Injury & Illness Prevention Program (IIPP)

The purpose of an Injury & Illness Prevention Program  is to establish a management framework for reducing the risks associated with workplace injuries and illnesses, and identifying what is required to promote the safety and health, and create an outline of policies and procedures to achieve safety and health goals.

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 EH&S (530-752-1493) if you need additional assistance.

Download the UC Davis IIPP Template

Download the Appendices

• A - Hazard Alert Form
• B1 - Example Office Job Safety Analysis
• B2 - Example Designated Safety Coordinator Job Safety Analysis
• C1 - Office Worksite Inspection Form
• C2 - Laboratory Worksite Inspection Form
• D - Accident Investigation Form
• E - Hazard Correction Form
• F - Safety Training Attendance Form

IIPP-Related Questions?