not commence work on a site if they are alone and should never attempt removal or relocation of heavy machinery or fittings without a colleague to check safety precautions are correctly in place. Emergency services attend the site and John’s arm is freed from the cabinet. He is taken to RPA hospital where he requires major surgery. This is followed by 12 months of rehabilitation. Full use of John’s arm is never restored.Richard is the supervisor of the team that John belongs to. He needs to deal with the incident and take appropriate action to prevent a recurrence in the future. Richard’s team has received WHS training for their role as per the policies of the organisation; however, this incident proves that not everyone is always complying with WHS policy and procedures.
Crown Institute of Business and Technology Pty LtdABN 86 116 018 412 National Provider No: 91371 CRICOS Provider Code: 02870D North Sydney Campus: 116 Pacific Highway North Sydney NSW 2060 Tel: +612 9955 0488 F 02 9955 3888 Sydney CBD Campus: Level 5, 303 Pitt St Sydney NSW 2000 Tel: +612 8959 6340 F 02 9955 3888 Canberra Campus:Suite 1, Level 4, 40 Cameron Avenue, Belconnen ACT 26 17 Tel:+612 6253 5184 BSBWHS401 Assessment 2 v2.1Page 4of 5Fill out the Incident form for John’s accident. Incident Reporting Form Details of person injured or involved(to be filled in by person injured or involved) Person Completing Report:___________________________ Date____________ Person(s) Involved:__________________________________ Person(s) job title:___________________________________ Event Detail Date of Event:___________________ Location of Event:___________________________ Time of Event:___________________ Witnesses:_________________________________ Description of Event (Describe tasks being performed and sequence of events) _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Was event/injury caused by an unsafe act (activity or movement) or an unsafe condition (machinery or weather?). Please explain: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ TO BE COMPLETED ONLY IF LOST TIME/IMJURY OR FIRST AID WAS REQUIRED Type of injury sustained: Cause of lost time/injury or first aid:
Crown Institute of Business and Technology Pty LtdABN 86 116 018 412 National Provider No: 91371 CRICOS Provider Code: 02870D North Sydney Campus: 116 Pacific Highway North Sydney NSW 2060 Tel: +612 9955 0488 F 02 9955 3888 Sydney CBD Campus: Level 5, 303 Pitt St Sydney NSW 2000 Tel: +612 8959 6340 F 02 9955 3888 Canberra Campus:Suite 1, Level 4, 40 Cameron Avenue, Belconnen ACT 26 17 Tel:+612 6253 5184 BSBWHS401 Assessment 2 v2.1Page 5of 5Was medical treatment necessary? Yes____ No:____ If yes, please name the hospital or physician Signature of Employee __________________________________________ Date ______________________ Signature of Supervisor _________________________________________ Date _______________________
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New South Wales, Pitt St Sydney NSW, Canberra, North Sydney Campus