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Incident Investigation Form Template for Malaysia

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Key Requirements PROMPT example:

Incident Investigation Form

"I need an Incident Investigation Form for our manufacturing facility in Penang, Malaysia, that specifically addresses machinery-related incidents and includes detailed sections for equipment inspection records and maintenance history."

Document background
The Incident Investigation Form is a crucial document required under Malaysian workplace safety regulations, specifically designed to comply with the Occupational Safety and Health Act 1994 and related DOSH guidelines. This form must be completed following any workplace incident, accident, or near-miss situation that could affect employee safety, property damage, or operational continuity. It serves multiple purposes: documenting the incident details, analyzing root causes, recording witness statements, outlining corrective actions, and maintaining compliance with Malaysian regulatory requirements. The form is essential for legal protection, insurance claims, and implementing preventive measures to avoid future incidents. It should be completed promptly after an incident occurs and requires input from various stakeholders including safety officers, department heads, and affected parties.
Suggested Sections

1. Incident Basic Information: Date, time, location, and type of incident

2. Affected Persons: Details of injured/affected individuals, including employees, contractors, or members of public

3. Incident Description: Detailed narrative of what occurred, including sequence of events

4. Immediate Actions Taken: Emergency response measures and immediate actions taken after the incident

5. Witness Information: Details and statements from witnesses

6. Investigation Findings: Analysis of direct and root causes of the incident

7. Property/Equipment Damage: Description and extent of damage to property or equipment

8. Corrective Actions: Immediate and long-term corrective measures to prevent recurrence

9. Investigation Team: Details of personnel conducting the investigation

10. Sign-off and Verification: Signatures of investigating team, management review and approval

Optional Sections

1. Environmental Impact Assessment: For incidents involving environmental damage or chemical spills

2. Medical Report Summary: For incidents involving serious injury requiring medical attention

3. Security Breach Details: For incidents involving security violations or unauthorized access

4. Production Impact Analysis: For incidents affecting production or operations

5. Third Party Involvement: For incidents involving contractors, vendors, or public

6. Regulatory Notification Details: For reportable incidents requiring authority notification

Suggested Schedules

1. Photographic Evidence: Photographs of incident scene, damage, or relevant conditions

2. Witness Statements: Detailed written statements from witnesses

3. Technical Reports: Equipment inspection reports, maintenance records, or technical assessments

4. Medical Reports: Detailed medical reports and treatment records

5. Risk Assessment: Pre-incident risk assessments and post-incident review

6. Training Records: Relevant training records of involved personnel

7. Incident Scene Diagram: Sketches or diagrams of incident location and contributing factors

8. Previous Incident History: Records of similar incidents or near-misses

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions






























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Relevant Industries

Manufacturing

Construction

Oil and Gas

Mining

Healthcare

Transportation

Logistics

Agriculture

Chemical Processing

Automotive

Electronics Manufacturing

Food Processing

Pharmaceutical

Utilities

Retail

Hospitality

Relevant Teams

Health and Safety

Operations

Human Resources

Legal

Compliance

Risk Management

Quality Assurance

Facilities Management

Security

Emergency Response

Environmental Health

Production

Maintenance

Relevant Roles

Health and Safety Manager

Operations Manager

Plant Manager

Site Supervisor

Risk Management Officer

Compliance Officer

Human Resources Manager

Department Supervisor

Quality Control Manager

Facility Manager

Production Manager

Security Manager

Emergency Response Coordinator

Environmental Health Officer

Line Supervisor

Maintenance Manager

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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