Templates
Business Checklists
Event Checklist
Business Startup Checklist
Marketing Checklist
Sales Checklist
SEO Checklist
Project Management Checklist
Personal Checklists
Moving Checklist
Wedding Checklist
Baby Checklist
Groceries Checklist
Travel Checklist
Cleaning Checklist
Checklist Forms
Slip and Fall Questionnaire
Useless
Poor
Ok
Good
Excellent
Excellent.
Scores 4.75 with 89 votes
Safety
31 tasks
By
Rachael
Table of Contents
Save
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
Save
Useless
Poor
Ok
Good
Excellent
Excellent.
Scores 4.75 with 89 votes
Share via:
Twitter
,
LinkedIn
,
Facebook
,
Whatsapp
11 views today
1 uses today
Table of Contents
Template
Print
Downloads
Related Templates
Related Checklists
Home Maintenance Checklist
By Nicole Nichols-West
Workplace Hygiene Checklist
By Jake R Brady
Related Checklist Templates
First Aid Kit Checklist
By Lauren Meir
Workplace Safety Checklist
By Alex Strickland
Network Security Checklist
By Alex Strickland
Focus Funnel Technique
By Checklister
More Checklist Templates
"Slip and Fall Questionnaire" not suitable?
Search the World's largest free library of checklist templates
