HomeMy WebLinkAbout318 - Incidents Reporting Procedures CITY OF PASCO
ADMINISTRATIVE ORDERS
Administrative Order No. 318
Administrative and Community Service
Subject: "Incidents" Having Potential for Liability/Reporting Initial Effective Date:
Procedures 10/29/86
Revised 121 8
Approved
The following Administrative Order is effective December 2, 2008 and supersedes
Administrative Order No. 53 dated October 29, 1986.
I. PURPOSE:
To establish policy and procedures for the investigation and reporting of all incidents
having a potential for liability of the City to any person, including City employees.
II. DEPARTMENTS AFFECTED:
All
III. POLICY:
When a City employee is involved in, or observes any type of incident which could
become a claim, or could involve City liability, the following procedures shall be
followed.
IV. DEFINITION:
"An Incident" is something that happens which may result in someone alleging liability
against the City. When a City employee observes or is involved in an incident, the
following procedures shall be followed:
V. PROCEDURES:
A. Give prompt and appropriate assistance as indicated by any City policy,
departmental or division policy or emergency conditions. Call 911 for emergency
medical assistance if needed.
B. Record all details or the incident to include names, time, exact location, and your
observations on an incident report form (attached) or any other type of field
manual in your possession at the time. Be observant and accurate. This
information will be used by the adjuster if a claim is filed and possibly as an aid
to our attorney should a lawsuit result.
Take pictures if possible.
C. If an incident report form is not used at the time of the incident, you should fill
one out as soon as possible and forward it to your supervisor or the
Administrative and Community Services department. Administrative and
Community Services will retain a file of all incident reports and forward a copy to
the City's insurance agents.
I. When documenting an incident, record only facts, not opinions. If there is
additional information that should be considered but not put in writing,
indicate on the form for the Claims Adjuster or City Attorney to contact
you.
2. When the Claims Adjuster or Attorney contacts you, be honest in your
comments and supply them with all the information you have.
D. Serious incidents should be phoned to the appropriate personnel right away. In
the event of an incident involving serious injury, a fatality, or large property loss
occurring after regular working hours, Evergreen Adjustment Service may be
contacted directly using the 24-hour phone number of(800) 933-4235. Examples
of incidents that should be reported immediately:
1. Auto Fatality
2. Pedestrian Fatality
3. Downed Stop Sign Accident
4. Witnessed Trip &Fall
5. Jail Suicide
6. Police Shooting
7. Any Serious Injury Involving Member's Property or Personnel
8. Large Property Loss
9. Sewer Back-up
10. Water Main Break
E. Do not admit liability or state that the City will take care of the damages. Refer
all questions to Administrative and Community Services.
Do not discuss the incident with anyone other than your supervisor or other
authorized personnel. Every incident is a potential claim and statements made by
you could result in the City having to assume liabilities that are not warranted.
F. Upon learning of an incident, the Departmental Director or Division Manager
shall insure that an Incident Report Form is completed and submitted to
Administrative and Community Services within one (1) working day. The
supervisor must sign the Incident Report Form.
If any person calls the City regarding an injury or damage to their personal
property, they shall be referred to Administrative and Community Services.
G. Administrative and Community Services will file the appropriate Incident Report
Form with the City's insurance carrier or take other appropriate action and shall
keep and file a copy of all forms by reference to date, department, name of
potential claimant and type of incident.
Administrative Order 300—"Incidents"Having Potential for Liability/Reporting Procedures
Page 2
CITY OF PASCO
INCIDENT REPORT FORM
This report shall be completed by the person in charge at the time of the incident occurred or was discovered.
Information is to be recorded immediately and this form forwarded to Administrative and Community
Services. Attach additional sheets if more space is needed than is provided on this form.
Name(s)of Person(s) Involved: Age Address Phone Employee?
Y;N
1
2
3
4
Date of Incident: Time: J am ❑pm
Location(Be Specific):
Describe all acts and resulting conditions in detail:
If statements were made by the person(s) involved, witnesses or anyone else, identify the person and describe
their statement:
Were pictures taken? If so, who has them?
What corrective measures, or assistance(if any) did City Employee take:
WITNESSES: (other than those involved)
Name Addresses: Phone
1.
2.
Other:
Reported by: Department:
Date:
Department Director/Division Manager Date