Restaurant Kitchen Incident Report Template (Staff Injuries)
A restaurant kitchen incident report documents a staff injury in a food-service setting — a slip on a wet floor, an oil or steam burn, or a knife or equipment cut — with the circumstances, care given, and signatures a workers' comp claim needs. Most restaurants are partially exempt from keeping the OSHA 300 log, but every restaurant must still report a work-related fatality to OSHA within 8 hours and an in-patient hospitalization, amputation, or loss of an eye within 24 hours (29 CFR 1904.39).
A restaurant kitchen is a fast-moving environment where a slip, a burn, or a cut can happen in seconds. This template covers the staff-injury side of restaurant incident reporting — for a customer fall, allergic reaction, or food complaint, see the separate customer incident report template.
What this template includes
Every field below is part of the free template and the mobile version — nothing is locked behind a paywall for filling out a single report.
- Report number and date/time of the incident
- Location or site
- Reporter's name and role
- Severity (minor, moderate, or critical)
- Person(s) involved — name, role, contact
- Witness(es) — name, phone
- Description of events
- Immediate action taken and root cause (if known)
- Up to 3 timestamped photographs
- Reporter signature
- Witness or supervisor signature
How to file a defensible restaurants & food service report
- 1
Document while it's fresh, not at the end of the shift
Record what happened, where in the kitchen, and what care was given right away — a busy shift makes details fade fast.
- 2
Photograph the hazard
A wet floor with no wet-floor sign, spilled oil, or an unguarded piece of equipment — a timestamped photo taken before cleanup backs up the report if a claim or OSHA question comes later.
- 3
Capture what OSHA and your insurer will ask about
Note whether the worker was hospitalized or suffered an amputation or loss of an eye — those have to be reported to OSHA within 24 hours — plus the medical treatment given and any days away from work or on restricted duty, which your workers' comp carrier will ask for.
- 4
Get it signed and route it same-shift
A manager or shift-lead signature, added before the shift ends, is what your workers' comp carrier expects a defensible report to have.
Common use cases
- Slip or fall on a wet kitchen floor
- Burn from hot oil, steam, or equipment
- Cut or laceration from kitchen equipment
- Strain from lifting or repetitive kitchen tasks
Frequently asked questions
Does a restaurant have to report every kitchen injury to OSHA?
No. Full-service restaurants, limited-service eating places, and bars (NAICS 7221, 7222 and 7224 — today's 7225 codes included) are on OSHA's partially exempt list in 29 CFR 1904 Subpart B, Appendix A, so most restaurants don't keep the routine OSHA 300 log or post a 300A unless OSHA or the Bureau of Labor Statistics asks in writing. Two things still apply to every restaurant: a work-related fatality must be reported to OSHA within 8 hours, and an in-patient hospitalization, amputation, or loss of an eye within 24 hours (29 CFR 1904.39). And every kitchen injury should still be documented the same shift — your workers' comp carrier needs that report to process the claim, and it's your record if the claim is ever disputed.
What about a customer who gets hurt in the dining room, not a staff member?
That's a different report — a customer incident isn't an OSHA matter, since OSHA recordkeeping only ever covers your own employees. Use the restaurant customer incident report template instead, which is built around liability documentation rather than OSHA recordability.
For the federal recordkeeping rules referenced above, see OSHA's recordkeeping requirements.
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