INCIDENT REPORT

FIRE INCIDENT IR No.: 000

Date: March 7, 2024

Time: 09:34
Location: Purok 3, Saray Iligan City

Event Type & Information

Injury or Illness Near Miss/Others Property Damage
Skin burn Description: Lost of houses
Airway Obstruction All things that burned including
Respiratory Failure documents
Respiratory Arrest Emotional Trauma
Struck by electricity/woods/heat Health Problems

Incident Details:

What: At first we see a too much smoke, we thought they were burning some dry leaf or waste materials
but then the fire occurs that’s the time we panic, tell all of our neighbor’s to evacuate call for
emergency response like fire station nearby, even we stop the fire from spreading but still there’s
a lot of damages cause by fire.
When: March 7, 2024
Where: Purok 3, Saray Iligan City
Who: Son of our neighbors
Root Cause Playing of candles and left it standing in their room when fell near the curtains that’s the fire occurs
Containment When we response at the fire incident we see a man that has a skin burn on his left arm so we put
Action: some ointment and apply bandaging, and also we apply splint to the person who struck by the
wood in his right foot, on the other side there’s a unconscious man we try to tap him but there’s no
response we realize that’s his not breathing i immediately apply CPR until he gain breathing and
check his pulse and it’s back to normal

Root Cause Analysis: (Check all applicable.)

Substandard Actions Substandard Conditions
Letting playing their kids of candles Houses made by woods
Negligence of parents squatter area
Lots of people lost their houses narrow roads
Trauma cannot immediately fine fire exit
cause of injuries tightness of way through their houses

Contributing Factors: (Check all applicable.)

Personal Factors Job Factors
Incapable of their doings Inadequate supervision
Lack of knowledge improper distance of houses
 unsafe behavior improper use of materials to build the house
No firewall

Accident/Incident
Type of Contact Contact With
Struck against Electricity
Struck by Heat
Caught in fire
Caught on Radiation
Caught between Caustics
Slip Noise
Fall on same level Toxic or noxious substances
Fall to below Dust
Over-exertion

Environmental Incident
Noise
Vibration
Contaminated Materials
Dust
Air Pollution
Water Pollution
Ecological disturbance
Agricultural
Archaeological

Corrective Actions:

Item No. Actions Who When Status

1 Conduct investigation Safety Team March 7, 2024 Closed

Disseminate to toolbox meeting

2 about Incident Reporting Safety Team March 7, 2024 Closed

3 Conduct Meeting with the OIC Safety Team March 7, 2024 Closed
Security

4 Conduct meeting of rebuilding the Safety Team March 7, 2024 Closed

houses and proper materials

5 Donating Clothes and foods and Safety Team March 7, 2024 Closed
other necessities

Recommendation:
1 Make sure that the houses is not close to each other make a proper measurements
2 Use a proper materials that cannot easily penetrate by the fire
3 Proper guidance of their children
4 Make sure that the path is easy to people to pass through

Prepared by: Xavier Ygay Date: March 7, 2024

 Checked by: Date:

Approved by: Date:

Attachment (Pictures/Documents)