You are the newly hired Director of Human Resources and Occupational Health & Safety at the "Scoops Ahoy", a very large ice cream retailer and party venue located in Hawkins, Ontario. It houses a retail store, an ice cream production facility, a small bakery, and a kid's party facility. The workplace employees 120 workers.

Due to a large snowfall the day before, the manager Scott Harrington realized that they have a large amount of snow and ice on the sloped roof of the facility and is concerned about the roof caving in from the weight. On the morning of January 5, 2023, Scott assigns three workers from the bakery to go on the roof and shovel the snow off. Scott gives the workers rubber boots and plastic shovels and tells them to ensure that all the snow & ice is removed from the roof by the end of the day.

At approximately 1:30 pm one of the workers, Ms. Robin Buckley notices ice build-up on the edge of the roof and goes over to kick it down. As she walks over to the edge she slips and falls over the edge of the roof to the parking lot 40 feet below. Robin suffers a fractured skull, a broken left shoulder, 6 broken ribs, a broken left elbow.

Worker Information:

Ms. Robin Buckley

906 East 2^nd Avenue

Hawkins, Ontario

L4T 7Y1

Date of Birth: May 21, 2004

Date of Hire: January 3, 2021

Employer Information:

Scoops Ahoy Inc.

10 Old Highway 77

Hawkins, Ontario

L4T 1W4

If there is anything about the company that you don't know, make it up. As your organization has some big-name backers, money is no object but still stay within reason. (No personal jetsJ) Make sure that this program only applies to this specific workplace and not the entire organization or multiple workplaces. Remember you are writing this report for the management of your company and not for the facilitator at Algonquin College.

P.S. - This workplace will fall under the Ontario Occupational Health & Safety Act and not the Canada Labour Code. Also note that for this assignment the workplace would fall under the Industrial Establishments Regulations.

Complete the investigation report below

INCIDENT INVESTIGATION REPORT

This form is provided to employers for the purpose of documenting the employer's investigation into a workplace incident. Please attach a separate sheet if necessary.

Call Centre After-hours health and Fax Mailing address Phone 604 276-3100 safety emergency 604 276-3247 WorkSafeBC

Toll-free 1 888 621-SAFE (7233) Phone 604 273-7711 PO Box 5350 Stn Terminal

Toll-free 1 866 922-4357 (WCB-HELP) Vancouver BC V6B 5L5

Employer name Ms. Robin B		Employer number
Employer head office address
City	Province	Postal code

Incident occurred ref: s. 3.4(a) Occupational Health and Safety Regulation (OHS Regulation)

Address where incident occurred
City(nearest)	Province	Postal code
Date of incident(yyyy-mm-dd)	Time incident occurred	a.m. p.m.

Injured person(s) ref: s. 3.4(b) OHS Regulation

Last name	First name	Job title/Occupation
1)
2)

Witnesses ref: s. 174(4) Workers Compensation Act (WCA) and s. 3.4(c) OHS Regulation

Last name	First name
1)
2)
3)

Incident description ref: s. 3.4(d)-(e) OHS Regulation

Briefly describe what happened, including the sequence of events preceding the incident. Please refer to the "IncidentInvestigation Reference Guide" for assistance when completing this report. The guide is available onWorkSafeBC.com.

Workers' Compensation Board of B.C.

Incident Investigation Report (continued)

Employer name

Employer number

Analysis

From the sequence of events, identify what events may have been significant in this incident occurring. An analysis of these events will assist in determining the underlying or causal factors in the occurrence. Please refer to the "Incident InvestigationReference Guide" for assistance when completing this report. The guide is available onWorkSafeBC.com.

Statement of causes ref: s. 174(2)(a)-(b) WCA and s. 3.4(f) OHS Regulation

List any unsafe conditions, acts, or procedures that in any manner contributed to the incident. Please refer to the "IncidentInvestigation Reference Guide" for assistance when completing this report. The guide is available onWorkSafeBC.com.

Incident Investigation Report (continued)

Employer name

Employer number

Recommendations ref: s. 174(2)(c) WCA and s. 3.4(g) OHS Regulation

Identify any corrective actions that have been taken and any recommended actions to prevent similar incidents.
Recommended corrective action	Action assigned to	Completion date or expected completion date (yyyy-mm-dd)
1)
2)
3)
4)

Persons conducting investigation ref: s. 3.4(h) OHS Regulation

Representative of	Name(please print)	Signature (optional)	Date signed (yyyy-mm-dd)
Employer
Worker
Employer Worker Other

Date Incident Investigation Report submitted to WorkSafeBC ref: s. 175(2)(b) WCA

(yyyy-mm-dd)

Follow-up action and report

Section 176 of the Workers Compensation Act states:

2. Following an investigation under this Division, the employer must without undue delay undertake any corrective action required to prevent recurrence of similar incidents.
4. As soon as is reasonably practicable, the employer must make report of the action taken under subsection (1) and (a) provide the report to the joint committee or worker representative, as applicable, or (b) if there is no joint committee or worker representative, post the report at the workplace.

Note: If the recommended corrective actions specified in the report have been implemented by the time it was prepared and submitted to WorkSafeBC, and the report was subsequently distributed or posted as required, compliance with section 176(2) has been met. In cases where the incident investigation report was submitted prior to the corrective actions being implemented, or those actions differ from the corrective actions recommended in the report, a separate follow-up report must be prepared and distributed or posted, in accordance with section 176(2).

Please refer to the "Incident Investigation Reference Guide" for assistance when completing this report. The guide is availableonline atwww.worksafebc.com/forms/assets/PDF/52E40Guide.pdf.