Dept. of Industrial Relations logo

Injury & Illness Prevention Model Program for Employers with Intermittent Employees

CS-1CS revised October 1996

ABOUT THIS MODEL PROGRAM

Every California employer must establish, implement and maintain a written Injury and Illness Prevention (IIP) Program and a copy must be maintained at each workplace or at a central worksite if the employer has non-fixed worksites. The requirements for establishing, implementing and maintaining an effective written injury and illness prevention program are contained in Title 8 of the California Code of Regulations, Section 3203 (T8 CCR 3203) and consist of the following eight elements:

  • Responsibility
  • Compliance
  • Communication
  • Hazard Assessment
  • Accident/Exposure Investigation
  • Hazard Correction
  • Training and Instruction
  • Recordkeeping

This model program has been prepared for use by employers in industries which have been determined by Cal/OSHA to historically utilize intermittent or seasonal workers. Intermittent or seasonal employment refers to controlling, directing, or directly supervising any worker other than permanent workers. You are not required to use this program. However, any employer in an industry which has been determined by Cal/OSHA as historically utilizing intermittent or seasonal workers and who adopts and implements this model program in good faith shall be deemed in compliance with IIP Program requirements.

Proper use of this model program requires the IIP Program administrator for your establishment to carefully review the requirements for each of the eight IIP Program elements found in this model program, fill in the appropriate blank spaces and check those items that are applicable to your workplace. The recordkeeping section requires that the IIP Program administrator select and implement the category appropriate for your establishment. Sample forms for hazard assessment and correction, accident/exposure investigation, and employee training and instruction are provided with this model program.

This model program must be maintained by the employer in order to be effective.


INJURY AND ILLNESS PREVENTION PROGRAM

RESPONSIBILITY

The Injury and Illness Prevention Program (IIP Program) administrator,
________________________________________________________________________
Program Administrator

has the authority and responsibility for implementing and maintaining this IIP Program for
____________________________________________________________.
Establishment Name

Managers and supervisors are responsible for implementing and maintaining the IIP Program in their work areas and for answering worker questions about the IIP Program. A copy of this IIP Program is available from each manager and supervisor.

COMPLIANCE

All permanent and intermittent workers, including managers and supervisors, are responsible for complying with safe and healthful work practices. Our system of ensuring that all workers comply with these practices include one or more of the following checked practices:

___ Informing employees of the provisions of our IIP Program;
___ Evaluating the safety performance of all employees;
___ Recognizing employees who perform safe and healthful work practices;
___ Providing training to employees whose safety performance is deficient;
___ Disciplining employees for failure to comply with safe and healthful
       work practices; and

COMMUNICATION

All managers and supervisors are responsible for communicating with all permanent and intermittent workers about occupational safety and health in a form readily understandable by all workers. Our communication system encourages all workers to inform their managers and supervisors about workplace hazards without fear of reprisal.

Upon hiring, management will identify any intermittent workers with special communication needs. Management will ensure that such a worker understands the safety and health requirements before being assigned to duties exposing them to workplace hazards.

Our communication system includes one or more of the following checked items:

___ New employee orientation including a discussion of safety and
       health policies and procedures.
___ Review of our IIP Program.
___ Workplace safety and health training programs.
___ Regularly scheduled safety meetings.
___ Effective communication of safety and health concerns between employees
       and supervisors, including translation where appropriate.
___ Posted or distributed safety information.
___ A system for employees to anonymously inform management about
       workplace hazards.
___ Our establishment has less than ten employees and communicates with
       and instructs employees orally about general safe work practices and with
       respect to hazards unique to each employee's job assignment.

HAZARD ASSESSMENT

Periodic inspections to identify and evaluate workplace hazards shall be performed by the following competent observer(s) in the following areas of our workplace:


Periodic inspections are performed according to the following schedule:

  1. When we initially established our IIP Program;
  2. When new substances, processes, procedures or equipment which present potential new hazards are introduced into our workplace;
  3. When new, previously unidentified hazards are recognized;
  4. When occupational injuries and illnesses occur;
  5. When we hire and/or reassign permanent or intermittent workers to processes, operations, or tasks for which a hazard evaluation has not been previously conducted; and
  6. Whenever workplace conditions warrant an inspection.

Periodic inspections consist of identification and evaluation of workplace hazards utilizing applicable sections of the attached Hazard Assessment Checklist and any other effective methods to identify and evaluate workplace hazards.

ACCIDENT/EXPOSURE INVESTIGATIONS

Procedures for investigating workplace accidents and hazardous substance exposures include:

  1. Interviewing injured workers and witnesses;
  2. Examining the workplace for factors associated with the accident/exposure;
  3. Determining the cause of the accident/exposure;
  4. Taking corrective action to prevent the accident/exposure from reoccurring; and
  5. Recording the findings and corrective actions taken.

HAZARD CORRECTION

Unsafe or unhealthy work conditions, practices or procedures shall be corrected in a timely manner based on the severity of the hazards. Hazards shall be corrected according to the following procedures:

  1. When observed or discovered;
  2. When an imminent hazard exists which cannot be immediately abated without endangering employee(s) and/or property, we will remove all exposed workers from the area except those necessary to correct the existing condition. Workers necessary to correct the hazardous condition shall be provided with the necessary protection

TRAINING AND INSTRUCTION

All permanent and intermittent workers, including managers and supervisors, shall have training and instruction on general and job-specific safety and health practices. Training and instruction can be provided through a brief on-site safety meeting. Any training and instruction shall be provided as follows:

  1. When the IIP Program is first established;
  2. To all new employees, except for those in construction who are provided training through a Cal/OSHA approved construction industry occupational safety and health training program;
  3. To all employees given new job assignments for which training has not been previously provided;
  4. Whenever new substances, processes, procedures or equipment are introduced to the workplace and represent a new hazard;
  5. Whenever the employer is made aware of a new or previously unrecognized hazard;
  6. To supervisors to familiarize them with the safety and health hazards to which workers under their immediate direction and control may be exposed; and
  7. To all employees with respect to hazards specific to each employee's job assignment.

Workplace safety and health training practices for all industries include, but are not limited to, the following:

  1. Explanation of the employer's IIP Program, emergency action plan and fire prevention plan, and measures for reporting any unsafe conditions, work practices, and injuries.
  2. Use of appropriate clothing, including gloves, footwear, and personal protective equipment.
  3. Information about chemical hazards to which employees could be exposed and other hazard communication program information.
  4. Availability of toilet, hand-washing and drinking water facilities.
  5. Provisions for medical services and first aid including emergency procedures.
  6. Prevention of musculoskeletal disorders, including proper lifting techniques.

In addition, we train all workers about the checked applicable items found in the attached List of Training Subjects.

RECORDKEEPING

We have checked one of the following categories as our recordkeeping policy.

__Category 1. Our establishment is on a designated high hazard industry list. We have taken the following steps to implement and maintain our IIP Program:

  1. Records of hazard assessment inspections, including the person(s) conducting the inspection, the unsafe conditions and work practices that have been identified and the action taken to correct the identified unsafe conditions and work practices, are recorded on a hazard assessment and correction form; and
  2. Documentation of safety and health training for each employee, including the employee's name or other identifier, training dates, type(s) of training, and training providers. are recorded on an employee training and instruction form. We also include the records relating to employee training provided by a construction industry occupational safety and health training program approved by Cal/OSHA.

Inspection records and training documentation will be maintained according to the following checked schedule:

__For one year, except for training records of employees who have worked for less than one year which are provided to the employee upon termination of employment; or
__Since we have less than ten workers, including managers and supervisors, we maintain inspection records only until the hazard is corrected and only maintain a log of instructions to employees with respect to employee job assignments when they are first hired or assigned new duties.

__Category 2. Our establishment has fewer than twenty workers and is not on a designated high hazard industry list. We are also on a designated low hazard industry list or have a workers' compensation experience modification rate of 1.1 or less, and have taken the following steps to implement and maintain our IIP Program:

  1. Records of hazard assessment inspections; and
  2. Documentation of safety and health training for each worker.

Inspection records and training documentation will be maintained according to the following checked schedule:

__For one year, except for training records of employees who have worked for less than one year which are provided to the employee upon termination of employment; or
__Since we have less than ten workers, including managers and supervisors, we maintain inspection records only until the hazard is corrected and only maintain a log of instructions to workers with respect to worker job assignments when they re first hired or assigned new duties.

__Category 3. We are a local governmental entity (any county, city, or district, and any public or quasi-public corporation or public agency therein) and therefore are not required to keep written records of the steps taken to implement and maintain our IIP Program.


LIST OF TRAINING SUBJECTS

We train our workers about the following checked training subjects:

AGRICULTURE PRODUCTION AND FARM LABOR AND MANAGEMENT SERVICES
(SIC Codes: 0111-0119, 0131-0139, 0161, 0171-0179, 0191, 0721-0724, 0761-0762)

__ Safe practices for operating any agricultural equipment, including procedures for cleaning, repairing, servicing and adjusting.
__ Electrical hazards.
__ Heat stress.
__ Ergonomic hazards, including proper lifting techniques and working on ladders or in a stooped posture for prolonged periods at one time.
__ Hazardous chemical exposures.
__ Other job-specific hazards, such as ______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

HEAVY CONSTRUCTION AND SPECIAL TRADES CONTRACTORS
(SIC Codes: 1611, 1721, 1751-1755, 1761, 1771)

__The employer's Code of Safe Practices.
__Good housekeeping, fire prevention, safe practices for operating any construction equipment, including procedures for cleaning, repairing, servicing and adjusting.
__Safe access to working areas.
__Protection from falls.
__Electrical hazards, including working around high voltage lines.
__Crane operations.
__Trenching and excavation work.
__Proper use of powered tools.
__Ergonomic hazards, including proper lifting techniques.
__Other job-specific hazards, such as ______________________________________________
_______________________________________________________________________________
__________________________________________________________________________

PRESERVED FRUITS AND VEGETABLES MANUFACTURING AND SUGAR AND CONFECTIONERY PRODUCTS
(SIC Codes: 2032-2038, 2061-2068)

__Guarding of belts and pulleys, gears and sprockets, and conveyor nip points.
__Machine, machine parts, and prime movers guarding.
__Lock-out/tag-out procedures.
__Materials handling.
__Ergonomic hazards, including proper lifting techniques.
__Noise.
__Other job-specific hazards, such as _________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

GENERAL MERCHANDISE, FOOD AND APPAREL STORES AND PHOTOGRAPHIC AND TAX PREPARATION
(SIC Codes: 5311, 5399, 5441, 5499, 5632, 5651, 7221, 7291)

__Ergonomic hazards, including proper lifting techniques.
__Materials handling.
__Other job-specific hazards, such as _________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

LOGGING
(SIC Code: 2411)

__Chainsaw and other power tool operation.
__Tree falling/bucking procedures and precautions, including procedures for recognizing and working with hazard trees, snags, lodged trees, and unsafe weather conditions.
__Yarding operations, including skidding, running lines, unstable or rolling logs, use of rigging and communication.
__Landing and loading areas, including release of rigging, landing layout, moving vehicles and equipment, and log truck locating, loading and wrapping.
__Ergonomic hazards, including proper lifting techniques.
__Other job-specific hazards, such as _________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

MOTION PICTURE PRODUCTION AND SERVICES AND THEATRICAL PRODUCERS
(SIC Codes: 7812-7819, 7922-7929)

__Fall protection from elevated locations.
__Use of elevated platforms, including condors and scissor lifts.
__Electrical safety.
__Safe use of explosives.
__Slips, falls, and back injuries.
__Noise.
__Ergonomic hazards, including proper lifting techniques.
__Other job-specific hazards, such as ______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

RECREATIONAL PARKS AND CAMPS AND MUSEMENT AND RECREATION SERVICES
(SIC Codes: 7032-7033, 7941-7948, 7996, 7999)

__Design, maintenance, operation, repair, inspection, assembly and disassembly of amusement rides or sports equipment.
__Electrical hazards.
__Bloodborne pathogens (for medical personnel and first aid providers.)
__Ergonomic hazards, including proper lifting techniques.
__Other job-specific hazards, such as ________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

SCHOOL BUSES, SCHOOLS, COLLEGES AND UNIVERSITIES AND JOB TRAINING AND RELATED SERVICES
(SIC Codes: 4151, 8211, 8221-8222, 8331)

__Driver safety.
__Hazard communication.
__Laboratory safety.
__Bloodborne pathogens (for medical personnel and first aid providers.)
__Ergonomic hazards, including proper lifting techniques.
__Other job-specific hazards, such as _________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

HAZARD ASSESSMENT CHECKLISTS

The following checklists contain safety and health hazard assessment items commonly found in the workplace. It is the employer's responsibility to identify, evaluate and control job-specific safety and health hazards in the workplace, and to meet all applicable Cal/OSHA requirements.

The following checklists are to be used as guides in identifying safety and health hazards in your workplace. Answer the questions contained in the General Workplace checklist and then identify and answer the questions contained in the checklist that applies to your specific industry.

GENERAL WORKPLACE
(SIC Codes: All)

__Is the Cal/OSHA poster Safety and Health Protection on the Job displayed in a prominent location where all employees are likely to see it?
__Do you have a written, effective Injury and Illness Prevention Program?
__Are all work areas properly illuminated?
__Are employees instructed in proper first aid and other emergency procedures?
__Do you have a fire prevention plan?
__Are all worksites clean and orderly?
__Are all spilled materials or liquids cleaned up immediately?
__Do you have eye wash facilities and a quick drench shower within the work area where employees are exposed to injurious corrosive materials?
__When lunches are eaten on the premises, are they eaten in areas where there is no exposure to toxic materials or other health hazards?
__Are aisles and passageways kept clear?
__Are the directions to exits, when not immediately apparent, marked with visible signs?
__Are hazardous substances identified which may cause harm by inhalation, ingestion, skin absorption or contact?
__Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment, such as ammonia, chlorine, epoxies, caustics?
__Is personal protective equipment provided, used and maintained wherever required?
__Are there written standard operating procedures for the selection and use of respirators where needed?
__Are restrooms and washrooms kept clean and sanitary?
__Are employees instructed in the proper manner of lifting heavy objects?
__Is there a list of hazardous substances used in your workplace?
__Is there a written hazard communication program dealing with Material Safety Data Sheets (MSDS) labeling, and employee training?
__Is each container for a hazardous substance (i.e. vats, bottles, storage tanks,) labeled with product identity and a hazard warning (communication of the specific health hazards and physical hazards)?
__Is there a Material Safety Data Sheet readily available for each hazardous substance used?
__Is there an employee training program for hazardous substances?
__Can the work be performed without eye strain or glare to the employees?
__Does the task require prolonged raising of the arms and does the neck and shoulders have to be stooped to view the task?
__Are there pressure points on any parts of the body (wrists, forearms, back of thighs)?
__Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion tasks?
__Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?
__Are you keeping the required records and documentation?
__Have arrangements been made to maintain required records for the legal period of time?

AGRICULTURE PRODUCTION AND FARM LABOR AND MANAGEMENT SERVICES
(SIC Codes: 0111-0119, 0131-0139, 0161, 0171-0179, 0191, 0721-0724, 0761-0762)

__Where workers do not understand English, are safety instructions and warnings presented in a language the workers understand?
__Are adequate first-aid materials are immediately available at the farm headquarters and/or on worker transportation buses?
__At remote locations, are provisions made in advance for prompt medical attention and are there is there at least 1 employee for every 20 employees trained for the administering of first aid?
__Is all agricultural equipment is properly guarded to prevent accidental contact by workers?
__Are safe practices for operating agricultural equipment, including procedures for cleaning, repairing, servicing and adjusting, being followed?
__Is all machinery or equipment capable of movement, required to be de-energized or disengaged and blocked or locked out during cleaning, servicing, adjusting or setting up operations, whenever required?
__Are safe work practices being followed during operation of self-propelled equipment?
__Where mobile farm equipment is towed by a tractor or truck and the tractor or truck driver cannot see the employees on the towed equipment, is there a positive signaling device installed on the towed equipment that can stop the towing equipment in case of an emergency?
__Are portable screw conveyors located seven feet or less above the work level substantially covered or guarded?
__Are augers guarded with either grating type guards or solid baffle style covers according to Cal/OSHA section 3446?
__Are ladders, steps, or other suitable climbing means provided where and when workers are required to work in or about farm structures such as permanent pools, ponds, water tanks, or reservoirs 4 feet or more in actual depth and where the slope and construction would make exit difficult?
__Are machines, aircraft, or applicators decontaminated in a safe area before they are overhauled or placed in storage?
__Are safety precautions as required by Title 3, Article 23 of the California Code of Regulations followed when using aircraft for crop dusting and spraying?
__Are safe work practices followed when using applicator rigs, tanks, and vessels containing fertilizer, insecticide, pesticide, and other chemical solutions of a hazardous nature?
__Is potable water provided, and access to permitted, at all times, during working hours and placed in locations readily accessible to all workers?
__Is potable water for drinking dispensed in single-use drinking cups or by fountains, and the water is fresh, pure, and suitably cool?
__Are adequate toilet and handwashing facilities available and do they meet Cal/OSHA section 3457 requirements?
__Are all ladders maintained in good condition, and are employees instructed to face the ladder when ascending or descending and prohibited from using ladders that are broken, missing steps, rungs, or cleats, broken side rails or other faulty equipment?
__Are employees instructed not to use the top 2 steps of ordinary stepladders as a step?
__Are employees made aware of the hazards caused by faulty or improperly used hand tools?
__Is each van, bus or truck used regularly to transport employees, equipped with an adequate number of seats, and equipped with the proper safety devices?
__Can the work be done without twisting or overly bending the lower back?
__Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion tasks?
__Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?
__Are hazardous substances identified which may cause harm by inhalation, ingestion, skin absorption or contact?
__Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment, such as ammonia, chlorine, and caustics?
__Is heat stress being evaluated and controlled?
__Are employees screened before assignment to areas of high heat to determine if their health condition might make them more susceptible to having an adverse reaction?

HEAVY CONSTRUCTION AND SPECIAL TRADES CONTRACTORS
(SIC Codes: 1611, 1721, 1751-1755, 1761, 1771)

__Are workers knowledgeable about and complying with the employer's Code of Safe Practices?
__Are safe practices for operating construction equipment, including procedures for cleaning, repairing, servicing and adjusting, being followed?
__Is good housekeeping maintained in all work areas, passageways, and stairs in and around buildings or other structures?
__Are all personal protective devices maintained in a safe, sanitary condition, and in accordance with manufacturer's instructions?
__Are approved safety glasses required to be worn at all times in areas where there is a risk of eye injuries such as punctures, abrasions, contusions or burns?
__Are hard hats provided and worn where danger of falling objects exists?
__Are hard hats inspected periodically for damage to the shell and suspension system?
__Is appropriate foot protection required where there is the risk of foot injuries from hot, corrosive, poisonous substances, falling objects, crushing or penetrating actions?
__Are all applicable safety precautions, practices, being used prior to and during entry into any excavation?
__Are appropriate protective devices utilized where applicable in the excavation?
__Are competent and qualified personnel used when blasting is required?
__Are workers protected from electrical hazards?
__Are the minimum number of toilets and washing facilities provided and are they clean and sanitary?
__Are portable metal ladders legibly marked with signs reading "CAUTION" "Do Not Use Around Electrical Equipment" or equivalent wording?
__Are all ladders maintained in good condition, and are employees instructed to face the ladder when ascending or descending and not to use the top 2 steps of ordinary stepladders as a step?
__Are employees prohibited from using ladders that are broken, missing steps, rungs, or cleats, broken side rails or other faulty equipment?
__Are floor openings guarded by a standard railing and toeboards or cover?
__Are elevator shafts in which cages are not installed and which are not enclosed with solid partitions and doors guarded on all open sides by standard railings and toeboards?
__Are workers adequately protected when working on temporary floors?
__Are scaffolds provided for all work that cannot be done safely by employees standing on permanent or solid construction at least 20 inches wide, except where such work can be safely done from ladders?
__When scaffolds are used, are they properly constructed in accordance with Cal/OSHA Article 22?
__When work is performed from thrustouts or similar locations, such as trusses, beams purlins, or plates of 4-inch nominal width, or greater, at elevations exceeding 15 feet above ground, water surface, or floor level below and where temporary guardrail protection is impracticable, are employees using approved safety belts or harnesses with attached lanyards?
__Are all tools and equipment (both, company and employee-owned) used by employees at their workplace in good condition?
__Are power tools used with the correct shield, guard or attachment recommended by the manufacturer, portable circular saws equipped with guards above and below the base shoe and checked to assure they are not wedged up, thus leaving the lower portion of the blade unguarded?
__Are all cord-connected, electrically-operated tools and equipment effectively grounded or of the approved double insulated type?
__Are ground-fault circuit interrupters provided on all temporary electrical 15 and 20 ampere circuits, used during periods of construction?
__Are only authorized and trained personnel permitted to use welding, cutting or brazing equipment?
__If cranes are used are they visually inspected for defective components prior to the beginning of any work shift and is a preventive maintenance program established?
__Are cranes of such design, that the boom could fall over backward, equipped with boomstops?

PRESERVED FRUITS AND VEGETABLES MANUFACTURING AND SUGAR AND CONFECTIONERY PRODUCTS
(SIC Codes: 2032-2038, 2061-2068)

__Is sufficient clearance provided around and between machines to allow for safe operations, set up and servicing, material handling and waste removal and is there a power shut-off switch within reach of the operator's position at each machine?
__Are all pulleys and belts, moving chains and gears and conveyor nip points that are within 7 feet of the floor or working level properly guarded ?
__Are revolving drums, barrels and containers required to be guarded by an enclosure that is interlocked with the drive mechanism, so that revolution cannot occur unless the guard enclosure is in place, so guarded?
__Is all machinery or equipment capable of movement, required to be de-energized or disengaged and blocked or locked out during cleaning, servicing, adjusting or setting up operations, whenever required?
__Does the lock-out procedure require that stored energy (i.e. mechanical, hydraulic, air,) be released or blocked before equipment is locked-out for repairs?
__Are only authorized and trained personnel permitted to use welding, cutting or brazing equipment?
__Are only trained personnel allowed to operate industrial trucks and does each industrial truck have a warning horn, whistle, gong, or other device which can be clearly heard above the normal noise in the area where operated?
__Before entering a confined space, are all appropriate tests conducted, precautions observed, permits obtained, and work practices followed?
__Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment?
__Can the work be done without twisting or overly bending the lower back?
__Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion tasks?
__Are there areas in the workplace where continuous noise levels exceed 85 dBA and if so, are engineering controls being considered to reduce the noise and/or is a hearing conservation program in effect?

GENERAL MERCHANDISE, FOOD AND APPAREL STORES AND PHOTOGRAPHIC AND TAX PREPARATION
(SIC Codes: 5311, 5399, 5441, 5499, 5632, 5651, 7221, 7291)

__Does the task require prolonged raising of the arms?
__Do the neck and shoulders have to be stooped to view the task?
__Can the work be done without twisting or overly bending the lower back?
__Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion tasks?
__Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?
__Are all pieces of furniture adjusted, positioned and arranged to minimize strain on all parts of the body?
__Are there pressure points on any parts of the body (wrists, forearms, back of thighs)?
__Are motorized vehicles and mechanized equipment inspected daily or prior to use?
__Are hand trucks maintained in safe operating condition?
__Are materials stacked or stored in a manner to prevent tipping or falling?
__Are aisles and passageways kept clear?
__Are spilled materials cleaned up immediately?
__Do employees complain about dizziness, headaches, nausea, irritation or other factors of discomfort when they use solvents or other chemicals?
__Is there a dermatitis problem - do employees complain about skin dryness, irritation, or sensitization?
__Are electrical appliances such as vacuum cleaners, polishers, vending machines grounded?
__Do extension cords being used have a grounding conductor?
__Are multiple plug adaptors prohibited?
__Are flexible cords and cables free of splices or taps?

LOGGING
(SIC Code 2411)

__Has first aid, communication and transportation been provided for?
__Do all employees have appropriate personal protective equipment?
__Is all equipment, including rigging, prime movers, winches, chain saws, and hand tools, inspected, maintained and safely operated?
__Are required distances maintained between falling, bucking, and other operations?
__When falling, are fallers located so that they will not endanger other employees?
__Are suitable warning signs or other controls provided where needed to prevent foot or vehicle traffic from entering danger areas?
__Are tree falling/bucking procedures and precautions, including procedures for recognizing and working with hazard trees, snags, lodged trees, being followed?
__Are yarding operations using effective communication systems, and are safe procedures being followed insetting and unhooking chokers?
__Are landing and loading operations, including release of rigging, landing layout, moving vehicles and equipment, and log truck locating, loading and wrapping, being safely performed by workers?
__Are landings of adequate size for the operations, properly prepared and laid out, and reasonably clear of debris?
__Are all logs stable on landings and decks?
__Is mobile equipment in suitable condition and provided with seat belts, backup alarms where required?
__Do tractors have suitable roll-over protection, canopies, and Jill-Poke protection?
__Is the yarder rigging, butt-rigging, guylines, and stumps being properly inspected, maintained and used?
__Are approved containers and tanks used for the storage and handling of flammable liquids?
__Is the transfer/withdrawal of flammable or combustible liquids performed by trained personnel?
__Are all tools and equipment (both company and employee-owned) used by employees at their workplace in good condition?

MOTION PICTURE PRODUCTION AND SERVICES AND THEATRICAL PRODUCERS
(SIC Codes: 7812-7819, 7922-7929)

__Are workers protected against accidental falls from elevated locations?
__Is the use of elevated platforms, including condors and scissors lifts, in accordance with safety regulations?
__Is the use of pyrotechnics in accordance with safe work practices?
__Are only authorized personnel allowed to handle pyrotechnic devices and material?
__Are work areas free from slipping, tripping, and falling hazards?
__Are your workplace electricians familiar with the Cal/OSHA Electrical Safety Orders?
__Do extension cords have a grounding conductor?
__Are all temporary circuits protected by suitable disconnecting switches or plug connectors at the junction with permanent wiring?
__Is exposed wiring and cords with frayed or deteriorated insulation repaired or replaced promptly?
__Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?
__Are workers trained in proper lifting techniques?
__Are work surfaces kept dry or appropriate means taken to assure the surfaces are slip-resistant?
__Is there safe clearance for equipment through aisles and doorways?
__Are employees trained in the use of fire extinguisher?
__Are there areas in the workplace where noise levels may exceed the permissible exposure limits?
__Is approved hearing protective equipment available to employees exposed to excessive noise levels?
__Are combustible scrap, debris and waste materials (i.e. oily rags) stored in covered metal receptacles and removed from the worksite promptly?
__If internal combustion engines are used, is carbon monoxide kept within acceptable levels?

RECREATIONAL AND AMUSEMENT PARKS AND CAMPS AND RECREATION SERVICES
(SIC Codes: 7032-7033, 7941-7948, 7996, 7999)

__Do amusement rides have the required testing, emergency brakes, anti-rollback devices, and speed limiting devices?
__Is the amusement ride inspected and maintained each day before use?
__Do only authorized persons perform or supervise the assembly or disassembly of amusement rides?
__Are your workplace electricians familiar with the Cal/OSHA Electrical Safety Orders?
__Are employees instructed to make preliminary inspections and/or appropriate tests to determine what conditions exist before starting work on electrical equipment or lines?
__Do extension cords being used have a grounding conductor?
__Are all temporary circuits protected by suitable disconnecting switches or plug connectors at the junction with permanent wiring?
__Are flexible cords and cables free of splices or taps?
__Are employees providing first-aid or medical services trained in infection control procedures?
__Is personal protective equipment provided to employees, and in all appropriate locations?
__Has medical surveillance including HBV evaluation, antibody testing and vaccination been made available to potentially exposed employees?
__Are there pressure points on any parts of the body (wrists, forearms, back or thighs)?
__Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?
__Are employees instructed in proper lifting techniques?
__Have emergency escape procedures and routes been developed and communicated to all employees?
__Are all work areas properly illuminated?
__Are all toilets and washing facilities clean and sanitary?
__Are employees trained in the safe handling practices of hazardous chemicals?

SCHOOL BUSES, SCHOOLS, COLLEGES AND UNIVERSITIES AND JOB TRAINING AND RELATED SERVICES
(SIC Codes: 4151, 8211, 8221-8222, 8331)

__Are employees who operate vehicles on public thoroughfares instructed in safe driving practices?
__Is there a list of hazardous substances used in your workplace?
__Is each container for a hazardous substance labeled with product identity and a hazard warning (communication of the specific health hazards and physical hazards)?
__Is there an employee training program for hazardous substances?
__Are incompatible laboratory chemicals separated in storage?
__Have standard operating procedures been established and are they being followed when cleaning up chemical spills?
__Is a Chemical Hygiene Plan developed and implemented?
__Are employees providing first-aid or medical services trained in infection control procedures?
__Is personal protective equipment provided to employees, and in all appropriate locations?
__Have infection control procedures been instituted where appropriate, such as ventilation, universal precautions, workplace practices, personal protective equipment?
__Has medical surveillance including HBV evaluation, antibody testing and vaccination been made available to potentially exposed employees?
__Are all pieces of furniture adjusted, positioned and arranged to minimize strain on all parts of the body?
__Can the work be performed without eye strain or glare to the employees?
__Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?
__Do employees complain about dizziness, headaches, nausea, irritation or other factors of discomfort when they use solvents or other chemicals?
__Is there is dermatitis problem - do employees complain about skin dryness, irritation, or sensitization?for work being performed?


HAZARD ASSESSMENT AND CORRECTION RECORD


Date of Inspection: Person Conducting Inspection:

Unsafe Condition or Work Practice:

Corrective Action Taken:

Date of Inspection: Person Conducting Inspection:

Unsafe Condition or Work Practice:

Corrective Action Taken:

Date of Inspection: Person Conducting Inspection:

Unsafe Condition or Work Practice:

Corrective Action Taken:

ACCIDENT/EXPOSURE INVESTIGATION REPORT


Date & Time of Accident:
Location:
Accident Description:
Workers Involved:

Preventive Action Recommendations:

Corrective Actions Taken:
Manager Responsible: Date Completed:

WORKER TRAINING AND INSTRUCTION RECORD

Worker's Name Training Dates Type of Training Trainers