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CS-1CS revised October 1996

This document is also available in Spanish.


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.



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.


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


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: