Module 3 & 4 Assessment: Workplace Health and Safety Incident Report

This report details a workplace health and safety incident investigation involving a fall from a rooftop at a construction site. The student, acting as a WHS advisor, analyzes the incident, referencing the Model Work Health and Safety Legislation. The report addresses the PCBU's responsibilities, record-keeping requirements, and legislative obligations. It outlines the initial actions, investigation preparation, equipment, interview techniques, data sources, and legal advisors involved. The assessment includes collating investigation data, determining the type of notifiable incident, and securing the scene. Furthermore, the report presents a fishbone diagram, analyzes the collected data, and presents findings in a formal report with an executive summary, purpose, methodology, findings, witness statements, and a training matrix. The investigation highlights the lack of safety measures, contributing factors, and the need for improved workplace safety practices.

Participant Name: INSERT NAME HERE
Module 3 Assessment Task
Part B
You are required to complete Module 3 Part B as part of your Module 4 assessment, as you
require skills from both Modules.
Everything that occurs in the workplace, must be done in accordance with the law. In completing this task,
access the Model Work Health and Safety Legislation. With reference to the legislation, read the following
incident scenario and respond to the questions.
As a Workplace Health & Safety Advisor for Australia-Wide Construction you are responsible to ensure that work
activities and tasks are conducted safely and follow the WHSMS procedures.
You receive a telephone call from John Smith the Site Supervisor at 8 Pullen Avenue, a nearby site, advising that
there has been an incident on site. The incident occurred at 9:20 am.
Craig Turner was working with Bruno Romano (spotter) and was installing tiles on the second story roof when he
has fallen off the roof. The worker was not using a harness. The worker fell to the ground, landing upon a stack
of timber. He has sustained severe back injuries and received internal injuries.
An ambulance was called and the worker was admitted to St Mathew’s hospital.
The incident was observed by two other workers, one plant operator who was operating an excavator nearby and
the worker who was acting as a spotter for the excavator operator.
Answer the following questions in regards to the scenario:
a) Does the PCBU have any responsibilities to the regulator in relation to this incident?
In your response make sure you reference the relevant Acts/Regulations/guidance documents that provide
you with this guidance.
The PCBU have responsibilities over the regulator in accordance with the Work Health and
Safety Act, 2011. The act states that every employees need to be provided with proper work
place safety equipments to ensure that hazards at work place does not occur
b) How long will you need to keep records of this incident for?
In your response make sure you reference the relevant Acts/Regulations/guidance documents that provide
you with this guidance.
According to the Work Health and Safety Act, 2011, the records need to be maintained till
the time an employee leaves an organisation
c) Does the PCBU have any legislative responsibilities in relation to the scene of this incident?
In your response make sure you reference the relevant Acts/Regulations/guidance documents that provide
you with this guidance.
The PCBU need to make enquires based on the reasons behind allowing the employee to
work without any safety equipments. The reason for dispatching timber at a place that
require repairs also need to be taken into consideration as per the Work Health and Safety
Act, 2011

Participant Name: INSERT NAME HERE
d) In reviewing the relevant legislative/guidance documentation on how to respond to an incident, you
will now detail the actions against each step that the PCBU and you are going to implement in line
with the investigation action plan.
Response – What are your initial actions for response?
The initial action of response is to probe into the matter of the unsafe activities that is
conducted in the organisation. The reason behind the lack of equipments and the illegal
dumping of wastes need to be taken into consideration. At the same time, statements from
the witness will be taken.
Preparation and Planning
What documents will you have prepared for an incident investigation?
The documents that need to be prepared include:
Legal papers of the work health and safety acts
Documents related to the work health and safety act as per the organisation
Legal documents stating the importance of work health and safety
Witness forms
Identify six pieces of equipment you could include in your investigation kit:
1. Recording devices 4. Flashlight
2. First aid kit 5. Measuring devices
3. Paper and pens 6. Camera
Investigation Preparation
a) Explain the actions/processes you will apply to undertake the investigation:
An initial investigation need to be conducted regarding the overall safety practise of the
place. This will be followed by an investigation into the current problem that has occurred at
the work place. Witness signatures will be taken about the incident
b) List and briefly explain four interview techniques you will apply during your investigation:
Four interview techniques include:
1. Face to face interview technique
2. Telephonic interview technique
3. MSN messenger interview technique
4. E-mail interview technique
c) In the table below, list 4 sources of data. For each source, identify what data you will collect and
how you will collect it.
Source of data Data to be collected Data collection method
Primary Data Detailed account of the
incident
Interview method

Participant Name: INSERT NAME HERE
Secondary Data Knowledge about
legislations and work
safety acts
Books and journals
The Institute of Quantitative
Social Science
Files regarding previous
work place incidents
Visiting library or online
sources
General Social Survey Topics related to work
place and safety
Questionnaire method
related to demographic and
behavioural attitude
For each collection method, explain how will you ensure that you are collecting reliable data:
1. Make the witness sign the papers
2. Gather reliable source of collecting data
3. Verify from people involved in the incidents
4. Verify the responses with the survey records
d) You may seek legal advice during an incident investigation - List the legal advisors you may contact
during an incident investigation to help you understand the PCBUs responsibilities and legalities
around an incident investigation.
 Work health and safety commission
 The Government of the country
 The solicitors of the firm
 Investors
 Owners

Participant Name: INSERT NAME HERE
Module 4 Assessment Task
Part A
This assessment will be referring to the incident with Craig that we began to investigate in Module 3
Assessment.
Now that you have informed the PCBU of what actions are required to manage the scene and you have planned
your investigative processes, it is time to investigate why this happened. A Workplace Health and Safety
Incident Notification Form has been completed and will assist you with your investigation. In addition, you have
obtained the following information from site:
● Workers JSA for task being conducted
● Witness statements about incident
● Training records of all involved
Use the evidence taken from site and the table below to help organise and collate your information.
a) Complete the following table to collate your investigation data/information
What happened: an overview
● Provide an overview of what happened.
● Nominate the type of notifiable incident –
was it death, serious injury or illness, or
‘dangerous incident’?
The incident that happened in the work place
is that Craig had fallen from a rooftop while
trying to install files. This type of incident can
be notified as serious injury
When did it happen?
● Date and time
The incident occurred at 9:20 a.m
Where did it happen?
● Incident address
● Details that describe the specific location
of the notifiable incident – for example
section of the warehouse or the
particular piece of equipment that the
incident involved – to assist instructions
about site disturbance
The incident occurred at 8 Pullen Avenue. The
second story roof top was the location of the
incident and Craig did not have any safety
equipment to help him while he was
performing the work
Who did it happen to?
● Injured person’s name, salutation, date
of birth, address and contact number
● Injured person’s occupation
● Relationship of the injured person to the
entity notifying
The injured person was Craig Turner who was
working under Bruno Romano
How and where are they being treated (if
applicable)?
● Description of serious injury or illness –
i.e. nature of injury
● First aid initial treatment of serious injury
Craig had suffered from severe back injuries
and had received several injuries. An
ambulance was called so that the person is
admitted to the St Matthews Hospital for
treatment

Participant Name: INSERT NAME HERE
or illness
● Where the patient has been taken for
treatment
Who is the person conducting the business or
undertaking (there may be more than one)
● Legal and trading name.
● Business address (if different from
incident address), ABN/ACN and contact
details including phone number and
email.
The person conducting the business was John
Smith and the incident took place in 8 Pullen
Avenue
What should be done to secure the scene?
● Action taken to preserve the scene and
by who.
The scene needs to be secured so that no
person visits the place. It is important that
safety equipments are installed in the scene to
secure the work place
Who notified the Regulator?
● Notifier’s name, salutation, contact
phone number and position at
workplace.
● Name, phone number and position of
person to contact for further information
(if different from above).
The name of the notifier was John Smith the
site supervisor
Module 4 Assessment Task
Part B
We have now collected and compiled the data for this investigation, and we should now start analysing your data
to help you determine the contributing factors. You will need to present your formal report in professional
manner and you must include the following headings as detailed below.
a) You need to complete a fishbone diagram for the incident.

Participant Name: INSERT NAME HERE
b) Analyse all the collected data and make a determination of why the incident occurred
c) Prepare your findings and data into a formal report which should include:
1. Executive Summary – Key points from the following sections of the report
i. The purpose of the report is to analyse the work health related
incident that took place in 8 Pullen Avenue
ii. The findings of the analysis are that the place had improper safety
equipment and due to this reason, Craig had to suffer from injury. At
the same time it can be said that the managers had no regard to
health and safety of the employees as they were forced to work under
improper circumstances
iii. The summary of the findings is that 8 Pullen Avenue need to update
their health and safety measure without which it can be difficult for the
place to maintain its business. The lack of support from the employers
in regard to the safety of the business have been a major factor for the
cause of the injury
iv. The organisation need to device plans that can propel the safety of the
place. They need to develop a work environment that can be
beneficial to the people by abiding by the rules and regulations of the
Australian legal policy.
2. Purpose - The purpose of the report is to investigate the accident that took
place in 8 Pullen Avenue at 9:20 am. A man named Craig Turner had
severely injured himself while trying to fix a file on the second story roof top
without proper protective gears
3. Methodology -The source of information was reported by John Smith, the site
supervisor
i. The investigation into the incident was done by analysing the safety
equipments and measures in 8 Pullen Avenue. Furthermore, legal
documents related to the Work Health and Safety Act, 2011 was
presented to the people after taking statements from the witnesses
that had seen the incident.
4. Findings
i. At 9:20 am, a man named Craig turner had climbed upon a second
story rooftop with the intension of fitting a file. However, due to lack of
safety equipments like the harness, he fell from the roof onto a pile of
timber and suffered from severe injuries and internal injuries. Bruno

Participant Name: INSERT NAME HERE
Romano was spotting him. The incident was observed by other people
such as two other workers along with a plant manager
ii. The contributing factors to the incident were the fact that the
organisation and its employees had little regard for health and safety.
Craig from his part had to be blamed for not carrying any safety
devices and the spotter was responsible for not forcing Craig to do the
same
1. Witness Statements
a. The witness Craig fall from a second story roof top onto
a pile of timber while trying to a fit a file
2. Training Matrix
a. Two of the witnesses were workers, one was a plant
manager with the skill to operate excavator and the
other witness was a spotter, with the responsibility to
oversee the operations
iii. The findings are varied as the hospital in which Craig had been taken
that is the St Matthews Hospital had confirmed the accident and the
injury caused by Craig
5. Summary -
i. The contributing factor to the fall was the lack of safety equipment and
the lack of training. The spotter and the manager needed to provide
training to Craig and the workers
ii. The things in place were the pile of timber that should not have been
there, instead there needed to be a harness and a proper periphery
around the roof
iii. The omissions identified is the lack of time for providing training to the
employees
iv. The non-complaint activity includes the lack of regard to the safety of
the employees and the lack of place for the dumping of timber
6. Recommendations -
i. The root causes identified are the lack of training and the lack of care
to the health and safety of the people. The reoccurrence of the event
need to be prevented by following the legal sections stated in the
Work Health and Safety Act of Australia.
ii. The legislation under the Work Health and Safety Act, 2011 states that
every organisation need to have a proper working place so that it can
provide the employees with the required safety and take care of their
health
iii. The costs to implement the safety equipments can be around $10,000
iv. The resources that are required include, equipments officers, safety
officers, helmets, tanners, periphery around the roof, ladder, a suitable
place to dump solid and liquid wastes and fire extinguishers.
7. Appendices

Participant Name: INSERT NAME HERE

Participant Name: INSERT NAME HERE
Module 4 Assessment Task
Part C
You have now received advice back from the WH&S Committee that they have accepted the recommendations
that you made in your report. Now you need to develop a plan to implement these changes.
Complete the short table below to begin the plan for implementation.
What is the WH&S initiative to be
implemented?
The WH&S initiative to be implemented is
providing training both theoretical and practical
about the use of safety equipments and gears
What legislative or procedural information
relates to this initiative and why is this
initiative required?
The legislation required to be is the Work Health
and Safety Act, 2011. The reason to follow this
initiative is that it provides a better understanding
of the safety needs of the employees
Who does this initiative affect?
How does it affect them?
What are the impacts on the organisation
or the affected parties?
This initiative secures the lives of the employees
working in an organisation that require
manufacturing or constructing items. It provides
the workers with a compensation benefit for any
type of injury. The organisation or the affected
party can get compensation from the
Government if proven the legality of the accident
What resources (including external
providers) does the initiative require?
The initiative require the support from the
Government as well as support from the owners
of an organisation
When will the initiative be implemented? The initiative need to be implemented in the
organisation with immediate effect
Who will assist you implementing the
initiative, and how will they assist you?
The assistance will be provided by the health
inspectors by talking and motivating the
employees about the importance of safety in a
work place
Implementing initiatives forms part of any
continuous improvement process.
A) What continuous improvement
process does AWC use to
implement initiatives like this?
B) As part of that process how will
you obtain feedback (explain
which step/s your feedback
process fits within the continuous
improvement process used by
AWC
The AWC uses PDCA cycle for continuous
improvement the failing standards in
organisations. The feedback from the employees
can be collected using interview wherein the
interview can be done one at a time via email

Participant Name: INSERT NAME HERE
What consultative and participative
processes do you plan on using during the
implementation? How can managing these
processes positively help influence
change?
The consultative and participative process
includes interacting with the employees so that
feedback can be gained in a proper manner. The
managing of the process can be done by
monitoring the health of the employees on a
regular basis after every 3 months
Describe 2 objectives/duties you would like
to see added to all position descriptions for
staff working at AWC so safety behaviours
can be measured.
To implement a training course of health and
safety of the employees
To ensure every equipment is checked after
every 3 months
How will you ensure that all individuals and
teams contribute to the continuous
improvement process of reviewing the
initiative?
List at least two (2) methods of review. For
each, list how others will contribute and
how this will be monitored.
Two methods of review includes
Monitoring the work progress of the employees
and encourage every department of an
organisation to contribute for its cause
Coaching or mentoring is a common need
for anyone who is undertaking a task or
process for the first time - especially if it is
an ongoing process - this is no different for
continuous improvement.
For the two methods you listed above, how
might workers need coaching or mentoring
to support the process?
Then, explain how would you ensure that
this was effective coaching and mentoring.
The workers need to be coached by providing
archive footage of incidents that indicate ill health
and safety. The effectiveness of the coaching
process can be monitored by identifying the
progress made by the employees. This can be
done by a conducting a performance appraisal
method
Once you have implemented change,
managed continuous improvement
processes and received feedback, how
would you compare the effectiveness of
your improvements in comparison to the
original project/process?
Comparison can be made by analysing the
changes using statistical tools such as graphs to
compare past effort with present progress.