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Worksheet 4.2 — FACT Documentation

Module 4 · Workplace Rights, Systems & Self-Advocacy

Worksheet 4.2 — FACT Documentation

Draft a FACT entry for a real or hypothetical situation.

Name: ______________________________

Date: ______________________

Facts → Actions → Contacts → Time

  1. Facts — What you directly observed, heard, or did.
  2. Actions & Contacts — Action taken; who was involved.
  3. Time — When exactly it happened.

Scenario: Unsecured Ladder Observed

  • Facts: Ladder unsecured near active walkway, 9:15am
  • Actions: Moved ladder, notified site lead immediately
  • Contacts / Time: Site lead Maria Lopez; Tuesday 9:15am

Facts

Actions

Contacts / Time

Evolve Workforce Solutions · Life Skills & Workforce Development