Incident cause analysis method (icam) checklist

Template Information

Icam investigation report

Category: construction

Template Questions

  • Collect information and evidence of the incident and report your findings here.
  • Item detail
  • Photo evidence
  • List the activities and events leading up to the time of the incident, when the incident happened and
  • Date & Time Date
  • Activity
  • What happened?
  • Why did it happen?
  • Actual Consequence
  • Potential Consequence
  • The contributing factors of this incident were analyzed using the Incident Cause Analysis Method (ICA
  • Enter defences here
  • Absent or Failed Defences
  • Organisational factor type
  • Details of defence
  • Enter Individual or Team Actions here
  • Individual or Team Actions
  • Details of Action
  • Enter Task or Environmental Conditions here
  • Task or Environment Conditions
  • Details of Condition
  • Enter Organisational Factors here
  • Details of Factor
  • Enter Recommended Corrective Actions here
  • CAR detail
  • Enter Lessons Learned here
  • Lesson
  • ICAM Report Author