Injury and Illness Prevention Model Program For Employers With Seasonal or Intermittent Workers

Cal/OSHA Publications Unit Rev. April 2018

Model Program Form:

Injury and Illness Prevention Model Program for Employers with Seasonal or Intermittent Workers

(also in MS Word )

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:

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 of 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 worker training and instruction are provided with this model program.

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


RESPONSIBILITY

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

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



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 worker 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 workers and supervisors, including translation where appropriate.
    ___ Posted or distributed safety information.
    ___ A system for workers to anonymously inform management about workplace hazards.
    ___ Our establishment has less than ten workers and communicates with and instructs workers orally about general safe work practices and with respect to hazards unique to each worker's job assignment.


HAZARD ASSESSMENT

Periodic inspections to identify and evaluate workplace hazards shall be performed by a competent observer 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; and
    2. When an imminent hazard exists which cannot be immediately abated without endangering worker(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 workers, except for construction workers who are provided training through a construction industry occupational safety and health training program approved by Cal/OSHA;
    3. To all workers given new job assignments for which training has not 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 workers with respect to hazards specific to each worker's job assignment.

Workplace safety and health practices for all industries using intermittent workers 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, injuries and when additional instruction is needed.
    2. Use of appropriate clothing, including gloves, footwear, and personal protective equipment.
    3. Prevention of musculoskeletal disorders, including proper lifting techniques.
    4. Information about chemical hazards to which workers could be exposed and other hazard communication program information.
    5. Availability of toilet, hand-washing and drinking water facilities.
    6. Provisions for medical services and first aid including emergency procedures.

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 has twenty or more workers; has a workers' compensation modification rate of greater than 1.1 and is not on a designated low hazard industry list; or, 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) or persons 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 worker, including the worker's name or other identifier, training dates, type(s) of training, and training providers are recorded on a worker training and instruction form. We also include the records relating to worker training provided by a construction industry occupational safety and health 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 workers who have worked for less than one year which are provided to the worker upon termination of employment; or
    __Since we have less than ten workers, including managers and supervisors, we only maintain inspection records until the hazard is corrected and only maintain a log of instructions to workers with respect to worker 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 workers who have worked for less than one year which are provided to the worker 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 we 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)

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


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 )

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

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


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 NAME TRAINING DATES TYPE OF TRAINING TRAINERS
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

April 2018