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Health & Safety Mgmt

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Accident Investigation Form

Accident Investigation Form
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Job Safety Analysis (JSA/JHA) Form
Job Safety Analysis (JSA/JHA) Form
Page 1
Job Information
JSA ID
Date
Date
dd-mm-yyyy📅
Time
--:--🕘
Prepared by
Hazards & Controls
Task / step being analyzed
Hazards identified
Existing controls
Additional controls required
Risk level
Low
Medium
High
Attachments (SOPs / photos)
Drag & drop files, or click to upload
SOP-Line3-Guard.pdf before-photo.jpg
Approval
Supervisor approval
Valid till
Date
dd-mm-yyyy📅
Time
--:--🕘
Status
Draft
Approved
Closed
✓
Submission complete · JSA approved
Routed to supervisor · valid till 31 May
AI JSA Review Live
Steps analyzed
0
High-risk tasks
0
Confidence
0%
Time saved
0m
What Knowella found in this JSA Job Safety Analysis · David Miller
!
High-risk task — Line 3 conveyor guard replacement
Requires additional controls + spotter before work begins.
!
Working-at-height hazard listed — confirm harness inspection date
PPE noted, but last inspection date isn't attached.
✓
LOTO & machine guarding captured as existing controls
Stored-energy hazard addressed in the plan.
✓
Supervisor approval & sign-off recorded
Reviewed by supervisor — status set to Approved.
✓
Valid-till date set (expires 31 May 2026)
JSA will auto-flag for renewal before expiry.
✦ Knowella AI
✓
SOP attached & crew notified for Line 3
Spotter assigned · harness recheck requested
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