酒店安全报告范本中英文对照

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1、安全报告员工口登记客人□未登记客人□安全事件□酒店编号：TJBHS事件编号：D・年月口受伤/事故报告发牛-日期//初次发现H期//时间具体位酒店名称报告完成日期//星期itel:和关员工姓名电话出生日期Milk社保号码男女电话SAP#DOH职位部门在当前岗位工作时间FTPT体重员工在以前的雇用经历（非本酒店）或前受伤、病史是否导致了事故/受伤的发生？事故发生前，当天工作小时数爭故发牛时是否用过酒精或药物？□是□否有她行纱物则试？□是□否受伤/事故信息受伤、事故描述（有必要可附额外说明材料）伤员是否同意急救？□是□否描述洒店提供的急救伤员冇否得到恰当的医疗？□是□否提供卜-列姓名、地址、医

2、生、医院、门诊部电话目击者姓名地址电话1.2.3.财产损失描述遗失或损坏的财产价值警署警察电话件号滑倒地面类型列出造成滑倒的原因（例如：油脂、绳索）？由于地而有水而导致滑倒？□是□否物料运输任务当受伤/事故发生时，所持举的物体重量1-5磅口16-30磅口超过30磅口器械使用情况（例如卡车）受伤/爭故发生前物体携带或移动的水平距离使用楼梯或梯子（圈一个）楼梯梯子阶梯数提交人员姓名（打印名）：职位：签字：日期：经理审核姓名（打印名）：职位:签名：日期:抄送：GMEAMCULF/BFCHRSECFOENGHSKPSECURITYREPORTASSOCIATE□REGISTERED□NON-RE

3、GISTEREDGUEST□SECURITYINCIDENT□HOTELCODE:TJBHSIncidentNo.:D-Mo/Day/YearINJURY/INCIDENTREPORTDATEOFOCCURANCE//DATEFIRSTNOTIFIED//TIMEOFDAYEXACTLOCATIONOFWHERELOSSOCCURREDHOTELNAMEADDRESSPHONE#SAP#DATEREPORTCOMPLETED//DAYOFWEEKPARTYORASSOCIATEINVOLVEDIFASSOCIATENAMEPHONENUMBERDATEOFBIRTHADDRESSSSNM

4、ALEFEMALEDOHOCCUPATIONDEPARTMENTLENGTHOFHOURSWORKEDONDAYOFINCIDENT(PRIORTOINJURY)?FTPTWEIGHTPRIMARYLANGUAGEDIDASSOCIATEJSPREVIOUSEMPLOYMENT,OFF-SITEACTIVITIES,ORPRIORINJURIES/ILLNESSCONTRIBUTETOACCIDENT/INJURIES?NUMBEROFHOURSWORKEDONDAYOFINCIDENT(PRIORTOINJURY)?POSSIBLEALCOHOLORDRUGUSEATTIMEOFINC

5、IDENT?□YES□NODRUGTESTADMINISTERED?□YES□NOINJURY/INCIDENTINFORMATIONDESCRIBEINJURY/INCIDENT(ATTACHADDITIONALPAGEIFNEEDED)DIDINJUREDPERSONAUTHOORIZEFIRSTAIDTREATMENT?□YES□NODESCRIBEFIRSTAIDTREATMENTADMINISTEREDBYHOTELDIDINJUREDPERSONRECEIVEOFF-PROPERTYMEDICALTREATMENT?□YES□NOPROVIDENAMEANDADDRESSOF

6、DOCTOFVHOSPITAL/CLINICPHONENUMBERWITNESSESNAMEADDRESSPHONENUMBER1.2.3.PROPERTYDAMAGE/LOSSDESCRIBEMISSINGORDAMAGEDPROPERTYVALUERESPONDINGPOLICEDEPT.RESPONDINGPOLICEOFFICERPHONENUMBERCASENUMBERSLIPANDFALLTYPEOFFLOORSURFACELISTANYOBJECTSORSUBSTANCETHATCONTRIBUTEDTOTHEFALL(i.e.,grease,cords,etc.)DIDF

7、OOTWEARCONTRBUTETOTHEACCIDENT?□YES□NOMATERIALHANDINGTASKSWEIGHTOFOBJECT(S)BEINGLIFTED/HANDLEDWHENINJURY/INCIDENTOCCURRED1-5LBS□16-30LBS□OVER30LBS□IDENTIFYMECHANICALEQUIPMENTUTILIZED(i.e.,cart)HORIZONTALDISTANCEOBJECTCA