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PUBLIC FACILITIES, RECREATION &
SPECIAL EVENTS DEPARTMENT
POLICY NUMBER 1.7
ACCIDENT REPORTING PROCEDURE
7/1/2007
4/13/2009; 8/1/2013; 2/5/2021
Section 1 – Administration
I. PURPOSE
To provide employees and supervisors standard procedures to be completed when an employee,
participant or volunteer is injured and/or is involved in an accident while on the job. This procedure
also covers vehicular accident reporting.
II. EMPLOYEE ACCIDENT/INJURY PROCEDURES
A. The following steps are to be followed when an accident and/or injury occurs at work.
1. If employee is injured, call the CorVel, workers’ compensation claims administrator,
24/7, to report the injury at 877-764-3574 option 1
a. For less than life or limb threatening injuries/illnesses, CorVel 24/7 Nurse will
direct the employee to the nearest Banner Occupational Health Clinic, if needed.
b. For life or limb threatening injuries or illnesses call 911. The supervisor or
designee would contact CorVel 24/7 on behalf of the employee.
2. The employee must notify the supervisor or designee of all accidents, injuries or job -
related illnesses, no later than the end of the shift. If the supervisor is unavailable,
the employee may leave a message on the supervisor’s office phone or city cell phone.
However, if emergency room/hospital care is required, the injured employee must
ensure actual contact is made with the supervisor or designee (provided the employee
is physically able to do so as a result of the accident or injury).
3. Upon notification of the accident or injury, the supervisor must investigate to
determine the cause of the accident and how a similar accident could be prevented in
the future. In addition, the supervisor should obtain names of witnesses and ensure
the area is free of any hazards that could contribute to additional injuries. The
Department Director must be notified as soon as possible (within 24 hours).
4. A New Incident/Accident Report must be submitted using the City of Glendale
Incident Intake Portal. If the employee is available, they should initiate the report by
logging into the portal and by completing the new incident form. Should the employee
not be available, the supervisor will then need to log into the portal and complete the
incident form. The incident report will get routed to the appropriate department
representative to complete the supervisor section.
5. The appropriate department representative will be responsible for completing the
supervisor section, which includes the Post Accident Determination form and the Root
Cause Analysis, must be completed within 24 hours of the incident.
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B. The following steps are to be followed if an employee is involved in a vehicular accident :
1. Do not move vehicles and immediately call the Glendale Police Department (623-930-
3000).
2. Contact must be made with supervisor or designee immediately if possible.
3. Obtain names, addresses, home and work phone numbers of the other driver, injured
parties, and witnesses.
4. Do not admit liability. Make no comment to anyone except the police, your supervisor
or risk management.
5. A New Incident/Accident Report must be submitted using the City of Glendale
Incident Intake Portal. If the employee is available, they should initiate the report by
logging into the portal and by completing the new incident form. Should the employee
not be available, the supervisor will then need to log into the portal and complete the
incident form. The incident report will get routed to the appropriate department
representative to complete the supervisor section.
6. The appropriate department representative will be responsible for completing the
supervisor section, which includes the Post Accident Determination form and the Root
Cause Analysis, must be completed within 24 hours of the incident.
C. The following steps are to be followed when a Safety Sensitive employee is involved in a
vehicular accident:
1. Safety Sensitive employees that are involved in a vehicular accident must follow the
same procedures listed in heading B.
III. Volunteer Accident/Injury Procedures
A. Any volunteer injured in the line of duty should follow the instructions below.
In case of non-emergency injuries:
1. The volunteer is expected to obtain immediate emergency care for serious
injuries/illnesses.
a. For life or limb threatening injuries or illnesses call 911. The supervisor or
designee would contact CorVel 24/7 on behalf of the employee.
b. If volunteer is injured, call the CorVel, workers’ compensation claims
administrator, 24/7, to report the injury at 877-764-3574 option 1.
c. For less than life or limb threatening injuries/illnesses, the volunteer should go
to the nearest Banner Occupational Health Clinic and be seen by a Banner
physician.
In case of emergency injuries:
1. Call 9-1-1.
2. Report the injury to your immediate supervisor at once.
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3. Call the CorVel, workers’ compensation claims administrator, 24/7, to report the injury at
877-764-3574 option 1.
4. Be transported by ambulance to the nearest hospital emergency room or appropriate
emergency facility.
For further information contact the City’s worker’s compensation representative at (623) 930 -2857.
The worker’s compensation representative will be able to provide you with information on the city’s
Third-Party Administrator for Workers’ Compensation benefits. Inform your healthcare provider to
direct all bills, reports, and authorization requests to that company.
B. Volunteer Accident/Injury Procedures
1. A New Incident/Accident Report must be submitted using the City of Glendale Incident
Intake Portal. If the employee is available, they should initiate the report by logging into
the portal and by completing the new incident form. Should the employee not be
available, the supervisor will then need to log into the portal and complete the in cident
form. The incident report will get routed to the appropriate department representative
to complete the supervisor section.
2. The appropriate department representative will be responsible for completing the
supervisor section must be completed within 24 hours of the incident
IV. Participant Accident/Injury Procedures
1. In case of a serious accident or medical condition, follow the instructions below:
▪ Call 9-1-1
▪ Identify yourself, the nature of the accident and your exact location
▪ Describe the nature of the injury as best you can to the 911 operators
▪ Provide any information about the injured individual such as age, date of birth,
name, sex, parents name, etc.
▪ Do not hang up the phone until the 911 operator has instructed you to do so
2. Notify the parents if participant is under 18 years old.
3. Notify the office as soon as the situation is under control. Call your immediate
supervisor.
4. A New Incident/Accident Report must be submitted using the City of Glendale Incident
Intake Portal. If the employee is available, they should initiate the report by logging into
the portal and by completing the new incident form. Should the employee not be
available, the supervisor will then need to log into the portal and complete the incident
form. The incident report will get routed to the appropriate department representative
to complete the supervisor section.
5. For severe accidents notify Risk Management at 623-930-2555.
6. The appropriate department representative will be responsible for completing the
supervisor section must be completed within 24 hours of the incident.
Authorized by: Date: February 23, 2021
James P. Burke, Director