Incident Reports / Form
Hazard and Near Miss Report
A simple report for hazards and near misses observed during home care service delivery.
Who it is for
Workers and coordinators who need to record hazards before they become incidents.
When to use it
Use when a worker identifies an unsafe condition, near miss, access issue, environmental hazard, or equipment concern.
What this template helps with
Clear worker notes
Consistent records
Easier follow-up
Example content
Hazard details:
- Date:
- Location:
- Hazard or near miss type:
- Observed by:
- Client informed:
Description:
- What was observed:
- Potential risk:
- Immediate action taken:
- Photos or evidence stored:
Follow-up:
- Coordinator notified:
- Action required:
- Owner:
- Due date:
- Review completed:
Disclaimer
These resources are provided for general operational documentation and educational purposes only. They do not constitute legal, clinical, medical, compliance, or professional advice. Organisations should review and adapt all documents according to their own policies, procedures, registration requirements, funding arrangements, and regulatory obligations.