INCIDENT REPORT

INCIDENT REPORT TERMS

Read through the following section before continuing
PURPOSE:

To report any incident which needed to be handled through HR office and/or the disciplinary, counseling, or grievance system.

GOAL:

To handle all work-related problems encountered in a professional way, have it resolved and recorded for future reference.

PROCEDURE:

1. Reporting Problems/Complaints:

1.1 Must be recorded via the online incident report form.
1.2 Not accepted via telephone, e-mail, WhatsApp, or SMS.
1.3 Must be reported within 24 hours.

2. Completing the Online Incident Report Form:

Must be filled out in full, including:

2.1 Clear dates
2.2 Times
2.3 Places
2.4 Names

3. If the Issue is Resolved by the Area/Branch/Department:

The manager/supervisor must submit a full report detailing:

3.1 The process followed.
3.2 The outcome.
3.3 Their signature confirming resolution.
3.4 The completed forms must be sent to HR for recording and filing in the accused employee’s file.

4. If the Manager/Supervisor Cannot Resolve the Issue:

4.1 The ONLINE incident report form must be completed by the supervisor/manager.
4.2 The form will be escalated to HR via the Jotform system for further handling.
4.3 Once the process is completed:HR will send a summary/letter of the outcome to the manager/supervisor.
4.4 The manager/supervisor must explain the outcome to the complainant and/or accused.
4.5 Relevant parties must sign off on the outcome.
4.6 HR will determine the confidentiality level of the complaint and decide who needs to be informed.

5. If the Complaint Leads to a Disciplinary Hearing:

5.1 The supervisor will act as the complainant.
5.2 The complainant will serve as a witness in the hearing.
5.3 HR will issue a Notice of Disciplinary to the manager/supervisor to deliver to the accused.
5.4 After the hearing, HR will determine the confidentiality level of the complaint and decide who needs to be informed.

INCIDENT DETAILS
Parties Involved
Name of Complainant*
Email of Complainant*
COMPLAINT AGAINST SUPERVISOR

Should this complaint be against the supervisor, please leave the "Name of Supervisor" and "Email of Supervisor" blank
Name of Complainant's Supervisor*
Email of Supervisor*
Name of Accused*
Date of Incident (IMPORTANT)*

DayMonthYear
Names of Witnesses*
Add "None" if no witnesses were present
Details of Incident

All information added to this section must come directly from the complainant's experience and may not be reworded by someone else.
Nature of Offence (Based on Company Rules & Reguations) *
Select multiple options by holding "CTRL" and clicking on multiple options
Where did the incident occur? (Names of places)*
How did the incident occur - give full details with dates, times, places and people involved*
Was the incident reported before completion of this IR form? To whom was it reported? *
Was any action taken ? *
If Action was taken - by whom?
If Action was taken - what action (all documentation MUST be uploaded?
DOCUMENT UPLOAD

Please note that this form has restrictions for the upload of supporting documents:
1. Each document cannot be larger than 500KB
2. Only 10 documents can be uploaded.
Should you need to send more documents, please email them directly to HR at ALL of these email addresses: marietha@wisani.co.za, mark@wisani.co.za, nthabisengmpiti@wisani.co.za , freek.engelbrecht@wisani.co.za with the Incident Report Number as the Subject
Document Upload

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Upload any supporting documents and photos here or email them directly to HR | Max size per file: 500KB, Max 10 files per submission Cancelof

SIGNATURES
Complainant
Complainant Signature

Clear
COMPLAINT AGAINST SUPERVISOR

Should this complaint be against the supervisor, please leave the Supervisor name and signature blank
Supervisor
Supervisor Signature

Clear
Date

DayMonthYear

Should be Empty:

INCIDENT REPORT TERMS

INCIDENT DETAILS

Parties Involved

Details of Incident

SIGNATURES