Slip and Fall Questionnaire
4.8/5 with 89 votes
Table of Contents
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- Did you have sunglasses on or anything to obstruct your view at the time
- Do you wear prescription glasses or contacts and were you wearing them at the time
- Was the light on in the area where you were at
- What type of floor was it
- How wet was the floor
- What time was it when this incident occurred
- Was there a checklist for cleaning
- Were there any wet floor signs or caution signs
- When was the last time the area was checked prior to the fall
- Did you actually fall on the floor
- Did you brace yourself and How
- What was on the floor
- How did the incident happen
- What kind of shoes were you wearing
- How old or new were your shoes
- Do you still have those shoes
- Do you know if this spill was reported prior to you falling
- Were your clothes wet or damaged after the incident
- Was anyone else walking in the area prior to you falling
- Did manager and/or employee look at substance after you fell
- Was there an incident report done
- Who took the report
- Were there any witnesses to the incident
- What did you do immediately following the incident
- Did anyone help you after the incident and who
- Did the manager and/or employee acknowledge the spill and incident
- If it was a stranger, did you get their contact information
- Any prior accidents? Any Injuries
- Any prior S&F ? Any Injuries
- Any prior injuries such as birth defects or child hood injuries
- Did you or anyone else take any pictures
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Presented by:
Rachael
Stats
Views
38
Views: 38
Uses
2
Uses: 2
Tasks
31
Tasks: 31
Who it's for
This Slip and Fall Questionnaire is for teams that want consistent execution, less rework, and clear ownership.
- Standardize quality - run the same Slip and Fall Questionnaire steps every time, regardless of who executes
- Save time - reuse a proven Slip and Fall Questionnaire workflow instead of rebuilding processes from scratch
- Improve accountability - assign owners and see what's done vs. what's pending
- Onboard faster - use the Slip and Fall Questionnaire checklist as the SOP and training guide
- Coordinate across roles - handoffs are clear and everyone works from the same source of truth
How to use it
How to use this Slip and Fall Questionnaire:
- Start by saving it - save as a Template if you'll reuse it, or as a Checklist if it's a one-off project.
- Customize it once for your workflow - remove what doesn't apply and add your team-specific steps.
- Assign ownership and execute - set owners/due dates where needed and track completion as work happens.
- Reuse without rebuilding - when Slip and Fall Questionnaire comes up again, start from your saved version and run it with clear ownership.
Rate this Checklist
5 stars
Scores 4.80 with 89 votes