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Safety Services > Environmental Health & Safety > Health & Safety > Injury and Illness Prevention Program
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Injury and Illness Prevention Program

 

Effective July 1, 1991, Cal-OSHA regulations require every employer to establish, implement and maintain an effective Injury and Illness Prevention Program. The program must be in writing and include the following elements:

  1. Management commitment/assignment of responsibilities
  2. Safety communications system with employees
  3. System for assuring employee compliance with safe work practices
  4. Scheduled inspections/evaluation system
  5. Accident Investigation
  6. Procedures for correcting unsafe/unhealthy conditions
  7. Safety and health training and instruction; and
  8. Recordkeeping and documentation

To assist UC Davis departments in establishing and implementing an injury illness prevention program, this Injury and Illness Prevention Plan (IIPP) template has been prepared by the Office of Environmental Health & Safety in accordance with University Policy (UCD Policy & Procedure Manual Section 290-15: Safety Management Program) and California Code of Regulations Title 8, Section 3203 (8 CCR, Section 3203).

To complete this template, enter requested data in each text box. Upon completion, print the document, obtain the necessary signatures, and review with departmental employees. Note the Job Safety Analyses (JSA's) provided are for reference only. JSA’s are specific to individual employees and their job requirements. Please contact your EH&S Safety Advisor if you need additional assistance.

 

UC Davis Injury and Illness Prevention Plan TEMPLATE (MS Word format)

Main Document  (download)

  1. Cover Page
  2. Preface
  3. Table of Contents
  4. Department Information
  5. Section I – Authority and Responsibilities
  6. Section II – Communications
  7. Section III – Employee Compliance
  8. Section IV – Hazards and Inspections
  9. Section V – Accident Investigation
  10. Section VI – Hazard Correction
  11. Section VII – Health and Safety Training
  12. Section VIII - Recordkeeping
  13. Section IX – Resources

Appendices

  1. A - Hazard Alert Form
  2. B1 - Example Office Job Safety Analysis
  3. B2 - Example Designated Safety Advisor Job Safety Analysis
  4. C1 - Office Worksite Inspection Form
  5. C2 - Laboratory Worksite Inspection Form
  6. D - Accident Investigation Form
  7. E - Hazard Correction Form
  8. F - Safety Training Attendance Form

 

 



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