Cleaning Workplace Incident Report Form (New Zealand)

The Cleaning Workplace Incident Report Form is tailored for cleaning businesses in New Zealand, providing a structured way to document workplace incidents. This form is essential for site supervisors, team leaders, and office managers to record details about injuries, near misses, chemical exposures, and other incidents that may require follow-up with WorkSafe or ACC.

Key features include: • Incident snapshot for immediate reporting, including business name, report number, and details of the incident. • Immediate response guidelines to ensure safety and proper documentation. • Sections for evidence collection, witness logs, and decisions regarding notification to WorkSafe, clients, and insurers. • A root cause review and corrective action plan to improve safety protocols and prevent future incidents. This form is a crucial tool for compliance with New Zealand's Health and Safety at Work Act and helps ensure a safe working environment for cleaning staff.