(a) Basic requirement. You must use Cal/OSHA 300, 300A, and 301 forms, or
equivalent forms, for recordable injuries and illnesses. The Cal/OSHA Form
300 is called the Log of Work-Related Injuries and Illnesses, the Cal/OSHA
Form 300A is called the Summary of Work-Related Injuries and Illnesses,
and the Cal/OSHA Form 301 is called the Injury and Illness Incident
Report. Appendices A through C give samples of the Cal/OSHA forms.
Appendices D through F provide elements for development of equivalent
forms consistent with Section 14300.29(b)(4) requirements. Appendix G is a
worksheet to assist in completing the Cal/OSHA Form 300A.
(1) What do I need to do to complete the Cal/OSHA Form 300?
You must enter information about your establishment at the top of the
Cal/OSHA Form 300 by entering a one or two line description for each
recordable injury or illness, and summarizing this information on the Cal/OSHA
Form 300A at the end of the year.
(2) What do I need to do to complete the Cal/OSHA Form 301 Incident
You must complete a Cal/OSHA 301 Incident Report form, or an equivalent
form, for each injury or illness required to be entered on the Cal/OSHA
(3) How quickly must each injury or illness be recorded?
You must enter each recordable injury or illness on the Cal/OSHA Form
300 and Cal/OSHA Form 301 Incident Report within seven (7) calendar days
of receiving information that a recordable injury or illness has occurred.
(4) What is an equivalent form?
An equivalent form is one that has the same information, is as readable
and understandable to a person not familiar with it, and is completed
using the same instructions as the Cal/OSHA form it replaces.
(5) May I keep my records on a computer?
Yes. If the computer can produce equivalent forms when they are needed,
as described under Sections 14300.35 and 14300.40, you may keep your
records using a computer system.
(6) Are there situations where I do not put the employee's name on the
forms for privacy reasons?
Yes. If you have a "privacy concern case," as described in
subsection (b)(7) of this section, you may not enter the employee's name
on the Cal/OSHA Form 300. Instead, enter "privacy case" in the
space normally used for the employee's name. This will protect the privacy
of the injured or ill employee when another employee, a former employee,
or an authorized employee representative is provided access to the Cal/OSHA
Form 300 under Section 14300.35(b)(2). You must keep a separate,
confidential list of the case numbers and employee names for your privacy
concern cases so you can update the cases and provide the information to
the government if asked to do so.
(7) How do I determine if an injury or illness is a privacy concern
You must consider the following injuries or illnesses to be privacy
(A) An injury or illness to an intimate body part or the reproductive
(B) An injury or illness resulting from a sexual assault;
(C) Mental illnesses;
(D) HIV infection, hepatitis, or tuberculosis;
(E) Needlestick injuries and cuts from sharp objects that are
contaminated with another person's blood or other potentially infectious
material (see Section 14300.8 for definitions); and
(F) Other illnesses, if the employee independently and voluntarily
requests that his or her name not be entered on the log.
(8) May I classify any other types of injuries and illnesses as privacy
No. This is a complete list of all injuries and illnesses considered
privacy concern cases
for purposes of Article 2.
(9) If I have removed the employee's name, but still believe that the
employee may be identified from the information on the forms, is there
anything else that I can do to further protect the employee's privacy?
Yes. If you have a reasonable basis to believe that information
describing the privacy concern case may be personally identifiable even
though the employee's name has been omitted, you may use discretion in
describing the injury or illness on both the Cal/OSHA forms 300 and 301.
You must enter enough information to identify the cause of the incident
and the general severity of the injury or illness, but you do not need to
include details of an intimate or private nature. For example, a sexual
assault case could be described as "injury from assault," or an
injury to a reproductive organ could be described as "lower abdominal
(10) What must I do to protect employee privacy if I wish to provide
access to the Cal/OSHA forms 300 and 301 to persons other than government
representatives, employees, former employees or authorized
If you decide to voluntarily disclose the forms to persons other than
government representatives, employees, former employees or authorized
representatives (as required by Sections 14300.35 and 14300.40), you must
remove or hide the employees' names and other personally identifying
information, except for the following cases. You may disclose the forms
with personally identifying information only:
(A) to an auditor or consultant hired by the employer to evaluate the
safety and health program;
(B) to the extent necessary for processing a claim for workers'
compensation or other insurance benefits; or
(C) to a public health authority or law enforcement agency for uses and
disclosures for which consent, an authorization, or opportunity to agree
or object is not required under Department of Health and Human Services
Standards for Privacy of Individually Identifiable Health Information, 45
NOTE: Authority cited: Section 6410, Labor Code.
Reference: Section 6410, Labor Code.