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OSHA + Cal/OSHA · 29 CFR 1904 (recordkeeping); CA T8 §3203(a)(5) (IIPP investigation)

Accident & Incident Investigation Program

The written program for investigating accidents, injuries, illnesses, near-misses, and property damage. Includes root cause analysis worksheets, witness statement forms, corrective action tracking, and OSHA 300 log alignment.

📄 22 pages· Microsoft Word (.docx)
Instant download
$295USD · one-time
22 pages · Microsoft Word (.docx)
Download link emailed the moment payment clears. Editable Microsoft Word source file, yours to reuse.
Regulatory anchor
OSHA + Cal/OSHA
29 CFR 1904 (recordkeeping); CA T8 §3203(a)(5) (IIPP investigation)
Also references: ANSI/ASSP Z16.2 · ISO 45001 §10.2

When this template is required

Required indirectly by OSHA 1904 (recordable injury/illness recordkeeping) and directly by CA T8 §3203(a)(5) (IIPP accident investigation). Workers compensation insurers, ISO 45001 management systems, and federal contractor safety programs all require systematic accident investigation.

Secondary citations:ANSI/ASSP Z16.2 · ISO 45001 §10.2

Why this template

Root cause analysis with 5 Whys + Fishbone

Investigations that stop at 'employee made a mistake' miss the system-level causes. The worksheet uses 5 Whys + Fishbone analysis to drive past surface causes to root causes — the only way to prevent recurrence.

Near-miss tracking included

Near-misses are 10-100x more frequent than recordable injuries and contain the same lessons. The near-miss report form encourages systematic reporting without the friction of treating it as a 'real accident.'

OSHA 300 log alignment

Investigations should feed the OSHA 300 log for recordable injuries. The program documents the determination process (work-related, new case, recordable, recording requirements per 1904).

Trend analysis built in

Individual investigations capture lessons from one event. Trend analysis (quarterly review of all investigations + near-misses) identifies systemic patterns that single investigations miss.

What you receive

  • Accident Investigation Program (Word .docx)
  • Incident report form (initial)
  • Investigation worksheet with root cause analysis (5 Whys + Fishbone)
  • Witness statement form
  • Photo documentation log
  • Corrective action tracking log
  • Near-miss report form
  • OSHA 300 log cross-reference
  • Trend analysis template (quarterly review)
Instant download

How you get it

This document is written and reviewed against the standard it cites, and it is ready now. The download link is emailed as soon as your payment clears.

STEP 1
You buy
Checkout takes a minute. We capture the email address the download link should go to.
STEP 2
It arrives
The download link is emailed the moment payment clears — no waiting, no back and forth.
STEP 3
You make it yours
Editable Microsoft Word. Fill in the site-specific fields, add your logo, and issue it. Written against 29 CFR 1904 (recordkeeping); CA T8 §3203(a)(5) (IIPP investigation).

Revisions included — if something about your operation changes what the document should say, reply to the delivery email and we will amend it.

Who buys this

  • Construction GCs and subcontractors
  • Manufacturing safety departments
  • Healthcare facility safety committees
  • Workers compensation claims management
  • Federal contractor accident reporting (EM 385-1-1)
  • ISO 45001 and ANSI Z10 management systems

Frequently asked

When should an accident be investigated?

Best practice: every recordable injury/illness, every property damage incident above a threshold (typically $1,000-$10,000), and significant near-misses. Some employers investigate every reported incident regardless of severity, on the principle that near-misses contain the same lessons as actual injuries. The program supports both threshold-based and universal investigation approaches.

What's root cause analysis?

Systematic investigation of the underlying causes of an incident, going beyond the immediate apparent cause. 5 Whys is the simplest: keep asking 'why' until you reach an actionable system-level cause. Fishbone (Ishikawa) is more structured: causes grouped into categories (People, Process, Equipment, Environment, Materials, Management). The worksheet supports both approaches.

How does this connect to OSHA 300 recordkeeping?

29 CFR 1904 requires employers (with 10+ employees in most industries) to record work-related injuries and illnesses on the OSHA 300 log. The accident investigation provides the data — whether the incident is work-related, whether it's a new case, what category to record. The program includes the OSHA 300 cross-reference to keep investigation and recording aligned.

Should we investigate near-misses?

Yes — best practice. Heinrich's pyramid (and modern equivalents) shows that near-misses far outnumber recordable injuries; the lessons are often the same. Investigating near-misses lets you prevent the actual injury that would have followed eventually. The near-miss form is shorter than the full investigation worksheet to lower the reporting friction.

Does this satisfy CA IIPP requirements?

Yes — CA T8 §3203(a)(5) requires the IIPP to include 'procedures for investigating occupational injury or occupational illness.' The Accident Investigation Program satisfies this element. It cross-references the IIPP and can be embedded as part of the IIPP or maintained separately.