Get Supervisor Investigation Form - Ecsu

Filling out the Supervisor Investigation Form - Ecsu is an essential step in documenting and addressing employee accidents or injuries. This guide will provide you with a clear, step-by-step approach to efficiently complete the form online.

Follow the steps to complete the Supervisor Investigation Form - Ecsu.

1. Click the ‘Get Form’ button to obtain the Supervisor Investigation Form - Ecsu and open it in your preferred digital editor.
2. Begin by entering the employee's name in the designated field, followed by the date of the injury and the department or division the employee belongs to.
3. Fill in the supervisor's name and the job title of the employee. Additionally, provide a contact phone number for the supervisor.
4. Indicate the date you were notified of the accident and conduct the date of your investigation. Make sure to circle whether this notification took place in the AM or PM.
5. Record the employee's shift and start time for the workday, detailing the specific time of the injury.
6. List any witnesses present during the incident. Be sure to attach a statement for each witness provided.
7. Detail any medical treatment provided to the injured employee, including names, titles, and contact phone numbers of those involved in the care.
8. Describe the events leading up to the injury and the circumstances surrounding it in the section provided. This description will help clarify the context of the incident.
9. Specify whether personal protective equipment (PPE) was required for the task and list any that were used, including checking whether PPE was in use at the time of the injury.
10. Document any objects, equipment, or substances that may have contributed to the injury and identify factors that may have caused the accident.
11. Assess whether the findings align with the employee's account of the incident. If not, provide a description that differs from the employee’s perspective.
12. Outline actions taken to prevent similar occurrences in the future and make detailed recommendations for the Safety and Health Director or Committee.
13. Ensure to sign the report as the supervisor and obtain the initials of the department head or area administrator. Prepare any necessary attachments, including witness statements.
14. After completing the form, save your changes, download it for your records, share it with necessary parties, or print a hard copy for submission.

Complete the Supervisor Investigation Form - Ecsu online today to ensure a thorough and timely response to workplace incidents.