Accident Incident Reporting Treeaining Course - FSO

Accident and Incident Reporting
V2. 1.8.2016
Objective
The purpose of this training is to provide employees with the
knowledge on when and how to report an accident or incident by
following the requirements outlined in Section 1.5 of Safetys Accident
and Incident Reporting Procedures.
Accident and Incident Reporting Procedures

General Overview
- Provides Safety with an opportunity to learn from events

- And to prevent similar events in the future
All incidents are required to be reported immediately

- From employee to the supervisor
- Then from the supervisor to the incident Hotline
Accountability
- Manager whose operation or employee who is involved is responsible for

initiating an accurate incident investigation of;
-
-
-
-
Employees
Contractors
Sub-contractors
Vendors

Reporting is a 9 step process
- Step 1 Evaluate, treat and/or transport
- Loss of Consciousness, seizure or disorientation is indication of injury may be
life threating and will require transport for medical evaluation
- After contacting 911 and taking interim precautionary measures immediately
notify SolarCity Incident Team
- Step 2 After initial assessment contact SolarCity Incident Team at (650)

963-5678
- They will advise the best method for treatment and/or transport in the advent
of first aid or non-life threating injuries

- Step 3 Assess the scene
- Verify no other employees are injured and are safe
- Account for all crew members
- Step 4 Secure the scene for accident the investigation

- Do not move or disturb items except to aide injured employee
- Or prevent harm to other employees or first responders
- Step 5 Take photographs of entire area

- Use multiple angles, as many as possible.

- Step 6 Discussion; do not discuss incident or accident with anyone not
under contract
- Do Not say No Comment
- State that the investigation is on going and information will be released when
completed
- Refer all questions to Director of Corporate Communications
- Step 7 Complete an Accident Investigation Report

- Master Incident Report completed by all managers of employee involved
- Employee Statements completed by all employees involved in an incident
- Witness Statements completed by all witnesses to an incident

- Step 8 Obtain statements from actual witnesses
- Step 9 Safety Management in collaboration with legal will review the
investigation report with the following:
- Manager, supervisor and affected employee
- Recommended corrective actions will be discussed
Incident Hotline (650) 963-5678

Incident Hotline

Incident Types
- Near Miss event where no injury or property damage occurred but it is
out of the ordinary
- Example: tool is dropped or slipped off from height but no person is struck or
property is damaged
- Property Damage regardless how minor or who owns the property, if

damage is noticed it must be reported
- Thermal Events MUST be reported immediately to following groups:
- Corporate Safety,
- Legal Team
- Incident Hotline

Incident Types
- Motor Vehicle all accident where a vehicle is being operated by a driver
and not in a legally parked position will be reported if it resulted in
-
-
-
-
Property damage
Injury
Illness
Legal citation or warning from law enforcement agent or official
- Definition of Legally Parked varies by city, county or state jurisdictions

- It is advised that a Motor Vehicle event is limited to any situation where the
driver is behind the wheel and the engine is on.
- Example: driver is rear-ended at a stop light or sign as it is not legally parked

Incident Types
- Injury & Illness both on and off duty are reported
- Determination for work related on non-work related reporting will be done by
Incident Management Team
- Emergency room visits needs to be called in IMMEDIATELY
- First Aid administered on site will be reported
- Whether first aid kit contents were used or not
- Fatality work related on non-work related fatalities shall be reported

IMMEDIATELY
- Reporting will be determined by Incident Management Team, Corporate Safety
and Legal

Incident Forms
- The Safety Grid Page Accident and Incident Reporting Procedures
Links to
Incident
Forms
Links to Incident
Repor2ng
Informa2on

Master Incident Forms completed by manager of employee
Select the proper
Incident Type from
drop down list
Select the proper Status

from drop down list
"ATTORNEY CLIENT COMMUNICATION -- WORK PRODUCT PREPARED AT REQUEST AND DIRECTION OF COUNSEL"
&YQMBJOXIBUZPVSFNFNCFSGSPNUIFJODJEFOUBOEUIFTFRVFODFPGFWFOUTMFBEJOHVQUPUIFJODJEFOU

&WFSZCPYPOUIJTGPSNOFFETUPCFDPNQMFUFQSJPSUPTVCNJUUJOH
Witness Form
All Fields must be lled in

prior to submi@ng form
Witness Statement
Phone #
Employee Name
Office
Department
Job #
Job Address
Hire Date
Job Title
Manager
Crew
Date Of Incident Time Of Incident Time Clocked In Time Work Began
&YQMBJOXIBUZPVSFNFNCFSGSPNUIFJODJEFOUBOEUIFTFRVFODFPGFWFOUTMFBEJOHVQUPUIFJODJEFOU
The form must be signed

and dated
I declare this is a true and factual statement of the events as I believe they happened.
Witness Signature:
Date:
All boxes in the form must be

lled in prior to submi@ng

Employee Incident Forms
&WFSZCPYPOUIJTGPSNOFFETUPCFDPNQMFUFQSJPSUPTVCNJUUJOH
Was there an injury?

/P:FT QSPWJEFXIJDICPEZQBSUXBTBGGFDUFECFMPX
Where did the incident occur:
Employee Incident Report

Phone #
Employee Name
Office
Department
Job #
Hire Date
Job Title
Manager
Crew
What tool, equipment, material and or chemicals were you using when the incident occurred?
Specify the activity you were performing when the incident occurred. (loading, moving, driving, pulling,
reaching, climbing, etc.)
Date Of Incident Time Of Incident Time Clocked In Time Work Began
Job Address
What steps could have been taken to prevent the incident.
Explain what you remember from the incident and the sequence of events leading up to the incident:
The form must be

signed and dated
*EFDMBSFUIJTJTBUSVFBOEGBDUVBMTUBUFNFOUPGUIFFWFOUTBT*CFMJFWFUIFZIBQQFOFE
Employees Signature
Top Half of Form
Was there an injury?

/P:FT QSPWJEFXIJDICPEZQBSUXBTBGGFDUFECFMPX
Where did the incident occur:
All boxes in the form must be

lled in prior to submi@ng
Date:
BoDom Half of Form
INCIDENT HOTLINE
(650)963-5678

Accident Incident Reporting Treeaining Course - FSO

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Accident and Incident Reporting

Accident and Incident Reporting Procedures

- Provides Safety with an opportunity to learn from events

All incidents are required to be reported immediately

- Manager whose operation or employee who is involved is responsible for

Accident and Incident Reporting Procedures

- Step 2 After initial assessment contact SolarCity Incident Team at (650)

Accident and Incident Reporting Procedures

- Step 4 Secure the scene for accident the investigation

- Step 5 Take photographs of entire area

Accident and Incident Reporting Procedures

- Step 7 Complete an Accident Investigation Report

Accident and Incident Reporting Procedures

Incident Hotline (650) 963-5678

Accident and Incident Reporting Procedures

Accident and Incident Reporting Procedures

- Property Damage regardless how minor or who owns the property, if

Accident and Incident Reporting Procedures

- Definition of Legally Parked varies by city, county or state jurisdictions

Accident and Incident Reporting Procedures

- Fatality work related on non-work related fatalities shall be reported

Accident and Incident Reporting Procedures

Accident and Incident Reporting Procedures

Select the proper Status

Accident and Incident Reporting Procedures

All Fields must be lled in

Date Of Incident Time Of Incident Time Clocked In Time Work Began

The form must be signed

All boxes in the form must be

Accident and Incident Reporting Procedures

Was there an injury?

Employee Incident Report

Date Of Incident Time Of Incident Time Clocked In Time Work Began

What steps could have been taken to prevent the incident.

The form must be

Top Half of Form

Was there an injury?

All boxes in the form must be

BoDom Half of Form

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