PURPOSE: To outline the steps to be taken for a Safety Incident.

POLICY: RMIS strives to provide its employees with a safe and healthful workplace environment. A separate Safety and Health Program manual is provided to every employee and every employee must follow all safety procedures and guidelines contained within the manual. Violations of the safety procedures and policies as contained within the Safety and Health Program manual are grounds for disciplinary action, including possible termination, at the discretion of RMIS.

It is ultimately the responsibility of each Supervisor to report all incidents to the Safety Manager and cc: Managing Member ASAP. When an employee completes a Safety Incident Report, it is the responsibility of the Supervisor to make sure every space is filled out on the report. When you leave spaces blank it causes our office to call you to verify that you intended to leave the question blank or just forgot to answer it. So please don’t leave blank spaces.

When a safety incident occurs you must call the Safety Manager to inform him/her of the incident, if he/she is not available you can speak to a Managing Member. Do not wait until the Safety Incident Report is completed to call.

Usually when a safety incident takes place the other parties involved will begin calling the office right away. Knowing the incident has occurred before we begin receiving calls helps us to communicate appropriately with all other parties. Also if you fax a report without calling there is a chance the information will not get to the appropriate person. If you call first we will be looking for the Incident Report.

FAX Report to: 1-303-789-9357

Once the Incident Report is complete, fax it immediately to the Safety Manager or the Director of Operations. We will report it to Human Resources and a Managing Member. He/she will advise everyone of the next steps to be taken.

*This procedure is separate from the minor Safety Violation process.

Please remember all incidents must be reported the same day as they occur!

PROCEDURES

1. Every safety incident will be investigated by the immediate supervisor and the Safety Manager to determine cause and prevention, and your responsibility to report them when they occur regardless of the severity.
a. All Safety Incidents must be reported within regulatory agencies time limits; State and Federal within eight (8) hours and clients/RMIS within twenty four (24) hours.

2. Complete the Safety Incident Report form immediately. This report requires you to obtain information from the others involved in the incident. The form must be completed in its entirety. If the other individuals involved have more questions or concerns direct them to call the corporate office and speak to the Safety Manager or a Managing Member. Otherwise inform them that our Corporate Office will contact them within a day or two.
a. Evidence such as people, list of personnel, materials involved and recording environmental factors such as weather, illumination, noise and physical factors such as fatigue, age and medical conditions, positions of equipment, physical location must be secured, preserved and collected through notes, photographs, witness statements and impounding equipment.
b. Witness interviews and statements must be collected, interviews, location for interviews and training for interviews should be reviewed annually. Follow up interviews are encouraged.
*If a question does not apply please write N/A in the space provided. Do not leave blank spaces.

3. The Safety Incident Report form is divided in to the following sections:
a. Report by Person Involved
1. Describe how the incident occurred
2. Safety Rules and Procedures
b. Causal Factors
c. Other Individuals Involved/Witnesses (Where Applicable)
1. Description of Incident
2. Additional comments or observations
d. Report By Investigator/Supervisor
1. Immediate corrective action taken
2. Additional remediation efforts to prevent future recurrence
3. Comments
e. Investigator/Supervisor Signature
f. Supervisor Statement
g. Employee Statement

4. Submit the report to the Safety Manager and cc: a Managing Member

5. Direct Supervisor coordinates the employee Drug Screen & Alcohol Test ASAP

6. Notify Human Resources if employee is injured to begin Worker’s Compensation procedures

7. Safety Manager begins investigation using the Accident/Incident Investigation Report form

8. Safety Manager submits final Accident/Incident Investigation Report and the Safety Incident Report to:

Bob DeHerrera – Director of Operations
Managing Member – Charles Wigglesworth, Ernie Wigglesworth
Lesley Hernandez – Human Resources