An important aspect of accident, incident or a near miss response is reporting the it for future reference. If one of these occurs on your property, the office staff, Pastor or Principal must be sure that there is a report. It should be completed for every accident, incident or near miss and filed with all pertinent information. A list of the names and phone numbers of witnesses should always be included, as well as photos of the site where the incident took place (prior to any needed repairs being done). If there is a claim presented later, or a lawsuit filed, there should be enough information in the file to begin the investigation of the case.

This following information is required.

  • Document all details of the incident; who, what, when, where, why
  • Collect the names of the victims and witnesses.
  • Record victims and witnesses accounts.
  • Take photographs of the incident site – slips, trips and falls do no
    always “just happen.”
  • File a police report.
  • Incident reports are for DSJ internal use only.

Property Damage, Auto, Cyber, Student and Volunteer Incident Report

Diocese of San Jose Incident Report

Please use the link below to fill out the incident report and submit to the Chancery Office – Loss Control & Prevention Coordinator theresa.lavoun@dsj.org within 24 hours.

Employee Injury – Contact Department of Human Resources

Workers’ Compensation