J's Creamery

Step 1 of 7

What happened?

Select the incident type and severity.

🩹

Employee InjuryAccident or near-miss

🚫

HarassmentBullying, rumors, misconduct

👤

Customer IncidentComplaint or confrontation

🔒

TheftFraud or cash issue

🏗️

PropertyDamage or hazard

⚠️

Policy ViolationDress, attendance, conduct

🍦

Food SafetyContamination or temp issue

📋

OtherDoesn't fit above

Severity*

Step 2 of 7

Who's filing this?

Your information as the person submitting this report.

Full Name* Your Role* Contact Number Date of Report Submit anonymously

Anonymous reports are reviewed but may limit follow-up.

Step 3 of 7

Who's involved?

The person this incident is about.

Name or description* Their Role

Harassment reports are taken seriously. Be as specific as possible with dates, times, and exact quotes.

Nature of Misconduct

Has this happened before?

Injury Details

Body Part Affected Medical Attention

Witnesses

Step 4 of 7

When & where?

Date, time, and location of the incident.

Date of Incident* Approximate Time Location* Location detail

Describe what happened*

Step 5 of 7

Evidence

Check anything that exists and note where to find it.

Where to find it

Step 6 of 8

Actions taken

What happened immediately after the incident.

Immediate Response

Was Trey notified? Return to work comfort Anything else to add?

Step 7 of 7

Follow-up & Sign

Recommended next steps and your certification.

Certification & Signature

By signing I confirm this report is accurate and truthful.

Sign below*

Printed Name*

Submitting...

Report Submitted

Dirt & Worms Quart

$0

J's Creamery Location and Hours