HR Forms and Checklists

Workplace Safety Forms

• Accident Injury and Illness Investigation
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  Use this form whenever a workplace accident, injury or illness occurs to properly document your investigation.​
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• CalOSHA Forms 300 300A and 301
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  A CalOSHA-created spreadsheet containing all three required forms to report workplace injuries.
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• Emergency Action Plan
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  Use this form to set up an Emergency Action Plan (EAP) for the workplace. The EAP includes which employees are in charge in case of an emergency and emergency contact phone numbers.
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• Fire Prevention Checklist
  Use this checklist to collect information related to fire prevention and to make sure you are taking proper measures to prevent fires in the workplace. This includes auditing those measures to ensure that they are being followed. This information should be integrated into your Fire Prevention Plan.  ​
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• Fire Prevention Plan
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  Use this form to set up a Fire Prevention Plan (FPP) for the workplace. The FPP inlcudes which employees are in charge in case of a fire and emergency contact phone numbers for local fire departments. 
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• Hazard Assessment and Correction Record
  When a workplace safety hazard is identified, use this form to document and evaluate the hazard, and then record all actions taken to correct the unsafe condition.
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• Hazard Communication Information Summary
  Use this form to collect information about potential hazards in your workplace. This information is critical for creating an effective and thorough Hazard Communication Program (HAZCOM).
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• Hazard Communication Program
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  Use this form to create a Hazard Communication Program (HAZCOM). An effective program includes a list of persons responsible for maintaining the program, how often the program is reviewed and updated, and how employees can receive safety data sheets. ​
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• Heat Illness Prevention Plan — Outdoor Employees — Spanish
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  Use this sample form to develop your company's plan and procedures for complying with Cal/OSHA regulations on heat illness prevention for outdoor workers. This form describes minimal steps applicable to most outdoor work settings to help prevent heat illness. Make sure to modify this sample form with specific procedures tailored to your workplace and the specific conditions at your worksites. Additional helpful information is available from Cal/OSHA.
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• Heat Illness Prevention Plan — Indoor Employees
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  Use this sample form to develop your company's plan and procedures for complying with Cal/OSHA regulations on heat illness prevention for indoor workers. This form provides information applicable to most indoor work settings to help prevent heat illness. Make sure to modify this sample form with specific procedures tailored to your workplace and the specific conditions at your worksites.  Additional helpful information is available from Cal/OSHA.
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• Heat Illness Prevention Plan — Indoor Employees — Spanish
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  Use this sample form to develop your company's plan and procedures for complying with Cal/OSHA regulations on heat illness prevention for indoor workers. This form provides information applicable to most indoor work settings to help prevent heat illness. Make sure to modify this sample form with specific procedures tailored to your workplace and the specific conditions at your worksites. Additional helpful information is available from Cal/OSHA.
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• Human Trafficking Model Notice - English and Spanish
  Free

  ​​​Certain businesses must post this model notice providing information relating to how to report suspected human trafficking and access to help and services. Information on who must post this notice​ can be found on the Office of the Attorney ​General's Human Trafficking​​​ webpage.​
  

  The notice to be posted must be at least 8.5 x 11 inches and size 16 font.​
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• Last Chance Agreement Checklist for Employee with Substance Abuse Problem
  Use this checklist when creating a Last Chance Agreement to give employees that were once productive and valuable but have developed recent performance problems — and have failed to correct them when identified — a last chance to improve their performance before termination. For example, a last chance agreement might be used with an employee that has developed a recent substance abuse problem.
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• Law Enforcement Encounter Policy Checklist
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  Use this checklist to create policies and procedures for your workplace in the event of any type of law enforcement encounter in the workplace.

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• Periodic Self-Inspection Requirements
  This list helps you identify self-inspection requirements contained in Cal/OSHA standards. Keep as a reminder to perform periodic inspections.
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• Serious Incident Report
  Send this report to the nearest Cal/OSHA District Office within eight hours of a serious injury or death.
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• Work Surfaces and Work Space Safety
  Specific Cal/OSHA standards govern workplace conditions and structures. Use this form to help you identify and meet these standards.
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• Workplace Violence Prevention Checklist
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  Use this checklist to help establish and maintain your workplace violence prevention plan and related procedures.
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• Workplace Violence Prevention Plan Key Definitions
  Contains key definitions for terms required in your workplace violence prevention plan.
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• Work-Related Injuries and Illnesses Log - Form 300
  Free
  You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, medical treatment beyond first aid, that are diagnosed by a physician or licensed health care professional, or meet any criteria listed in CCR Title 8 sec. 14300.8 through 14300.12. You must complete an Injury and Illness Incident Report (Cal/OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you're not sure whether a case is recordable, call your local Cal/OSHA office for help.
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• Work-Related Injuries and Illnesses Summary- Form 300A
  Free
  All establishments covered by 8 CCR sec. 14300 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember to review the log to verify that the entries are complete and accurate before completing this summary. Post this Summary page from February 1 to April 30 of the year following the year covered by the form.
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