Safety Playbook

SAFETY INCIDENT REPORT FORM

In the event of an accident, there are specified time frames within which the trade partners/suppliers must notify OSHA, depending on the type of injury that occurred. Call the nearest OSHA office, or if the incident occurs after hours, call the OSHA 24-hour hotline at 1.800.321.6742. Please refer to the chart below.

If any accident or incident occurs on the job site, small or large, it is the responsibility of the Site Manager to immediately fill out a safety incident report form, located in the Century Toolbox. This form is required to be completed if any of the following events occur: • Injury or Death

INJURED WORKER

- Trade Partners/Suppliers - Buyer/Prospective Buyer - Homeowner - Visitor • Employee Injury (Workers Comp) or Death • Company Property Damage or Theft

REPORT TO OSHA WITHIN 8 HOURS

YES

Was it fatal?

INSTRUCTIONS:

• Prior to filling out the safety incident report form: - Call 911 (if necessary) - Administer CPR/First Aid (only if certified) • Immediately notify your direct manager and Division Safety Officer (DSO) • Refer to the Century Toolbox home page to fill out the safety incident report form

NO

Was the worker admited to a hospital?

YES

• Fill out the form to the best of your ability. Please only provide factual information, and not opinions. This must be submitted within 24 hours of the incident. If hospitalization or a fatality occur, the report must be submitted within 2 hours of the accident. Focus on gathering as much information as you can. After receiving your submission, if there is anything missing, we may contact you to get more details. • Should the media, press, or an outside agency request information, direct all inquiries to your Division President or Division Manager, who will then contact our Legal team • Log the incident on SiteDocs (see page 37 for details)

NO

REPORT TO OSHA WITHIN 24 HOURS

Was there an amputation?

YES

NO

Did someone lose an eye?

YES

NO

NO OSHA REPORT REQUIRED

SAFETY PLAYBOOK | Reporting Incidents | 33