The Incident Investigation Form is a crucial document required under Saudi Arabian workplace safety regulations, particularly aligned with the Saudi Labor Law (Royal Decree No. M/51) and OSHAD requirements. This document must be completed following any workplace incident, accident, or near-miss situation that could affect employee safety, property, or environmental integrity. It serves multiple purposes: documenting the incident details, analyzing root causes, establishing corrective actions, and meeting regulatory reporting requirements. The form is designed to capture all necessary information required by various authorities including the Labor Office, GOSI, and relevant safety inspection bodies. It plays a vital role in risk management, continuous improvement of safety protocols, and maintaining compliance with Saudi workplace safety standards.
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1. Incident Information: Basic details including date, time, location, and type of incident
2. Affected Persons: Information about individuals involved in or affected by the incident, including employees, contractors, or visitors
3. Incident Description: Detailed narrative of what occurred, including sequence of events
4. Immediate Actions Taken: Description of emergency response and immediate measures taken after the incident
5. Witness Statements: Accounts from people who witnessed or were involved in the incident
6. Root Cause Analysis: Investigation findings identifying primary and contributing causes
7. Environmental/Property Impact: Assessment of damage to property or environmental effects
8. Corrective Actions: Measures to be implemented to prevent recurrence
9. Investigation Team: Details of personnel conducting the investigation
1. Medical Report Section: Required when the incident involves injury or health impacts
2. Equipment/Machinery Investigation: Required when incident involves equipment failure or malfunction
3. Chemical/Hazardous Material Details: Required for incidents involving dangerous substances
4. Security Incident Details: Required for incidents involving theft, violence, or security breaches
5. Environmental Impact Assessment: Required when incident has potential environmental consequences
6. Third Party Involvement: Required when external parties or contractors are involved
1. Appendix A - Photographic Evidence: Photos, videos, or visual documentation of the incident scene
2. Appendix B - Investigation Methodology: Detailed description of investigation methods and procedures used
3. Appendix C - Witness Statement Forms: Standardized forms containing detailed witness accounts
4. Appendix D - Technical Reports: Specialist reports, lab analysis, or technical assessments
5. Appendix E - Risk Assessment: Updated risk assessment following the incident
6. Appendix F - Relevant Documentation: Pre-incident procedures, maintenance records, training records, etc.
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