- All incidents must be reported on the same day of the
occurring incidents.
- Faculty members witnessing the incidents or staff supervisors are
responsible for filing a report:
- Unsafe conditions, or near-misses: Use the "Hazard Report form (pink).
- Incidents with injuries or illness: Use the "Accident Injury and
Illness Report, UH Form 29" and the "Honolulu Community
College Incident Report."
- All students/employees suffer from injuries/illnesses, including
minor ones, must be directed to the Health Office (Lorri Taniguchi,
Health Nurse).
- If a student sustains an injury/illness in class, the instructor
must accompany the student to the Health Office. If the instructor
feel that it is necessary for him/her to stay in class, please
designate another student to accompany the injured student to the
Health Office.
- In case of a serious injury, such as heavy bleeding or loss of
consciousness, call 911 for an ambulance and immediate call the Health
Nurse (Ext. 282, 00), Security (Ext.142, Ext. 245) and Chulee Grove
(Ext. 478) to report the incident.
- Your decision may save someone's life. If you think that the
injured needs an ambulance, do not hesitate to call 911, even if the
injured refuses.
HONOLULU COMMUNITY COLLEGE UNIVERSITY OF HAWAII
HAZARD REPORT
DATE OF REPORT: _____________________________
HAZARD DESCRIPTION:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
HAZARD LOCATION:
_________________________________________________________________________
_________________________________________________________________________
HOW DO YOU THINK WE CAN CORRECT THE HAZARD(S):
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
WOULD YOU LIKE TO BE INFORMED OF THE ACTION(S) TAKEN?
NAME: ___________________________________________ TEL: ___________________
RETURN THIS FORM TO CHULEE GROVE'S MAILBOX, FACULTY MAILBOX ROOM, ADMIN
BUILDING. THANK YOU.
|