the employee post-incident.
10. Describe the exact location where the event occurred to provide precise context.
11. List the names of any witnesses who were present during the incident.
12. Complete the section about the person filling out the report, including their name and signature, followed by the date of completion.
13. In the management section, provide the name and position of the person completing that section of the form.
14. Answer whether the person completing the report is trained in accident investigation and detail any equipment involved.
15. If applicable, indicate whether a job safety analysis (JSA) exists for the equipment and the date the last JSA was performed.
16. Document whether similar incidents have occurred before and whether they involved the same individual or location.
17. Note if the scene was visited during the investigation, along with the date and time of the visit, if applicable.
18. Complete the primary unsafe act and condition sections by selecting the relevant issues from the provided options and offering detailed explanations.
19. Fill out the immediate and long-range actions to prevent recurrence, specifying any additional assistance needed.
20. After finishing the form, save it with a unique filename that includes the incident date, employee name, and division or bureau name. Ensure a completed copy is kept on file and sent to the proper safety coordinator.

Take action now: Complete your FL FDACS-01510 form online!