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Hazard Checklist: Injury and Illness Prevention Program PDF Version California State Compensation Insurance Fund
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California State Compensation Insurance Fund

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HAZARD satisfactory Needs
Attention
Target Date of
Correction
Date
Corrected
Do you have a written, effective Injury and Illness Prevention Program?        
Do you have a person who is responsible and has authority for overall activities of the Injury and Illness Prevention Program?        
Do you have a system for identifying and evaluating your workplace hazards?        
Do you systemically correct these hazards in a timely manner?        
Do you provide training in both general and specific safe work practices?        
Do you encourage employee participation in health and safety matters?        
Do you maintain an ongoing safety training program?        
Do you have a system in place that ensures employees will be recognized for safe and healthful work practices?        
Will employees be disciplined for unsafe safety or health acts?        
Is there a labor-management safety committee?
(Optional)
       
If there is no safety committee, is there a system in place for communicating safety and health concerns to employees?        
On construction sites, is a Code of Safe Practices posted?        
Are "toolbox" meetings conducted every 10 days, or sooner if appropriate?        
   
Name Date

 

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