ASSAULTIVE BEHAVIOR CALOSHA 200 & 300A REPORTS (Current ...wp.sbcounty.gov/dbh/wp-content/uploads/2016/12/DBH_Safety_Prog… · When you approach your car, have your keys in hand

ASSAULTIVE BEHAVIOR

CALOSHA 200 & 300A REPORTS (Current year and 4 years back)

DRIVER’S SAFETY AWARENESS TRAINING

PROGRAM

EMERGENCY ACTION PLAN

ERGONIMICS

FIRE DRILL REPORTS

HAZARDOUS CONDITIONS & CORRECTIVE ACTION DOCUMENTATION

IIPP & ILLNESS & INJURY REPORTS

INSPECTIONS (FIRE MARSHAL, QUARTERLY, ANNUAL, HIPAA,

MEDICAL/, CARF, COUNTY VEHICLE)

LEGISLATION/DBH SPM’S/ SAFETY ROLES &

RESPONSIBILITIES

SAFETY COMMITTEE MINUTES

SAFETY POSITION

TRAINING (MONTHLY SAFETY PRESENTATION, HANDS-ON FIRE EXTINGUISHER, ROSTERS)

ARCHIVE

Safety Program Activities (2006) Regional Reps Phone Number Area/Program/Clinic Covered Tina Entz 909-463-5234 JMHS, JETS, CONREP/STAR, Homeless, AB2034/Team House, Housing/Employment Deanna Jaglowski 760-955-7417 All Desert/Mnt. region programs Mike Schertell 909-854-3458 Chino, Upland, Vista, Boys & Girls Club, Nueva Vida, Casa Ramona Lucille Cruz 909-421-9435 All BHRC programs Rene Da Metz 909-386-5415 Cottage 4, Bldgs. 3, 4, & 6, EVRC (Gilbert St. Complex)

Activity Required Action Send to Due Date Due Date Due Date Due Date Annual Bldg. Inspection Reports

Conduct Inspection & Submit Corrective Action Plan

Gwen Morse Clinic Sup&

RSR

15 Oct 06

Assaultive Behavior Drill Conduct Drill – Submit Report RSR 22 Jan 06 22 Apr 06 22 Jul 06 22 Oct 06 Blood Borne Pathogens Training

Attend Training - Mandatory for medical waste generators or those who handle meds. BLI’s optional

N/A 25 Oct 06

Disaster Plan Review/Update RSR 22 Apr 06 Emergency Action Plan (EAP) Update and Train Staff- Submit

Acknowledgement for m RSR 22Apr 06

Fire Drill Reports Conduct Drill – Submit Report RSR 22 Jan 06 22 Apr 06 22 Jul 06 22 Oct 06 Driver’s Awareness Attend Required Training and Update File BLI 30 Jun 06 Hands-On Fire Extinguisher Training

Conduct and Document RSR 31 Oct 06

Hazard Com Program Review & Update RSR 22 Jan 06 Illness & Injury Pvn Pgm.(IIPP) Fill in the blanks (BLUE) RSR 22 Apr 06 Medical Waste Mgt Pgm Inspection

Conduct Inspection & file report Maintain in Safety Binder

22 Jan 06 22 Jun 06

¼ bldg. insp. Rpt Conduct Inspection – Submit Report RSR 22 Jan 06 22 Apr 06 22 Jul 06 22 Oct 06 ¼. HIPAA Security Review Conduct Inspection – Submit Report RSR 22 Jan 06 22 Apr 06 22 Jul 06 22 Oct 06 ¼ Injury Report Accomplish and email Gwen Morse

& RSR 9 Jan 06 10 Apr 06 13 Jul 06 19 Oct 06

¼ Safety Committee BHRC (Rialto) F 119 – 120 1:30 PM – 3:30 PM

Regional Reps attend – BLI’s are welcome (optional)

N/A 20 Jan 06 21 Apr 06 21 Jul 06 20 Oct 06

Training (Monthly Safety Topic) Conduct monthly – maintain in Section 13 of this binder

N/A 20 Jan 06

20 Feb 06

20 Mar 06

20 Apr 06

20 May 06

20 Jun 06

20 Jul 06

20 Aug 06

20 Sep 06

20 Oct06

20 Nov 06

20 Dec 06

Assigned to clinic staff – rotated annually

C:\Users\d1212\Downloads\DBH_Safety_Program_Binder.doc

Safety Program Activities (2007) Regional Reps Phone Number Area/Program/Clinic Covered Tina Entz 909-463-5234 JMHS, JETS, CONREP/STAR, Homeless, AB2034/Team House, Housing/Employment Deanna Jaglowski 760-955-7417 All Desert/Mnt. region programs Mike Schertell 909-854-3458 Chino, Upland, Vista, Boys & Girls Club, Nueva Vida, Casa Ramona Lucille Cruz 909-421-9435 All BHRC programs Rene Da Metz 909-386-5415 Cottage 4, Bldgs. 3, 4, & 6, EVRC (Gilbert St. Complex)

Activity Required Action Send to Due Date Due Date Due Date Due Date Due Date Due Date Due Date Annual Bldg. Inspection Reports

Conduct Inspection & Submit Corrective Action Plan

Gwen Morse Clinic Sup&

RSR

15 Oct 07

Assaultive Behavior Drill

Conduct Drill – Submit Report RSR 22 Jan 07 22 Apr 07 22 Jul 07 22 Oct 07

Blood Borne Pathogens Training

Attend Training - Mandatory for medical waste generators or those who handle meds. BLI’s optional

N/A 25 Oct 07

Disaster Plan Review/Update RSR 22 Apr 07 Emergency Action Plan (EAP)

Update and Train Staff- Submit Acknowledgement for m

RSR 22Apr 07

Fire Drill Reports Conduct Drill – Submit Report RSR 22 Jan 07 22 Apr 07 22 Jul 07 22 Oct 07 Driver’s Awareness Attend Required Training and

Update File BLI 30 Jun 07

Hands-On Fire Extinguisher Training

Conduct and Document RSR 31 Oct 07

Hazard Com Program Review & Update RSR 22 Jan 07 Illness & Injury Pvn Pgm.(IIPP) Fill in the blanks (BLUE) RSR 22 Apr 07 Medical Waste Mgt Pgm Inspection

Conduct Inspection & file report Maintain in Safety Binder

22 Jan 07 22 Jun 07

¼ bldg. insp. Rpt Conduct Inspection – Submit Report

RSR 22 Jan 07 22 Apr 07 22 Jul 07 22 Oct 07

¼. HIPAA Security Review

Conduct Inspection – Submit Report

RSR 22 Jan 07 22 Apr 07 22 Jul 07 22 Oct 07

¼ Injury Report Accomplish and email Gwen Morse & RSR

9 Jan 07 10 Apr 07 13 Jul 07 19 Oct 07

¼ Safety Committee BHRC (Rialto) F 119 – 120 1:30 PM – 3:30 PM

Regional Reps attend – BLI’s are welcome (optional)

N/A 20 Jan 07 21 Apr 07 21 Jul 07 20 Oct 07

Training (Monthly Safety Topic)

Conduct monthly – maintain in Section 13 of this binder

N/A 20 Jan 07

20 Feb 07

20 Mar 07

20 Apr 07

20 May 07

20 Jun 07

20Jul 07

20 Aug 07

20 Sep 07

20 Oct 07

20 Nov 07

20 Dec 07

Assigned to clinic staff – rotated annually


Safety Program

Org Chart

BLIs

Mike SchertellRSR

West End

BLIs

Tina EntzRSR

Forensics & Homeless

BLIs

Deanna JaglowskiRSR

Desert Region

BLIs

Lucille CruzRSR

BHRC

BLIs

Rene Da MetzRSR

Gilbert St Complex

Gwen MorseDBH Disaster/Safety Coordinator

DeAnna Avey- MotikeitAssistant Director

Allan RawlandDirector

DBH Safety

Committee

Management & Supervisors


BINDER: DBH Safety Program

SECTION: 1

AREA: Assaultive Behavior Drills 25

Assaultive Behavior Drills DBH Safety Binder Section 1

Assaultive Behavior drills are conducted EVERY OTHER MONTH in ALL DBH facilities (Jan, Apr, Jul, Oct) – see schedule in front of Section 1 in this binder). Use the standard drill reporting format in DBH SPM #7-1-20 to complete the report. This duty should be assigned to a staff member in your facility (for one year) then rotated. He/she needs to submit the report to the BLI/Supervisor. The BLI/Supervisor will submit the report to the Regional Safety Rep. These drills can be based on actual events – processing what went well and what areas need improvement, or a scenario can be created and acted out or discussed at a tabletop. Facilities that don’t regularly see clients should base their drills on potential scenarios of employee violence or client encounters. Email or send hard copies of the report to your RSR no later than the 22nd of the reporting month. Keep a HARD COPY in this binder, Section 1.


Section 1 Assaultive Behavior Drill

SCHEDULE OF COMPLETION: Conducted quarterly (submitted to RSR in Jan, Apr, Jul & Oct – by the 22nd of the month) CONDUCTED BY: Assigned staff member, BLI or supervisor REPORT FORMAT: Use standard report format – reference DBH SPM 7-1.20 (a sample is located in this section) DOCUMENTATION REQUIREMENTS: Maintain copy of the report in this section and forward report to RSR SEND REPORT TO: Your Regional Safety Rep _____________ by the 22nd of the month. Methods OF SUBMISSION: Email or hard copy

Enter date submitted

MONTH JAN APR JUL OCT Date Submitted


No. 7-1.20, Attachment 3, Page 1 of 1

INTEROFFICE MEMO

DATE: PHONE FROM: MAIL CODE TO: DBH SAFETY COORDINATOR via REGIONAL SAFETY REPRESENTATIVE SUBJECT: ASSAULTIVE BEHAVIOR DRILL FOR THE MONTH OF __________________ Date drill conducted: Total time spent on drill: Briefly describe the drill design: Briefly describe the major issues staff discussed as a result of the drill: Describe the resolution to any questions/issues raised by the drill. List the name of all staff who participated in or watched the drill: CROSS REFERENCE LISTING

7-1.20 Evacuation of Clinic Due to Dangerous Client 7-1.21 Clients in Possession of Firearms and other Weapons 7-2.20 Safety in the Field 12-1.10 Tarasoff – Duty to Warn Potential Victims Threats of Assault on Staff Members


Place copies of

Assaultive Behavior

Drills Conducted

Here


SAN BERNARDINO COUNTY SHERIFF’S DEPARTMENT - OFFICE OF COUNTY SAFETY & SECURITY

Personal Safety Tips

Dealing with Internal (Workplace) Violence

Always report all threats or behaviors that you believe could lead to an outburst or act of violence at a future date. However, if a situation has gone beyond reporting and your well-being is threatened, follow these tips: • Talk the person into calming down. • Empathize and sympathize. • Ask the person what you can do to help him or her. • Make sure they know you understand their position by re-stating what it is they’re upset

about. • Focus on the behavior and not the person. Set reasonable boundaries on their behavior. (“If

you yell one more time, I’m calling security.”) • Immediately call for help when necessary.

Dealing with External Violence

Here are some personal safety tips to protect yourself from external violence, which may occur anywhere, from workplaces to home:

• Don’t open the door to a stranger before or after regular business hours. Use picture ID to

positively identify an individual you don’t recognize. Confirm the ID with someone else. • When you work early or late let security guards or a friend know so they can check on you. • If anyone calls while you’re alone, never mention that fact to the caller. • Report “strange” looking customers to security or supervisors. • Always take note of the appearance of “strange” visitors, vehicles, or customers in case a

crisis occurs later. • Build a rapport with customers so you’ll be able to distinguish strangers from repeat

customers. • When you walk outdoors, take a moment and pause. Scan the entire area for anything that

should arouse suspicion. If it feels wrong, it probably is. • Walk to and from your car with another person. • Keep purses and other valuables out of sight in your car – both when it’s parked and when

you’re moving.


• When you approach your car, have your keys in hand ready to unlock the door. Check in, around, and under the car BEFORE you get in.

• Alter habit patterns. Park in different areas; vary routes home. If followed, do not stop and confront the person. Call the CHP by dialing 9-1-1 on your cell phone or drive to the nearest Police Department, park in front and go quickly to the front door.

• Don’t get on an elevator if you’re suspicious of someone on it. If you’re on the elevator and a suspicious person gets on, get off or push the next floor to get off. Stand close to the floor-selection buttons and if someone threatens you, press as many of the buttons as you can. The elevator will stop often and you’ll have more chances to escape or get help.

• Avoid stairwells in parking garages. Crime rates are excessively high there. The auto ramp is less isolated, and if you have to scream for help, you’re more likely to be heard. Walk as far away from parked cars as possible. Vans, tall hedges and dumpsters provide good hiding places from which an attack could be launched.

Dealing with Angry/Violent Customers When dealing with customers who are angry or potentially violent: • Apologize for the inconvenience. • Empathize and sympathize with customers. • Ignore sarcastic remarks and personal attacks. • Don’t argue with customers. • Explain to customers things you CAN do to help, not what you CAN’T do. • Don’t accuse customers. You may be wrong. • Call for help when necessary.

Handling the Crisis If you are faced with a customer, employee, or thief with a weapon, don’t resist. If he or she wants your money or vehicle, give it up quickly. It can be replaced. Follow these tips if you have been the victim of an attack or have witnessed one: • Call 9-1-1 and Security immediately. • Carefully and accurately describe the act and the attacker. • Do not change anything at the scene where the violence occurred. • Do not clean up, reset furniture or touch any objects handled by the attacker. • In the event of rape, do not wash yourself or change clothes until a doctor has

completed an exam. Forensics will need to examine your clothing for evidence. If the incident was not an attack / threat that warrants a call to police, immediately report it to your supervisor or other authorities at your workplace. Notify Risk Management (386-8625) (County Policy # 09-08 vb) Contact Sheriff's OSS (909) 387-0346.

FORM 2011 SHERIFF'S OFFICE OF SAFETY AND SECURITY


10 Tips for Workplace Violence Prevention

1. BE EMPATHIC Try not to be judgmental of your adversary's feelings. They are real - even if not based on reality - and must be attended to.

2. CLARIFY MESSAGES Listen to what is really being said. Ask reflective questions, and use both silence and restatements.

3. RESPECT PERSONAL SPACE Stand al least 1 1/2 to 3 feet from the acting-out person. Encroaching on personal space tends to arouse and escalate an individual.

4. BE AWARE OF BODY POSITION Standing eye-to-eye or toe-to-toe with the individual sends a challenge message. Standing one leg length away and at an angle off to the side is less likely to escalate the tension.

5. PERMIT VERBAL VENTING WHEN POSSIBLE Allow the individual to release as much energy as possible by venting verbally. If this cannot be allowed, state directives and reasonable limits during lulls in the venting process.

6. SET AND ENFORCE REASONABLE LIMITS If the individual becomes belligerent, defensive, or disruptive, state limits and directives clearly and concisely.

7. AVOID OVERREACTING Remain calm, rational, and professional. How you, the staff person, respond

will directly affect the individual's response.

8. USE PHYSICAL TECHNIQUES AS A LAST RESORT Use the least restrictive method of intervention possible. Employing physical techniques on an individual who is only acting out verbally can escalate the situation.

9. IGNORE CHALLENGE QUESTIONS When the subject challenges your position, training, policies, etc., redirect the individual's attention to the issue at hand. Answering these questions often fuels a new set of problems.

10. KEEP YOUR NONVERBAL CUES NONTHREATENING Be aware of your body language, movement, and tone of voice. The more an individual loses control, the less he/she listens to your actual words. More attention is paid to your nonverbal cues. SBSD OFFICE OF SAFETY AND SECURITY FORM 2000-00


San Bernardino County Workplace Violence

Policy



SECTION: 2

AREA: CalOSHA 200 & 300A Reports 40

CALOSHA 300 A (Formerly the CalOSHA 200 Log) DBH Safety Binder Section 2

This report or set of documents (as of 2003 is now known as the CalOSHA 300A) are the reports generated following a CalOSHA reportable injury. These employee injury report sections MUST be maintained whether they contain reports or not. The CalOSHA 300A reports are generated from Risk Management each year and are forwarded to the DBH Safety Coordinator. The reports usually arrive in the dept. in late January and will be distributed to all DBH supervisors. When you receive them, post the reports immediately - next to your CalOSHA (5) posters until 30 Apr each year, then remove them and place the reports in Section 2 of the DBH Safety Program Binder and maintain for 5 years. Remove the oldest year reports – 5 years or older and shred them. You should have 5 sections (one for the current year, and four years prior). Reference San Bernardino County Employee Health & Safety Manual, Section 4 (Page 2, Item 1), Section 17, pages 128 – 129.

CalOSHA 300A 2006

CalOSHA 200

2002

CalOSHA 300 A 2005

CalOSHA 200

2003

CalOSHA 300 A 2004


Section 2

CalOSHA 200/300A Reports

SCHEDULE OF COMPLETION: 1 February & 1 May (annually) ACTIONS REQUIRED: Post next to CalOSHA posters from time of receipt until 30 April every year. (30 April) Remove from bulletin board and file in this binder (in the appropriate year’s section) DOCUMENTATION REQUIREMENTS: None required – posting & filing (in this section) only REPORT FORMAT: Generated by Risk Management SEND REPORT TO: N/A Methods OF SUBMISSION: N/A

Enter date completed

MONTH Post next to CalOSHA

posters

1 Feb 06

File in this section

1 May 06 Date Completed



SECTION: 3

AREA: Driver’s Safety Awareness Training Program

8

Driver/Vehicle Safety Program DBH Safety Binder Section 3

This section contains the documents for insuring all DBH staff have received the proper driver’s training, understand what to do in the event of an accident and properly conduct daily inspections of vehicles (inventory safety functions and safety equipment). EVERY employee should complete the DBH Employee Driver Training Record. If the employee does not require any additional training, the form can simply be filed in Section 3 of the DBH Safety Program Binder. See San Bernardino County Employee Health & Safety Manual Policy # 09-06 (Page 5), 09-04 (Page 6) and Section 16, (Page 120-121) . See attached DBH program and documentation requirements.

Section 3 Driver’s Safety Training

SCHEDULE OF COMPLETION: Conducted with every employee – at hire and annually thereafter CONDUCTED BY: SUPERVISOR/BLI ACTIONS REQUIRED:

1. Complete DBH Employee Driver Training Record (Attachment 1) for EACH employee & file in designated area of this section (this will instruct employees to review Attachments 4 –9)

2. Complete Employee Training Checklist (Attachment 3) for EACH employee & file in designated area of this section

3. Schedule employees for required training – enter documentation of completion into designated area of this section

DOCUMENTATIN REQUIREMENTS: Maintain all documentation in this section (in designated area) SEND REPORT TO: N/A (File all documentation in this section) Methods OF SUBMISSION: N/A

COMPLETED Enter date Completed

MONTH Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Completed

DBH Drivers’ Safety Program

Supervisors are responsible for insuring all drivers have received the proper training and have documentation for employees operating private or County- owned vehicles for County business. Below are a few quick steps to get you rolling in the right direction: HERE’S WHAT YOU NEED TO DO:

Completed Task Attachment Have each employee complete the

drivers’ safety training document.

Schedule affected employees for the required county vehicle training.

Have all employees review the County/DBH SPMs regarding use of county vehicles..

Place copies of the DBH Vehicle Safety Inspection Checklist in the glove box of each vehicle

Attachment 2

Complete the DBH Driver Training Record for each employee who will drive a personal or County-owned vehicle on County business- insuring employees understand procedures for daily vehicle inspection & accident reporting instructions.

Attachment 1

Once vehicle safety training is completed, document on the Employee Training Checklist.

Attachment 3

Insure all drivers are trained on routine vehicle maintenance, fueling, and service center procedures and have been given copies of locations for each.

Attachments 4 – 7 & 9

Insure accidents are reported properly and drivers receive periodic refresher training.

DBH SPM 12-2.13

DBH Employee Driver Training Record

This form must be completed by all DBH staff (whether or not the staff member will drive a personal or County vehicles for County business). (All required training should be completed within the first 90 days of hire.) The form may also be used to document corrective driver training. Employee Name: Classification/Job Title: Current Unit of Assignment: Date of Hire:

CA License #:

Private auto insurance liability limits have been met (if personal vehicle is used) YES NO ($5,000.00 for property damage, $15,000.00 for single injury or death and $30,000.00 for multiple injury or death) Co. Policy 12-02 (Attachment 8) Type of Vehicle(s) Driven: (Circle all that apply) Personal vehicle Passenger van Truck Other: ______________ Average number of one-way trips made on County business with County or personal vehicle (Weekly): (Circle One)

Reviewed Type of Training Date Completed

Training Provided by

Driver Awareness Course Risk Management Employee Safety Cklst.

(Attachment 3) Supervisor

Professional Driving I Risk Management Professional Driving II Risk Management Vehicle Safety Inspections (Attachment 2)

Supervisor or assigned Vehicle Maintenance Instructions

Co. Policy 12-04 (Attachment 9)

Supervisor or assigned Co. Vehicle Service Cntrs

(Attachments 5 – 7)

Supervisor or assigned Co. Authorized Fueling Stations

(Attachment 4)

Supervisor or assigned Accident Reporting

(DBH SPM 12-2.12)

Supervisor or assigned Vehicle Fueling Locations

(Attachment 4)

Supervisor or assigned Employee Signature

Date:

Employee Signature

Date: Yes No ANNUAL REFRESCHER TRAINING Date of

Training Conducted by

(Annual) Employee Safety Cklst. Supervisor (Refresher) Driver Awareness Risk Mgt. (Refresher) Professional Driving I Risk Mgt. (Refresher) Professional Driving II Risk Mgt.

*Must attend Driver Awareness or a Professional Driver I/II training course.

0 * 1 - 10 * 11 - 20 * 21 +

Attachment 1

INSERT COPIES OF

DBH Employee Driver

Training Record

• HERE

EMPTRNG.FRM

DBH Vehicle Safety Inspection Checklist Conduce a brief safety inspection of DBH-owned vehicles EACH DAY before putting the vehicle into service. For vehicles driven by more than one person each day, it is recommended each driver document his/her own vehicle safety inspection. Maintain a white binder with blank copies of the checklist in the vehicle. Turn in inspections to the program supervisor/BLI quarterly. Check the left column for all items in good repair. If a discrepancy is found, document in the comments section with the date, details of the discrepancy and to whom it was reported. Completed Vehicle Safety Inspection Checklists must be maintained in the DBH Safety Binder (Section 3).

Vehicle Number:

Conducted by (Driver):

Date

OK

INSPECTION ITEM COMMENTS/REPORTED

Driver has attended required Driver’s Training Course

Body of vehicle (No visible damage) Brakes functioning (And emergency brake) County Accident Reporting Documents (In glove box) Emergency Equipment (Fire ext, flashlight, first aid kit) Gas Head, high beams, tail and signal lights (Functioning) Horn (Properly functioning) Mirrors (Clean and adjusted to driver) Periodic Scheduled Maintenance (On schedule) Seat Belts (All available/properly functioning) Steering Control Tires (Properly inflated ) Visible fluid leaks (Check ground under vehicle) Windows/windshield (Clean, no visible damage) Wiper blades (In good repair and functioning)

Attachment 2

INSERT COPIES OF

COMPLETED

VEHICLE INSPECTIONS

HERE

EMPLOYEE TRAINING CHECKLIST County of San Bernardino This report is to be completed by the Supervisor and New Employee within five (5) working days of employment or new assignment. Additional forms are to be prepared as the employee receives safety training during the course of employment, at least annually. NAME:

BIRTH DATE:

DATE EMPLOYED:

JOB TITLE:

DEPT. ASSIGNED:

I HAVE BEEN INSTRUCTED IN THE FOLLOWING SUBJECTS THAT ARE CHECKED.

YES

NO

1

Safety policies and programs

2

Safety rules, both general and specific to the job assignment

3

Safety rule enforcement procedures

4

Use of tools and equipment

5

Proper work shoes and other personal protective equipment

6

Handling of material

7

Lifting and use of lifting equipment, such as hoists and cranes

8

How, when, and where to report injuries

9

Importance of housekeeping

10

Special hazards of job

11

When and where to report unsafe conditions

12

Safe operation of vehicle (See below)

13

Personal protective equipment: / /

14

Hazardous materials: / / /

15

Tools/Equipment: / / /

16

List all training not indicated above (use back of form if necessary):

1. Driver’s Awareness Training (or Professional Driver’s I/II Training) 2. Emergency Evacuation Plan 3. Haz Com Program

4. Other: _________________________________________________________________ EMPLOYEE SIGNATURE:

DATE:

Follow up on employee will be observed: Employee has performed operation to the satisfaction of the undersigned. An observation was completed on the date indicated. SUPERVISOR SIGNATURE:

DATE:

IMPORTANT: If employee is transferred to another job, an additional safety instruction report must be completed.

Attachment 3

INSERT COPIES OF

EMPLOYEE TRAINING

CHECKLIST

HERE

SAN BERNARDINO COUNTY (Keep a copy in ALL assigned County Vehicles)

AUTHORIZED REFUELING LOCATIONS County Operated Facilities Apple Valley Road Yard Fontana Sheriff's Station Prado Regional Park 11923 Joshua Road 17780 Arrow Blvd. 16700 S. Euclid Avenue Apple Valley, CA 92307 Fontana, CA 92335 Chino, CA 91710 760-247-8208 909-387-7855 909-597-4260 Monday - Friday 7:30 - 4:00 p.m. 24 Hours - 7 Days Emergency Use Only Unleaded-Diesel Unleaded - Diesel Unleaded – Diesel Baldy Mesa Road Yard Glen Helen Regional Park Running Springs Road Yard 12397 Sycamore Road 2555 Glen Helen Parkway 1920 Wilderness Road Victorville, CA 92392 San Bernardino, CA 92407 Running Springs, CA 92382 760-949-0335 909-880-2522 909-336-0680 Monday - Friday 7:30 - 4:00 p.m. Emergency Use Only Emergency Use Only Unleaded-Diesel Unleaded – Diesel Diesel Only Barstow Road Yard Glen Helen Rehabilitation Center San Bernardino Main Yard 29802 Highway 58 Glen Helen Road 210 N. Lena Road Barstow, CA 92311 San Bernardino, CA 92403 San Bernardino, CA 92415 760-256-3631 909-880-7550 909-387-7855 24 Hours - 7 Days Monday – Friday 8:00 - 4:00 p.m. 24 Hours - 7 Days Unleaded-Diesel Unleaded Only Unleaded - Diesel – CNG Big Bear Road Yard Moabi Regional Park Trona Road Yard 40290 North Shore Drive Interstate 40/Park Moabi Road 80311 Trona Road Big Bear Lake, CA 92315 Needles, CA 92363 Trona, CA 93562 909-866-2167 760-326-3831 760-372-5888 Monday - Friday 7:30 - 4:00 p.m. Emergency Use Only Emergency Use Only Diesel Only Unleaded – Diesel Diesel Only Big Bear Sheriff's Station Twin Peaks Sheriff's Station Twentynine Palms Service Center 477 Summit Blvd. 26010 Highway 189 73663 Manana Big Bear, CA 92315 Twin Peaks, CA 92391 Twentynine Palms, CA 92277 909-866-0100 909-336-0600 760-367-9885 24 Hours - 7 Days 24 Hours - 7 Days 24 Hours - 7 Days Unleaded - Diesel Unleaded - Diesel Unleaded – Diesel Needles Service Center West Valley Service Center Calico Ghost Town 5 Airport Road 12672 4th Street Interstate 15/Ghost Town Road Needles, CA 92363 Rancho Cucamonga, CA 91730 Yermo, CA 92398 760-326-4117 909-463-5127 760-254-2122 Monday - Friday 7:30 - 5:00 p.m. 24 Hours - 7 Days Emergency Use Only Unleaded - Diesel Unleaded - Diesel Unleaded Only Crestline Road Yard Morongo Basin Sheriff's Station Chino Road Yard 23188 Crest Forest Road 6527 White Feather Road 7000 Merrill Avenue Crestline, CA 92325 Joshua Tree, CA 92252 Chino, CA 91710 909-338-2140 760-366-4175 909-597-6270 Monday - Friday 7:30 - 4:00 p.m. 24 Hours - 7 Days Monday – Friday 7:30 - 4:00 p.m. Unleaded - Diesel Unleaded - Diesel Unleaded - Diesel

Attachment 4

Vehicle Service Centers for vehicle malfunctions:

BARSTOW

NEEDLES

Attachment 5

29 PALMS

WEST VALLEY

Attachment 6

Fleet Management 210 North Lena Road San Bernardino, CA 92415-0130 909.387.7881

LENA RD – SAN

Attachment 7

COUNTY OF SAN BERNARDINO POLICY MANUAL No. 12-02 ISSUE 1 PAGE 1 OF 1 By EFFECTIVE 10/15/74 SUBJECT PRIVATE VEHICLE USED ON COUNTY BUSINESS APPROVED NANCY E. SMITH CHAIRMAN, BOARD OF SUPERVISORS POLICY STATEMENT The following rules shall govern the use of private vehicles used on County business: 1. Employees authorized to use private vehicles on County business shall possess a valid California Driver's License. 2. Private vehicles used on County business shall be covered by vehicle liability insurance at least equal to the minimum requirements of the California Vehicle Code. Such requirements currently are: a. $15,000 for single injury or death. b. $30,000 for multiple injury or death. c. $5,000 for property damage. Employees who do not meet the above requirements shall not be permitted to use private vehicles on county business until such requirements are met.

Attachment 8

COUNTY OF SAN BERNARDINO POLICY MANUAL No. 12-04 ISSUE 3 PAGE 1 OF 2 By EFFECTIVE 2/3/92 SUBJECT VEHICLE SERVICES POLICY APPROVED LARRY WALKER CHAIRMAN, BOARD OF SUPERVISORS POLICY STATEMENT It is the policy of the Board of Supervisors to provide and maintain essential, safe, presentable and identified transportation equipment to the officials and employees of San Bernardino County. POLICY AMPLIFICATION 1. This policy is to be accomplished primarily through the operation of a central Motor Pool and Garage. 2. The effective operation of the County Vehicle Services Department is governed by a system of rules and procedures relating to the control and use of County Motor Pool vehicles. 3. The County Administrative Officer is the responsible authority for appointing a Vehicle Services Committee which shall establish the operating rules and procedures for County Motor Pool vehicles. 4. The General Services Group is the designated authority for administering the County Motor Pool in accordance with the rules and procedures established by the Vehicle Services Committee. 5. It is the responsibility of each Assistant Administrative Officer or Department Head to insure that all personnel who operate County vehicles are made aware of the Motor Pool rules and procedures, and that they comply with them. 6. The Vehicle Services Committee is authorized to adopt rules and procedures relating to Motor Pool operations in accordance with Board of Supervisors’ Policy and the following special requirements: a. Persons other than County employees and authorized volunteers will not be allowed to operate a County Motor Pool vehicle without written permission of the Department Head. b. Employees assigned to operate a County Motor Pool vehicle must possess a valid California

Attachment 9

COUNTY OF SAN BERNARDINO POLICY MANUAL NO. 12-04 ISSUE 3 PAGE 2 OF 2 driver’s license for the type of vehicle operated. c. Before operating a vehicle, employees must visually check it for safety concerns, and they must adjust and use safety belts. d. It is the intent of the Board to restrict use of credit cards to minimum essential requirements. e. The official County emblem or approved alternate insignia will be affixed to each County vehicle unless specifically exempted by the Vehicle Services Committee. f. The objectives of the Corporate Trip Reduction Plan will be accommodated within the Vehicle Services Rules and Procedures


Section 5 Ergonomics

LIST OF RESPONSIBLITIES:

1. Supervisor completes (Risk Management) Ergonomics Training for New Supervisors upon first supervisory assignment

2. Supervisor/BLIs conduct ergonomic training with employees (November) annually – See this section & Section 13 of this manual

3. Supervisor conducts periodic assessments of employees workstations using checklist (in this section)

4. Supervisor requests industrial ergonomic assessment of workstations (Risk Management) when required – ordered through Yvonne Armstrong (DBH Staff Analyst II)

CONDUCTED BY: SUPERVISOR DOCUMENTATION REQUIREMENTS: Maintain documentation of Ergonomic studies, requests for furniture or corrective equipment in this section (in designated area) SEND REPORT TO: N/A (File all documentation in this section) Methods OF SUBMISSION: N/A

Supervisor Attends: ERGONOMICS FOR SUPERVSORS (Risk Mgt. Course)

Enter date Completed

MONTH Supervisor Supervisor Supervisor Supervisor Date Completed



Section 4 Emergency Action Plan

(EAP) SCHEDULE OF COMPLETION: April (annually by the 22nd of the month) ACTIONS REQUIRED:

1. Make a COPY of and keep the original as your master. Fill in all SITE-SPECIFIC information highlighted in BLUE.

2. Make copies for ALL staff 3. Review with staff 4. Staff sign Acknowledgement Sheet 5. Keep original Staff Acknowledgement Sheet in this section (designated area) 6. Send copy of the Staff Acknowledgement sheet to your RSR ______________________

NOTE: This EAP is contained in this section of your manual and can be sent to you electronically (Make your request for e-copy via email to Gwen More)– must be site-specific CONDUCTED BY: SUPERVISOR/BLI

REPORT FORMAT: Use the standardized plan contained in this section of the manual SEND SHEET TO: Regional Safety Rep _______________________________ Methods OF SUBMISSION: HARD COPY ONLY

Enter date completed

April

MONTH 2006 Date Completed


Emergency Action Plan Date: ____________________

Facility Name/Location:__________________________

_______________________ Facility Supervisor: ______________________ BLI: ________________________

Program Manager: _____________________ Dep Dir: _______________________

Purpose

CALOSHA's Emergency Action Plan standard, found at 29 CFR 1926.35, requires Department of Behavioral Health to have a written emergency action plan (EAP). This EAP addresses emergencies that our program expects may reasonably occur at any of our construction sites.

The EAP communicates to employees, policies and procedures to follow in emergencies. This written plan is available, upon request, to employees, their designated representatives, and any CALOSHA officials who ask to see it.

Under this plan, our employees will be informed of the plan's purpose, emergency escape procedures and route assignments, procedures to be followed by employees who remain to control critical plant operations before they evacuate, procedures to account for all employees after emergency evacuation has been completed, rescue and medical duties for those employees who perform them, preferred means of reporting fires and other emergencies, types of evacuations to be used in various emergency situations, and the alarm system.

The safety and health manager, ENTER Safety Rep/BLI NAME, is the program coordinator, acting as the representative of the plant manager, who has overall responsibility for the plan. Mr./Ms. ENTER SUPERVISOR & BLI NAME will review and update the plan as necessary. Copies of this plan may be obtained from This plan is kept in the red safety folder # 14 (name file location clinic, building & room number) in This plan is kept in the red safety folder # 14 (name file location clinic, building & room number).

If after reading this program, you find that improvements can be made, please contact the safety and health manager, ENTER BLI NAME. We encourage all suggestions because we are committed to the success of our emergency action plan. We strive for clear understanding, safe behavior, and involvement in the program from every level of the company.

Emergency Escape Procedures and Assignments

Our emergency escape procedures and assignments are designed to respond to many potential emergencies including: fire, assaultive client/employee, chemical spills, utility failure, flood, earthquake, (enter site specific potential hazards)

Employees need to know what to do when they are the first persons to discover an emergency and when they are alerted to a specific emergency. Our safety and health manager, has developed alternate procedures for responding to an emergency, depending on what the emergency is. The following guidelines apply to all EAPs: 1. All employees are trained in safe evacuation procedures, and refresher training is conducted whenever the employee's responsibilities or designated actions under the plan change, and


whenever the plan itself is changed. In addition, the employer must review with each employee, upon initial assignment, the parts of the plan which the employee must know to protect the employee in the event of an emergency.

2. The training includes use of floor plans and workplace maps (Attachment 1) which clearly show the emergency escape routes included in the Emergency Action Plan. Color coding aids employees in determining their route assignments. These floor plans and maps are available and posted at all times in every area of the company to provide guidance in an emergency.

3. As a matter of general practice, stairwells are the primary means for evacuation. Elevators (if applicable) are used only when authorized by a fire or police officer, or to assist physically disabled personnel.

4. No employee is permitted to re-enter the building until advised by the Safety Manager (after determination has been made that such re entry is safe).

5. A map of refuges/safe zones and medical triage area are given in this table (primary and secondary assembly zones are meeting areas designated in a location deemed safe for each group of employees within the facility (Attachment 2) in the Department of Behavioral Health:

See the appendix for a copy of the building plans with means of egress procedures for each group evacuating an area or building.

6. Floor Wardens (insert names and assignments) have been appointed to assist with the safe evacuation of occupants and those with special needs. They will also assist the manager to insure all occupants are out of the building and will conduct the accountability check.

Each department reports to there respective representative as follows:

(enter your answer - how you account for ALL staff, clients, and visitors to your facility - who is responsible for taking roll)


The supervisor and BLI (s) will remain behind (or at a safe distance from the building) to insure complete evacuation, then will depart to the building and will check in with the floor wardens for the accountability roll call. The procedures to be taken by those employees who have been selected to remain behind to care for essential plant operations until their evacuation becomes absolutely necessary include: 1. The monitoring of plant power supplies and water supplies, essential services which cannot be shut down for every emergency alarm, and

2. Manufacturing processes (if applicable) which must be shut down in stages or steps where certain employees must be present to assure that safe shut down procedures are completed, including the following manufacturing processes: All individuals will evacuate the facility in emergency.

3. In the event of fire, attempt to close all doors as you evacuate the building. If the scene is unsafe to do so, evacuate immediately.

Trained evacuation personnel conduct head counts once evacuation has been completed. There is at least one trained evacuation person for each twenty employees in the workplace to provide adequate guidance and instruction at the time of an emergency. The employees selected are trained in the complete workplace layout and the various alternative escape routes from the workplace. All trained personnel are made aware of employees with disabilities who may need extra assistance, such as using the buddy system, and of hazardous areas to be avoided during emergencies. Before leaving, these employees check rooms and other enclosed spaces in the workplace for employees who may be trapped or otherwise unable to evacuate the area. A copy of the list of trained personnel appears below:

(enter your answer) - list those people who will secure the building, contact emergency personnel (if applicable) and account for all evacuees. (Include names & titles)

Name Title

FLOOR WARDENS: Once each evacuated group of employees have reached their evacuation destinations, each trained Floor Warden (evacuation employee):

• Takes roll of his or her group. • Makes sure all persons are accounted for. • Reports in to a central checkpoint managed by the company safety and health officer. • Assumes role of department contact to answer questions.


(enter your answer - include duties such as checking restrooms, group rooms, meeting rooms, contacting emergency services, taking roll at the assembly point, etc.)

Name Duties

Rescue and Medical Duty Assignments Rescue and medical aid may be necessary during emergency situations. Circumstances calling for rescue and/or medical aid include:

This plan is kept in the red safety folder # 14 (name file location clinic, building & room number)

Name Location/bldg/room #

EMERGENCY RESPONSE TEAM (ERT) members are responsible for performing rescue duties in case of an emergency requiring rescue. Members of the ERT include: (enter your answer - List the names & titles of those given these assignments)

Name Title

FIRST AID RESPONDERS are to provide medical assistance within their capabilities to


employees requiring it during an emergency situation. Designated first aid responders include the following individuals:

(enter your answer - list the two members of your facility who are First Aid/CPR certified and responsible for responding to medical first aid situations)

Name Title

Professional emergency services responding in an emergency will help with and direct all rescue and medical duty assignments upon their arrival on site.

Emergency Reporting Procedures

In the Event of a Fire

FIRE ALARM LOCATIONS - When a fire is detected, go to the nearest fire alarm station and activate the alarm by pulling on the lever. The alarms will notify the Emergency Response Team as well as the (enter your answer - list the names and phone numbers of the responding agencies -- fire/police dept., medical response) Fire Department. Fire alarms are located on each floor near the elevators, and also near each entry/exit door.

FIRE ALARM PULL STATION LOCATION

RESPONDING AGENCY & PHONE #

The Emergency Response Team will perform assigned duties and will meet the fire department to assist them in putting out the fire. Head counts should be given to the (enter your answer - list the names and phone numbers of the responding agencies -- fire/police dept., medical response) Fire Chief or fire fighter. No employees are to return to the buildings until the "all clear” is given by the ERT leader or the (enter your answer - list the names and phone numbers of the responding agencies -- fire/police dept., medical response) Fire Chief.

Agency Phone #

In the Event of a Tornado


The Safety Manager has access to (enter your answer - indicate if your facility does or does not have PA or alarm systems). When a tornado watch has been issued by the National Weather Service, the weather page will sound, followed by a weather bulletin with further information. At that point, the Safety Manager or his designee will turn on the scanner to monitor the National Weather Service reports. The Safety Manager will use the tornado horn to warn employees of tornado (N/A).

In the event of a tornado, it is corporate policy to provide emergency warning and shelter. At the time the tornado horn sounds, all employees are responsible for evacuating to their assigned shelters in a tornado emergency. Following is a table with shelter assignments listed:

No shelters have been designated for employees. If a mass evacuation was necessary, employees would be instructed where to reassemble.

Trained Evacuation Personnel

CRITICAL FACILITY OPERATIONS PERSONNEL The following employees are designated to remain behind during evacuation to care for critical plant operations:

(enter your answer – names & titles)

Name Title

In the event of a complete evacuation of the facility, no will remain in place.

Trained Evacuation Personnel

A sufficient number of employees have been designated by the facility and trained to assist in safe and orderly emergency evacuation for all types of emergency situations. The list of people trained includes at least one person from every area for every shift. These employees are to help direct all employees during emergency evacuation, serve as a resource of information about emergency procedures, and conduct head counts once evacuation has been completed. A copy of the list of trained personnel appears below: (enter your answer - list those people who will secure the building, contact emergency personnel (if applicable) and account for all evacuees. (Include names & titles)

Name Title


Safety Manager Responsibilities

Here at Department of Behavioral Health, the Safety Manager (name & title)

Name Title

is responsible for the following activities. He or she must:

1. Develop a written emergency action plan for regular and after hours work conditions.

2. Immediately notify the local fire or police departments, and the building owner/superintendent in the event of an emergency affecting the office.

3. Integrate the emergency action plan with the existing general emergency plan covering the building occupied.

4. Distribute procedures for reporting a fire, bomb threat, or other emergency, the location of fire exits, and evacuation routes to each employee.

5. Conduct drills to acquaint the employees with emergency procedures, and to judge the effectiveness of each plan. Fire drills are required by Department of Behavioral Health quarterly fire drills are required.

6. Satisfy all local fire codes and regulations as specified.

7. Train designated employees in the use of fire extinguishers and the application of medical first aid techniques.

8. Keep key management personnel home telephone numbers in a safe place in the office for immediate use in the event of an emergency. Distribute a copy of the list to key persons to be retained in their homes for use in communicating an emergency occurring during non-work hours.

9. Decide to remain in or evacuate the workplace in the event of an emergency.

10. If evacuation is deemed necessary, the safety manager ensures that:

• Notify Department management of the emergency and facility operational status Employees are notified and a head count is taken to confirm total evacuation of all employees.

• When practical, equipment is placed and locked in storage rooms or desks for protection. • The building owner/superintendent is contacted, informed of the action taken, and asked to

assist in coordinating security protection.


• In locations where the building owner/superintendent is not available, security measures to protect employee

• All records and property are arranged as necessary.

Training

At the time of an emergency, employees should know what type of evacuation is necessary and what their role is in carrying out the plan. In cases where the emergency is very grave, total and immediate evacuation of all employees is necessary. In other emergencies, a partial evacuation of nonessential employees with a delayed evacuation of others may be necessary for continued plant operation. We must be sure that employees know what is expected of them during an emergency to assure their safety.

This document is not one for which casual reading is intended or will suffice in getting the message across. If passed out as a statement to be read to oneself, some employees will choose not to read it, or will not understand the plan's importance. In addition, training on the plan's content is required by CALOSHA.

A better method of communicating the emergency action plan is to give all employees a thorough briefing and demonstration. Department of Behavioral Health has chosen to train employees through presentation followed by a drill. Our local fire department requires Fire drills are required by Department of Behavioral Health quarterly fire drills, so we cover related EAP information at that time.

A better method of communicating the emergency action plan is to give all employees a thorough briefing and demonstration. Department of Behavioral Health has all managers and supervisors present the plan to their staffs in small meetings.

Our building houses several places of employment, so we have set up a building wide EAP including all employers in the building. Department of Behavioral Health has informed our employees of their duties and responsibilities under the plan. The standardized plan is kept by the Safety Manager and is accessible by affected employees at This plan will be reviewed annually by the facility Supervisor and BLI.

Types of Emergency Evacuations

At this facility, the following types of emergency evacuation exists in addition to those detailed earlier in this plan:

1. Assaultive client/employee, earthquake and bomb threats.

(Refer to DBH SPMs 7-10.20 (assaultive clients), 7-1.21 (clients with weapons) , 7-2.10 (bomb threats), 7-1.11 (earthquakes) for procedures that ensure a better understanding of the written program.)


Place a copy of the

INTERNAL BUILDING

FLOOR PLAN

HERE


Place a copy of the

OUTDOOR MAP TO PRIMARY & SECONDARY

ASSEMBLY AREAS

HERE



SECTION: 5

AREA: Ergonomics 9

Ergonomics Program DBJ Safety Binder Section 5

This section contains ergonomic study requests and reports and any employee complaint (written or otherwise) regarding repetitive motion injuries or problems, requests for ergonomic studies and/or equipment requested to correct an ergonomic problem. All requests for Workstation Ergonomic Assessments should be directed through Yvonne Armstrong, HR Staff Analyst II (909-386-0707). Reference the San Bernardino County Employee Health & Safety Manual, Section 12.


Section 5 Ergonomics


5. Supervisor completes (Risk Management) Ergonomics Training for New Supervisors upon first supervisory assignment

6. Supervisor/BLIs conduct ergonomic training with employees (November) annually – See this section & Section 13 of this manual

7. Supervisor conducts periodic assessments of employees workstations using checklist (in this section)

8. Supervisor requests industrial ergonomic assessment of workstations (Risk Management) when required – ordered through Yvonne Armstrong (DBH Staff Analyst II)

CONDUCTED BY: SUPERVISOR DOCUMENTATION REQUIREMENTS: Maintain documentation of Ergonomic studies, requests for furniture or corrective equipment in this section (in designated area) SEND REPORT TO: N/A (File all documentation in this section) Methods OF SUBMISSION: N/A Supervisor Attends: ERGONOMICS FOR SUPERVSORS – (Risk Mgt. Course)

Enter date training was completed MONTH Supervisor Supervisor Supervisor Supervisor Date Completed


INTEROFFICE MEMO DATE: March 11, 2004 PHONE: 387-7022 FROM: RUDY LOPEZ, Director Department of Behavioral Health TO: ALL DBH EMPLOYEES SUBJECT: SAFETY SERVICES CONTACT

Please coordinate requests to schedule ergonomic evaluations with Pearl Holliday (now Yvonne Armstrong) , Staff Analyst II, effective immediately. You may reach Ms. Holliday via e-mail or at 386-0707. Thank you. RL:ph cc: Steven Robles, County Safety Officer

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Insert

• Ergonomic Assessment Requests • Reports • Corrective Action Documents

Here

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Department of Behavioral Health Ergonomics Program

Program: Date Reviewed: Supervisor: BLI: PURPOSE The purpose of this program is to inform and employees of Department of Behavioral Health we are committed to preventing or reducing the incidence and severity of musculo-skeletal disorders (MSDs), keeping workers on the job, and boosting productivity and workplace morale. Our Ergonomics Program is the most effective way to reduce risk, decrease exposure, and protect our workers against MSDs. This program applies to all work operations; however, it does not address injuries caused by slips, trips, falls, vehicle accidents, or similar accidents. Grandfather Clause Because our Ergonomics Program has been implemented before November 14, 2000 and contains the following OSHA-required elements, we are allowed to continue our program instead of complying with 29 CFR 1910.900(d) - (y): · MANAGEMENT LEADERSHIP- We have an effective MSD reporting system with prompt responses to reports, clear program responsibilities, and regular communication with employees about our program. · EMPLOYEE PARTICIPATION- Our facility program encourages early reporting of MSDs and active involvement by employees and their representatives in the implementation, evaluation, and future development of our program. Reports should be made to the immediate supervisor or BLI. · JOB HAZARD ANALYSIS AND CONTROL- We have implemented a process that identifies, analyzes, and uses feasible engineering, work practice, and administrative controls to control MSD hazards or to reduce them to the levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D or to the extent feasible. We also evaluate controls to assure that they are effective. Personal protective equipment (PPE) may be used to supplement engineering, work practice, and administrative controls, but PPE may only be used alone where other controls are not feasible. Where PPE is used, we provide it at no cost to employees.

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· TRAINING- We train managers, supervisors, and employees (at no cost to these employees) in the following: our program and their role in it, the recognition of MSD signs and symptoms (using a workplace checklist for each employee), the importance of early reporting, the identification of MSD hazards in jobs in our workplace, and the methods our facility is taking to control MSD hazards. Training sessions using handouts, video, and observation are used to train supervisors in the recognition of and mitigation of ergonomic problems. · PROGRAM EVALUATION- Our facility regularly reviews the elements of the program and its effectiveness as a whole, using such measures as reductions in the number and severity of MSDs, increases in the number of jobs in which MSD hazards have been controlled, or reductions in the number of jobs posing MSD hazards to employees. Identified deficiencies in the program are corrected in a timely manner. At least one review of the elements and effectiveness of the program took place prior to January 16, 2001. Department of Behavioral Health has implemented a policy prior to January 16, 2002, that provides MSD management as specified in 29 CFR 1910.900(p), (q), (r), and (s). These and all other policies or procedures do not discourage employees from participating in the program or reporting the signs or symptoms of MSDs or the presence of MSD hazards in the workplace. For more information on our Ergonomics Program, program evaluations prior to January 16, 2001, and our MSD management policy, contact (enter your answer). BASIC INFORMATION Informed employees are critical to assure the accuracy of our reporting system. (Facility Supervisor ____________________________ is responsible for providing all existing and new employees with the following information in (method - written/oral/training) form within 14 days of hiring by signing the Employee Training Checklist. At the same time, the information is also posted (location ________________________________________________________________). (Facility Supervisor ____________________________ provides the information in the language and at levels the employees comprehend. If our facility has workers who cannot read, (____________________________ (enter your answer) communicates the information orally or through visual displays or graphics.

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REPORTING Any employee reports of MSDs and MSD signs or symptoms are taken seriously by Department of Behavioral Health. Reports may indicate actual "MSD incidents." They may also indicate an element(s) of our Ergonomics Program is not properly functioning. This is why it is important to critically evaluate employee reports. These injuries will be discussed at quarterly DBH Safety Committee meetings. We use the following method(s) for reporting MSDs and MSD signs and symptoms: (enter your answer__________________________________________________) Our reporting system ensures (enter your answer_______________________) receives and promptly responds to the report, evaluates the report to determine whether the reported MSD or MSD signs or symptoms qualify as an MSD incident, and takes appropriate action. A report is considered to be an MSD incident if: · The MSD is work-related and requires days away from work, restricted work, or medical treatment beyond first aid; or · The MSD signs or symptoms are work-related and last for 7 consecutive days after the employee reports them to the facility. Our facility has the option to request the assistance of a health care professional (HCP) in making this determination, at no cost to the employee. When HCP assistance is requested, Department of Behavioral Health refers to the following HCP(s): to Yvonne Armstrong and Risk Management. If an MSD incident has occurred, to Yvonne Armstrong and Risk Management determines whether the job meets the "action trigger" specified in the Ergonomics Program Standard. A job meets the action trigger if both of the following conditions exist: · An MSD incident has occurred in that job; and · The employee's job routinely involves, on one or more days a week, exposure to one or more relevant risk factors at the levels described in the Basic Screening Tool in Table W-1 of 29 CFR 1910.900. The following occurs depending on whether or not a job meets the action trigger: If ____________________________________________________________ Then ____________________________________________________________ The employee's job does not meet the action trigger

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Our facility does not need to take further action for the MSD incident. The employee's job does meet the action trigger Our facility must either: · Comply with the quick fix option (see the Quick Fix Option section), or · Develop and implement a Full Ergonomics Program that includes these elements: management leadership, employee participation, job hazard analysis, hazard reduction and control measures, MSD management, training, and program evaluation. QUICK FIX OPTION A "quick fix option" is a way to quickly and completely fix a job that meets the action trigger when an MSD incident has occurred in that job. The benefit to using the quick fix option is that the hazards are controlled quickly and more informally, employee(s) in that job are safer, and our facility does not need to set up the Full Ergonomics Program for that job. We may use the quick fix option for a job if in the preceding 18 months: · Our employees have experienced no more than one MSD incident in that job, and · There have been no more than two MSD incidents in our establishment. If we do quick fix a problem job, we follow these steps: 1. The facility promptly makes MSD management available, as appropriate (see the MSD Management section). 2. (enter your answer _____________________________________________) talks with employee(s) in the job and their representatives about the tasks they perform that may relate to the MSD incident, observes the employee(s) performing the job to identify which risk factors are likely to have caused the MSD incident, and asks employee(s) performing the job and their representatives to recommend measures to reduce exposure to the MSD hazards identified. 3. (enter your answer________________________________________________) implements quick fix controls within 90 days after the job has been determined to meet the action trigger. For each problem job, we use feasible engineering, work practice, or administrative controls, or any combination of these, to reduce MSD hazards in the job. Where feasible, engineering controls are the preferred method of control. Personal protective equipment (PPE) may be used to supplement engineering, work practice, or administrative controls, but PPE may be used alone only where other controls are not feasible. Any PPE used is provided at no

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cost to employees. MSD hazards must be controlled or reduced in accordance or to levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D. 4. (enter your answer - the Supervisor _______________________________) trains the employee(s) in the use of the selected quick fix controls within 90 days after the job has been determined to meet the action trigger. 5. (enter your answer_the Supervisor _________________________________) checks the job within 30 days after controls are implemented: · If (enter your answer_the Supervisor _______________________ or Risk Management) determines that the MSD hazards have been reduced to the levels specified in 29 CFR 1910.900 Appendix D, then no further action except to maintain controls for that job, training related to those controls, and record keeping is required; or · If (enter your answer__the Supervisor _______________________ or Risk Management determines that the MSD hazards have not been reduced to the levels specified in 29 CFR 1910.900 Appendix D, then our facility must implement a Full Ergonomics Program. 6. For three years, (enter your answer __the Supervisor ___________________________) keeps a record of the quick fix process for each job to which it is applied. 7. (enter your answer __the Supervisor ______________________________) Note: If any one of the following occurs, we must set up the Full Ergonomics Program for the job: · The quick fix controls do not sufficiently reduce the MSD hazards within the quick fix deadline (within 120 days after the job is determined to meet the action trigger); or · Another MSD incident is reported in that job within 18 months; or · More than two MSD incidents occur in your establishment within 18 months of each other. MANAGEMENT LEADERSHIP The following Ergonomics Program Administrator(s) coordinates the Ergonomics Program elements for our facility: (enter your answer_Human Resources (Yvonne Armstrong takes requests for Ergonomic Assessments, Risk Management conducts the assessments and makes recommendations for corrective actions, Risk Mgt and/or Property Management orders corrective equipment and Risk Management monitors corrective actions). This person(s) is responsible for setting up and managing the program so that managers, supervisors, and employees know what our facility expects. Our Program Administrator(s) is accountable for meeting these responsibilities because we: (enter your answer _rely on their

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expertise to make recommendations). He/She has the authority (delegated ability to take action) to carry out his/her duties in a timely manner so that progress is made in meeting program goals. He/She is also provided with the following resources and information sufficient to meet those responsibilities: (enter your answer_Provide a report including required equipment and adjustments___________________). (enter your answer _the Supervisor, ___________________________) has examined our existing policies and practices to ensure that they encourage and do not discourage reporting and participation in our program. In this way, early reporting of MSDs, MSD signs and symptoms, and MSD hazards and meaningful employee participation in the program are more likely to occur. The reporting of MSD signs and symptoms is especially important because the success of the program depends on such reporting. All facility incentive programs are designed to reward safe work practices (such as active participation in the program, the identification of MSD hazards in the workplace, and the reporting of the early signs and symptoms of MSDs), rather than to reward employees for having fewer MSDs or lower rates of MSDs. (enter your answer The Supervisor ___________________________________) process to with employees about the Ergonomics Program and their concerns about MSDs so they have the information necessary to protect themselves from MSDs and have effective input into the operation of the program. EMPLOYEE PARTICIPATION All employees and their representatives are expected to understand our MSD reporting system, so that reports of MSDs, MSD signs and symptoms, and MSD hazards are received in a timely and systematized manner. (enter your answer_the Supervisor____________________________) responds promptly to all reports. See the Reporting section of this program. (enter your answer_the Supervisor___________________________________) provides employees and their representatives with a summary of the requirements of the Ergonomics Program Standard, 29 CFR 1910.900, along with other basic information about MSDs, MSD signs and symptoms, MSD hazards, and our Ergonomics Program. See the Basic Information section for details about the summary and information. A copy of 29 CFR 1910.900 is located (enter your answer__in Section 5 of the DBH Safety Program Binder). We also provide access to: (enter your answer _County Ergonomic Program standards). This and other information about the program can be obtained (enter your answer_on the Risk Management Intranet and Public Safety Folder in Outlook). However, no confidential or private information of a personal nature, such as medical records, will be provided. There are many ways for employees,

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or their designated representatives, if applicable, to be involved in developing, implementing, and evaluating each of the program elements: (enter your answer_training is provided on the standard. BLIs are also available for reporting of MSDs). Our program can only be effective if employees are involved in the important elements of the program. JOB HAZARD ANALYSIS When a job meets the action trigger, we perform a job hazard analysis for that job. However, we may rely on a previously conducted analysis to the extent it is still relevant. We include all employees who perform the same job, or a sample of employees in that job who have the greatest exposure to the relevant risk factors. Here are the steps we use in our job hazard analysis: 1. Talk to employees-Our facility talks with employees and their representatives about the tasks the employees perform that may relate to MSDs. This is done using the following method(s): (enter your answer _upon hire and is documented on the Employee Training Checklist and is also covered in Section 13 of the DBH Safety Program Binder as a training topic each November). 2. Observe Performance-Our facility observes employees performing the job to identify the risk factors in the job and to evaluate the magnitude, frequency, and duration of exposure to those risks. This is done using the following method(s): (enter your answer _BLIs watch for informal erognomic corrections made by employees, Supervisors attend the Ergonomics for Supervisors course and keep a watchful eye for injuries). 3. (enter your answer __the Supervisor ______________________________) will determine if there is an MSD hazard in the job, the job will be termed a "problem job." However, if it is determined that MSD hazards pose a risk only to the employee who reported the MSD, our facility may limit our job controls, training, and evaluation to that individual employee's job. HAZARD REDUCTION AND CONTROL MEASURES Job hazard controls are engineering, administrative, and work practice controls, or any combination of these, used to reduce or eliminate MSD hazards. While engineering controls, where feasible, are the preferred method, administrative and work practice controls also may be important in addressing MSD hazards. Personal protective equipment (PPE) may also be used to supplement engineering, work practice, and administrative controls, but may only be used alone where other controls are not

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feasible. Where PPE is used, our facility provides it at no cost to employees and meets the requirements of OSHA's PPE Standard, 29 CFR 1910.132. Note: Examples of PPE include vibration-reduction gloves and carpet layer's knee pads. Although (1) evidence for back belt effectiveness is limited, (2) a number of studies report inconclusive results, and (3) several others showed negative effects, OSHA permits back belts to be used as PPE. It would, however, be inappropriate to consider back braces and wrist braces/splints used for treatment after an injury as PPE. Ultimately, our facility implements job hazard controls to bring us to one of three ends, as required by OSHA: · The MSD hazards are controlled; · The MSD hazards are reduced in accordance with or to levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D; or · The MSD hazards are reduced to the extent feasible. Then at least every three years, (enter your answer_the Supervisor with the assistance of the BLI, including feedback from those who perform the job task) assesses the job to determine whether additional feasible controls would control or reduce MSD hazards. If so, (enter your answer _the Supervisor ______________________________________) implements them until the MSD hazards have been controlled or reduced in accordance with or to levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D. In each case above, (enter your answer _the Supervisor _________________________________) ensures that appropriate controls are still in place, are functioning, and are being used properly. (enter your answer___the Supervisor _________________________________) also determines whether new MSD hazards exist and, if so, takes steps to reduce the hazards as outlined below. Our facility follows these steps to reduce MSD hazards: 1. Ask for recommendations- (enter your answer ___the Supervisor _________________________________) asks employees in the problem job and their representatives to recommend measures to reduce MSD hazards. 2. Identify and implement initial controls- (enter your answer the Supervisor _________________________________)identifies and implements initial controls within 90 days after a job is determined to meet the action trigger. Initial controls are controls that substantially reduce the exposures even if they do not control the hazards or reduce them in accordance with or to levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D. The following method is used to

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identify initial controls: (enter your answer______________________________________). 3. Identify and implement permanent controls- (enter your answer ___Risk Management) identifies and implements permanent controls within two years after a job is determined to meet the action trigger, except that initial compliance can take up to 2011, whichever is later. Permanent controls control the hazards or reduce them in accordance with or to levels below those in the hazard identification tools in 29 CFR 1910.900 Appendix D. The following method is used to identify permanent controls: (enter your answer______________________________________). 4. Track our progress- (enter your answer _____Risk Management) tracks our progress and ensures that our controls are working as intended and have not created new MSD hazards. This includes consulting with employees in problem jobs and their representatives. (enter your answer ____Risk Management)evaluates controls (enter your answer _______________________________________) after implementation using one of the following methods or measures: (enter your answer _______________________________________). If hazards have not been adequately controlled or new MSD hazards have been created, (enter your answer___ Risk Management) identifies additional control measures that are appropriate and then implements them. After initial evaluation, (enter your answer __ Risk Management) evaluates controls as needed. MSD MANAGEMENT MSD management is a process to manage MSD incidents when they occur. MSD management is made available promptly to employees in jobs that meet the action trigger whenever an MSD incident occurs, at no cost to employees and at a reasonable time and place, i.e., during working hours. In other words, our facility assures that employees with MSDs receive timely attention for the reported MSD, including: · Access to a health care professional (HCP), · Any necessary work restrictions, including time off work to recover, · Work restriction protection, and · Evaluation and follow-up of the MSD incident. Note: MSD management does not include medical treatment, emergency, or post-treatment procedures. Whenever it is determined that an employee has suffered an MSD incident and the job meets the action trigger, we follow these steps:

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1. (enter your answer __the Supervisor _______________________________ & Risk Management) respond promptly to prevent the employee's condition from getting worse. 2. (enter your answer _ the Supervisor _______________________________ & Risk Management) provide employees with prompt access to an HCP for evaluation, management, and follow-up: (enter your answer _______________________________________). We refer employees to the following HCP(s): (enter your answer_EHAP (Wellness Program) (enter your answer__Human Resources) has determined that this person(s) is knowledgeable in the assessment and treatment of work-related MSDs to ensure appropriate evaluation, management, and follow-up of employees' MSDs. 3. (enter your answer_______________________________________) provides the HCP with the information necessary for conducting MSD management. This information includes: · A description of the employee's job and information about the physical work activities, risk factors, and MSD hazards in the job; · A copy of the Ergonomics Program Standard (29 CFR 1910.900 and Appendices); and · A list of information that the HCP's opinion must contain. · (enter your answer_______________________________________) 4. (enter your answer_______________________________________) instructs the HCP that his/her opinion may not include any findings or information that is not related to workplace exposure to risk factors, and that the HCP may not communicate such information to the employer except when authorized to do so by State or Federal law. 5. (enter your answer_______________________________________) obtains a written opinion from the HCP and ensures that the employee is also promptly provided a copy. This written opinion must contain: · The HCP's assessment of the employee's medical condition as related to the physical work activities, risk factors, and MSD hazards in the employee's job; · Any recommended work restrictions, including, if necessary, time off work to recover, and any follow-up needed; · A statement that the HCP has informed the employee of the results of the evaluation, the process to be followed to effect recovery, and any medical conditions associated with exposure to physical work activities, risk factors, and MSD hazards in the employee's job; and · A statement that the HCP has informed the employee about work-related or other activities that could impede recovery from the injury.

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· (enter your answer_______________________________________) 6. If (enter your answer___________________________________) selects an HCP to make a determination about temporary work restrictions or work removal, the employee may select a second HCP to review the first HCP's finding at no cost to the employee. If the employee has previously seen an HCP on his or her own, at his or her own expense, and received a different recommendation, the employee may rely upon that as the second opinion. · If our HCP and the employee's HCP disagree, (enter your answer_______________________________________) must, within 5 business days after receipt of the second HCP's opinion, take reasonable steps to arrange for the two HCPs to discuss and resolve their disagreement. · If the two HCPs are unable to resolve their disagreement quickly, (enter your answer_______________________________________) and the employee, through your respective HCPs, must, within 5 business days after receipt of the second HCP's opinion, designate a third HCP to review the determinations of the two HCPs, at no cost to the employee. · (enter your answer___________________________________) must act consistently with the determination of the third HCP, unless (enter your answer) and the employee reach an agreement that is consistent with the determination of at least one of the HCPs. · (enter your answer_______________________________________) and the employee or the employee's representative may agree on the use of any expeditious alternative dispute resolution mechanism that is at least as protective of the employee as the review procedures in this step six. 7. (enter your answer_______________________________________) promptly determines whether temporary work restrictions or time off work that (enter your answer_______________________________________) or the HCP determines to be necessary are necessary. · Whenever (enter your answer_______________________________________) places limitations on the work activities of the employee in his or her current job or transfers the employee to a temporary alternative duty job, our facility provides the employee with Work Restriction Protection (WRP), which maintains the employee's employment rights and benefits, and 100 percent of his or her earnings, until the EARLIEST of the following occurs: · The employee is able to resume the former work activities without endangering his or her recovery; or · An HCP determines that the employee can never resume his or her former work activities; or · 90 calendar days have passed. · Whenever an employee must take time off from work, our facility provides that employee with WRP, which maintains the employee's

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employment rights and benefits and at least 90 percent of his or her earnings until the EARLIEST of the following occurs: · The employee is able to return to the former job without endangering his or her recovery; or · An HCP determines that the employee can never return to his or her former job; or · 90 calendar days have passed. · Our facility has the option to condition the provision of WRP on the employee's participation in MSD management. We may reduce the employee's WRP by the amount the employee receives during the work restriction period from a publicly or an employer-funded compensation or insurance program, or from a job made possible by virtue of the employee's work restriction. · Our facility may fulfill the obligation to provide WRP benefits for employees temporarily removed from work by allowing employees to take sick leave or other similar paid leave (e.g., short-term disability leave), provided that such leave maintains the worker's benefits and employment rights and provides at least 90 percent of the employee's earnings. · (enter your answer_______________________________________) 8. (enter your answer_______________________________________) TRAINING The following employees must complete training under the Ergonomics Program: (enter your answer___Supervisors – Ergonimics for Supervisors, Employees – Ergonomics Orientation – Section 13 DBH Safety Program Binder). However, if an employee in these categories has received training in certain required topics within the last three years, initial training in those specific topics is not required. Before we can meet the prior training exception, (enter your answer__the Supervisor______________________________) must be able to demonstrate that the employee has retained sufficient knowledge to meet the requirements for initial training. He/She/They determines this by (enter your answer_reviewing workstation adjustments and other hazard controls with the employee). Our facility follows this initial training and retraining schedule: (enter your answer_upon hire and annually thereafter). (enter your answer__the Supervisor_____________________________________) will identify trainees in each set of new employees and make arrangements with department management to schedule training. (enter your answer__the Supervisor_____________________________________) will also identify those existing employees who need retraining. (enter your answer__the Supervisor __________________________ or Risk Management

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are responsible for conducting training. His/Her/Their qualifications include: (enter your answer_Supervisor – attendance at Ergonomics for Supervisors Course or Risk Mgt. – instructors of Ergonomics for Supervisors Course). Training topics include: (enter your answer_ Definition of MSDs, MSD hazards, MSD incidents, MSD

symptoms Tasks/Jobs identified as high risk for MSD,

Training is done (enter your answer_at hire and annually thereafter or following a MSD incident/injury). All training and information is provided in a language the trainee will understand. The facility training program includes an opportunity for employees to ask questions and receive answers (enter your answer_from the supervisor or Risk Mgt. staff). This allows employees to fully understand the material presented to them. Training also includes: (enter your answer_handouts and a workstation ergo assessment checklist). TRAINING CERTIFICATION (enter your answer_______________________________________) is responsible for keeping records certifying each employee who has successfully completed training. Each certificate includes: (enter your answer_______________________________________). PROGRAM EVALUATION It is inherent that problems may occasionally arise in this Ergonomics Program. Although we may not be able to eliminate all problems, we try to reduce exposures to and eliminate as many problems as possible to improve employee protection and encourage safe practices. By having our Ergonomics Program Evaluator(s), (enter your answer_______________________________________), thoroughly evaluate and, as necessary, promptly take action to correct any compliance deficiencies in our program, we can eliminate problems effectively. Note: The occurrence of an MSD incident in a problem job does not in itself mean that the program is ineffective. At Department of Behavioral Health, our program evaluation, performed (enter your answer_______________________________________), by our Program Evaluator(s), involves the following: (enter your answer_______________________________________),

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To make this evaluation, our Evaluator(s) will ask himself/herself several questions, including: (enter your answer_______________________________________), Our Evaluator(s) will also: (enter your answer_______________________________________) Our facility may discontinue its Ergonomics Program for a job, except for maintaining controls and training related to those controls, if we have reduced exposure to the risk factors in that job to levels below those described in the Basic Screening Tool in Table W-1. RECORD KEEPING (enter your answer) keeps the following records: _______________________________________________________________________ RECORDS Located where? _In the DBH Safety Binder, Section 5 and in personnel records. Kept for how long? _5 years______________________________________ Note: In addition to the retention periods listed above, our facility also complies with the retention periods required by OSHA's rule, Access to Employee Exposure and Medical Records (29 CFR 1910.1020). Compliance Time Frames The following table will help determine when and if the sections of our Ergonomics Program must take place: 29 CFR 1910.900 paragraph Action TIME FRAME (d) BASIC INFORMATION PROVIDED TO EMPLOYEES By October 15, 2001 for existing employees or within 14 days of hiring

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(e), (f) Determine if a job meets the Action Trigger Within 7 calendar days after determining that the employee has experienced an MSD incident (p), (q), (r), (s) INITIATE MSD MANAGEMENT Within 7 calendar days after determining that a job meets the Action Trigger (h), (i) Initiate Management Leadership and Employee Participation Within 30 calendar days after determining that a job meets the Action Trigger (t)(4)(i) INITIATE JOB HAZARD ANALYSIS Within 60 calendar days after determining that a job meets the Action Trigger (m)(2) IMPLEMENT INITIAL CONTROLS Within 90 calendar days after you determine that a job meets the Action Trigger (t)(5)(ii) TRAIN CURRENT EMPLOYEES, SUPERVISORS OR TEAM LEADERS Within 90 calendar days after you determine that the employee's job meets the Action Trigger (m)(3) IMPLEMENT PERMANENT CONTROLS

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Within 2 years after you determine that a job meets the Action Trigger, except that initial compliance can take up to January 18, 2005 whichever is later (u) EVALUATE ERGONOMICS PROGRAM Within 3 years after you determine that a job meets the Action Trigger (y) Discontinue your Ergonomics Program for a job, except for maintaining controls and training related to those controls When you have reduced exposure to the risk factors in that job to levels below those described in the Basic Screening Tool in Table W-1. See the Quick Fix Option section of this written plan for compliance time frames to be used for that option.

Glossary – Term - Definition Administrative controls Administrative controls are changes in the way that work in a job is assigned or scheduled that reduce the magnitude, frequency or duration of exposure to ergonomic risk factors. Examples of administrative controls for MSD hazards include: 1. Employee rotation; 2. Job task enlargement; 3. Alternative tasks; 4. Employer-authorized changes in work pace. Control MSD hazards Control MSD hazards means to reduce MSD hazards to the extent that they are no longer reasonably likely to cause MSDs that result in work restrictions or medical treatment beyond first aid. Employee representative means, where appropriate, a recognized or certified collective bargaining agent. Engineering controls

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Engineering controls are physical changes to a job that reduce MSD hazards. Examples of engineering controls include changing or redesigning workstations, tools, facilities, equipment, materials, or processes. Follow-up Follow-up means the process or protocol an employer or HCP uses to check on the condition of an employee after a work restriction is imposed on that employee. Health care professionals (HCPs) Health care professionals (HCPs) are physicians or other licensed health care professionals whose legally permitted scope of practice (e.g., license, registration or certification) allows them to provide independently or to be delegated the responsibility to carry out some or all of the MSD management requirements of this standard. Job Job means the physical work activities or tasks that an employee performs. This standard considers jobs to be the same if they involve the same physical work activities or tasks, even if the jobs have different titles or classifications. Musculo skeletal disorder (MSD) Musculo skeletal disorder (MSD) is a disorder of the muscles, nerves, tendons, ligaments, joints, cartilage, blood vessels, or spinal discs. For purposes of this standard, this definition only includes MSDs in the following areas of the body that have been associated with exposure to risk factors: neck, shoulder, elbow, forearm, wrist, hand, abdomen (hernia only), back, knee, ankle, and foot. MSDs may include muscle strains and tears, ligament sprains, joint and tendon inflammation, pinched nerves, and spinal disc degeneration. MSDs include such medical conditions as: low back pain, tension neck syndrome, carpal tunnel syndrome, rotator cuff syndrome, DeQuervain's syndrome, trigger finger, tarsal tunnel syndrome, sciatica, epicondylitis, tendinitis, Raynaud's phenomenon, hand-arm vibration syndrome (HAVS), carpet layer's knee, and herniated spinal disc. Injuries arising from slips, trips, falls, motor vehicle accidents, or similar accidents are not considered MSDs for the purposes of this standard. MSD hazard

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MSD hazard means the presence of risk factors in the job that occur at a magnitude , duration, or frequency that is reasonably likely to cause MSDs that result in work restrictions or medical treatment beyond first aid. MSD incident MSD incident means an MSD that is work-related, and requires medical treatment beyond first aid, or MSD signs or MSD symptoms that last for 7 or more consecutive days after the employee reports them to you. MSD signs are objective physical findings that an employee may be developing an MSD. Examples of MSD signs are: (1) Decreased range of motion; (2) Deformity; (3) Decreased grip strength; and (4) Loss of muscle function. MSD symptoms MSD symptoms are physical indications that an employee may be developing an MSD. For purposes of this standard, MSD symptoms do not include discomfort. Examples of MSD symptoms are: (1) Pain; (2) Numbness; (3) Tingling; (4) Burning; (5) Cramping; and (6) Stiffness. Personal protective equipment (PPE) Personal protective equipment (PPE) is equipment employees wear that provides a protective barrier between the employee and an MSD hazard. Examples of PPE are vibration-reduction gloves and carpet layer's knee pads. Problem job Problem job means a job that the employer has determined poses an MSD hazard to employees in that job. Risk factor

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Risk factor means, for the purpose of this standard: force, awkward posture, repetition, vibration, and contact stress. Work practice controls Work practice controls are changes in the way an employee performs the physical work activities of a job that reduce or control exposure to MSD hazards. Work practice controls involve procedures and methods for safe work. Examples of work practice controls for MSD hazards include: (1) Use of neutral postures to perform tasks (straight wrists, lifting close to the body); (2) Use of two-person lift teams; (3) Observance of micro-breaks. Work-related Work-related means that an exposure in the workplace caused or contributed to an MSD or significantly aggravated a pre-existing MSD. Work restriction protection (WRP) Work restriction protection (WRP) means the maintenance of the earnings and other employment rights and benefits of employees who are on temporary work restrictions. Benefits include seniority and participation in insurance programs, retirement benefits and savings plans. Work restrictions Work restrictions are limitations, during the recovery period, on an employee's exposure to MSD hazards. Work restrictions may involve limitations on the work activities of the employee's current job (light duty), transfer to temporary alternative duty jobs, or temporary removal from the workplace to recover. For the purposes of this standard, temporarily reducing an employee's work requirements in a new job in order to reduce muscle soreness resulting from the use of muscles in an unfamiliar way is not a work restriction. The day an employee first reports an MSD is not considered a day away from work, or a day of work restriction, even if the employee is removed from his or her regular duties for part of the day. ATTACHMENTS

(enter your answer)

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INSERT COPIES OF

Supervisor Ergonomic

Training Certificate

HERE

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Ergonomic Training for Staff HOW TO USE THIS TRAINING:

1. Print out all pages and make copies of pages 3-5 for employees 2. (BLI/SUPERVISOR) Familiarize yourself with the background Information

(Page 1) 3. Hand out the materials and provide the training at a staff meeting 4. Have all employees in attendance sign the roster (page 2) and place the roster

in Section 3 of your DBH Safety Program Binder.

What is the purpose of ergonomics in the workplace?

The goals of ergonomics are to:

Decrease risk of injury/illness Enhance worker productivity Improve quality of work life

Subchapter 7. General Industry Safety Orders Group 15. Occupational Noise

Article 106. Ergonomics §5110. Repetitive Motion Injuries(RMIs)

(3) Training. Employees shall be provided training that includes an explanation of:

(A) The employer's program; (B) The exposures which have been associated with RMIs; (C) The symptoms and consequences of injuries caused by repetitive motion; (D) The importance of reporting symptoms and injuries to the employer; and (E) Methods used by the employer to minimize RMIs. Please not: Supervisors are required to attended the ERGONOMICS FOR SUPERVISORS course through Risk Mgt (PERC). If you are a new supervisor, have not attended, or would like a refresher on supervisors' responsibilities to this program, please watch the PERC schedule to schedule yourself for this course. You can view the Risk Mgt schedule for the course at this site: http://countyline/PERC/training/frameWholeTraining.htm

http://countyline/PERC/training/frameWholeTraining.htm

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DBH Monthly Safety Training (November 2005)

ERGONOMICS made SIMPLE (Employee Training Handout)

Millions of people work with computers every day. This illustrates simple, inexpensive principles that will help you create a safe and comfortable computer workstation. There is no single “correct” posture or arrangement of components that will fit everyone.

However, there are basic design goals, some of which are shown in the accompanying figure, to consider when setting up a computer workstation or performing computer-related tasks. Consider your workstation as you review the checklist to see if you can identify areas for improvement in posture, component placement, or work environment. This checklist provides suggestions to minimize or eliminate identified problems, and allows you to create your own "custom-fit" computer workstation.

Is your workstation is ERGO FIT? Have your supervisor review the checklist (Attachment 1) with you at your workstation.

http://www.osha.gov/SLTC/etools/computerworkstations/index.html









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Ergonomic Checklist for Supervisors (Attachment 1) WORKING POSTURES–The workstation is designed or arranged for doing computer tasks so it allows your Y N 1. Head and neck to be upright, or in-line with the torso (not bent down/back). If "no" refer to Monitors, Chairs and Work Surfaces.

2. Head, neck, and trunk to face forward (not twisted). If "no" refer to Monitors or Chairs. 3. Trunk to be perpendicular to floor (may lean back into backrest but not forward). If "no" refer to Chairs or Monitors.

4. Shoulders and upper arms to be in-line with the torso, generally about perpendicular to the floor and relaxed (not elevated or stretched forward). If "no" refer to Chairs.

5. Upper arms and elbows to be close to the body (not extended outward). If "no" refer to Chairs, Work Surfaces, Keyboards, and Pointers.

6. Forearms, wrists, and hands to be straight and in-line (forearm at about 90 degrees to the upper arm). If "no" refer to Chairs, Keyboards, Pointers.

7. Wrists and hands to be straight (not bent up/down or sideways toward the little finger). If "no" refer to Keyboards, or Pointers

8. Thighs to be parallel to the floor and the lower legs to be perpendicular to floor (thighs may be slightly elevated above knees). If "no" refer to Chairs or Work Surfaces.

9. Feet rest flat on the floor or are supported by a stable footrest. If "no" refer to Chairs, Work Surfaces.

10. Backrest provides support for your lower back (lumbar area). 11. Seat width and depth accommodate the specific user (seat pan not too big/small). 12. Seat front does not press against the back of your knees and lower legs (seat pan not too long).

13. Seat has cushioning and is rounded with a "waterfall" front (no sharp edge). 14. Armrests, if used, support both forearms while you perform computer tasks and they do not interfere with movement.

"No" answers to any of these questions should prompt a review of Chairs. 15. Keyboard/input device platform(s) is stable and large enough to hold a keyboard and an input device.

16. Input device (mouse or trackball) is located right next to your keyboard so it can be operated without reaching.

17. Input device is easy to activate and the shape/size fits your hand (not too big/small). 18. Wrists and hands do not rest on sharp or hard edges. "No" answers to any of these questions should prompt a review of Keyboards, Pointers, or Wrist Rests.

19. Top of the screen is at or below eye level so you can read it without bending your head or neck down/back.

20. User with bifocals/trifocals can read the screen without bending the head or neck backward.

21. Monitor distance allows you to read the screen without leaning your head, neck or trunk forward/backward.

WORK AREA–Consider these points when evaluating the desk and workstation. The work Y N

http://www.osha.gov/SLTC/etools/computerworkstations/components_monitors.html

http://www.osha.gov/SLTC/etools/computerworkstations/components_chair.html

http://www.osha.gov/SLTC/etools/computerworkstations/components_desk.html








http://www.osha.gov/SLTC/etools/computerworkstations/components_keyboards.html

http://www.osha.gov/SLTC/etools/computerworkstations/components_pointers.html














http://www.osha.gov/SLTC/etools/computerworkstations/components_wrist_rests.html


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area is designed or arranged for doing computer tasks so the 22. Monitor position is directly in front of you so you don't have to twist your head or neck. 23. Glare (for example, from windows, lights) is not reflected on your screen which can cause you to assume an awkward posture to clearly see information on your screen.

"No" answers to any of these questions should prompt a review of Monitors or Lighting/Glare. 24. Thighs have sufficient clearance space between the top of the thighs and your computer table/keyboard platform (thighs are not trapped).

25. Legs and feet have sufficient clearance space under the work surface so you are able to get close enough to the keyboard/input device.

26. Document holder, if provided, is stable and large enough to hold documents. 27. Document holder, if provided, is placed at about the same height and distance as the monitor screen so there is little head movement, or need to re-focus, when you look from the document to the screen.

28. Wrist/palm rest, if provided, is padded and free of sharp or square edges that push on your wrists.

29. Wrist/palm rest, if provided, allows you to keep your forearms, wrists, and hands straight and in-line when using the keyboard/input device.

30. Telephone can be used with your head upright (not bent) and your shoulders relaxed (not elevated) if you do computer tasks at the same time.

"No" answers to any of these questions should prompt a review of Work Surfaces, Document Holders, Wrist Rests or Telephones.

31. Workstation and equipment have sufficient adjustability so you are in a safe working posture and can make occasional changes in posture while performing computer tasks.

32. Computer workstation, components and accessories are maintained in serviceable condition and function properly.

33. Computer tasks are organized in a way that allows you to vary tasks with other work activities, or to take micro-breaks or recovery pauses while at the computer workstation.

"No" answers to any of these questions should prompt a review of Chairs, Work Surfaces, or Work Processes.

If you need a more thorough assessment of an employee’s workstation, contact Risk Management for an official ergonomic study (employee-specific).

(Don’t wait until painful problems develop into incapacitating conditions.)


http://www.osha.gov/SLTC/etools/computerworkstations/wkstation_enviro.html


http://www.osha.gov/SLTC/etools/computerworkstations/components_doc_holders.html



http://www.osha.gov/SLTC/etools/computerworkstations/components_telephone.html



http://www.osha.gov/SLTC/etools/computerworkstations/workprocess.html


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Monthly Safety Training Sign In Roster Employees are required to be provided with a monthly (brief) safety training. Please have EACH employee (in attendance) print and sign their name on this roster and maintain all Monthly Safety Training rosters in the DBH Safety Manual (Section 3).

Title of Training ERGONOMICS Date: Presenter: Name of Employee (Please Print) Signature

Page ___ of ___

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SECTION: 6

AREA: Fire Drill Reports 23

Fire Drills Section 6

Fire drills are conducted QUARTERLY for DBH facilities (no later than the 22nd of each drill month Drills will be conducted in Jan, Apr, Jul and Oct year). See the schedule in the front of this DBH Safety Binder). Use the attached standardized Fire Drill Report Format. Forward (email) a COMPLETE copy of this report should be forwarded to your RSR - who will forward them to Disaster/Safety Coordinator at BHRC. Reference the San Bernardino County Health & Safety Manual, Section 4 (Page 39 – 44). Place a copy of your report in Section 6 of the DBH Safety Binder

Version 5 Feb 06

INTEROFFICE MEMO DATE: PHONE: FROM: (clinic/facility name here) TO: SUBJECT: Fire Drill Safety Report – (MONTH/YEAR of report)

1. ALARM ACTIVATION Fire Department /Alarm Company Notified YES NO

Fire Department Arrival Time: N/A For Drill Purposes

Only

Make-up drill - failed previous drill this month (Check here)

2. BUILDING EVACUATION Evacuation Ordered by: Time Evacuation Ordered: Time Evacuation Completed: Total Elapsed Time:

3. BUILDING CLEARANCE INSPECTION Building / Occupants Accounting Status YES NO All Clients Accounted For All Staff Accounted For All Doors Closed All Staff Actively Participated Fire Safety Officer Rounds Made First Aid Required If yes, explain: First Aid Kits, Flashlights and Fire Extinguishers Inspected/Documented 4. DRILL RESULTS

PASS FAIL Place a CHECK MARK below

Checked emergency lights If fire drill failed, please check the reason below: Inspected & signed off fire

extinguisher tags (MONTHLY)

Not all occupants were evacuated # of Flashlights brought to the staff assembly point

Unable to account for everyone # of first aid kits brought to the staff

assembly point

Exceeded evacuation time requirement

Version 5 Feb 06

Fire Drill Requirements: Fire drills are conducted in accordance with your Emergency Evacuation Plan once a quarter (before the 22nd of the month in January, April, July, and October) at all facilities housing DBH staff and/or clients, and document drills on the standardized Fire Drill Safety Report Memo format (See reverse).

Instructions for completing monthly fire drill report memo: 1. ALARM ACTIVATION:

Fire Department/Alarm Company Notified • Check YES only if the facility has responded to an actual emergency. • Check NO & N/A For Drill Purposes Only if conducting a fire drill. • Indicate if this is a make-up drill for a failed drill in the reporting month

Fire Department Arrival Time • Annotate the time the fire department arrived ONLY if the facility responded to an actual real emergency. • Leave blank or indicate N/A if conducting a fire drill.

2. BUILDING EVACUATION: Evacuation of a building should occur within 2 minutes after the activation of the fire alarm.

• Enter the name(s) of the individual(s) conducting the fire drill, alarm activation, and building clearance inspection (BLI, BEC, etc.) • Enter the time the alarm was activated (hour, minutes, seconds). • Enter the time the last occupant exited the building (hours, minutes, seconds). • Enter the TOTAL TIME it took to complete the building evacuation.

3. BUILDING CLEARANCE INSPECTION: A staff roster should be used by the building inspector to insure all staff are accounted for. Each

person should be checked off by name. Clients/training attendees should be accounted for using sign in rosters. Attached is an example staff roster, separated by section and supervisor. CHECK ONE BLOCK ONLY (See Below)

• Enter the name(s) of the individual(s) conducting the fire drill and building clearance inspection (BLI, BEC, etc.) • Check YES ONLY all clients/visitors were accounted for or evacuated from the facility. • Check YES ONLY if all staff are accounted for. • Check YES all doors were closed upon inspection. • Check YES if all staff (present during the drill) participated in the activity. • Check YES if any first aid assistance was provided. • If first aid was required, explain what assistance was rendered and report as required by the SB County Employee Safety and Health Manual (Pages

129 – 158) and Department Section, DBH Safety Supplement #10. 4. DRILL RESULTS:

• Check PASS only if:

1) The building was evacuated in 2 minutes or less AND 2) All occupants were accounted for AND

• Check FAIL if:

1) The building was evacuation time took more than a reasonable time to evacuate OR 2) Any item in #3 was checked NO (Exceptions – First Aid Required & All Doors Closed)

• 1) Emergency lights in the facility should be checked at each drill. Find and push the test button on EACH lighting unit in the facility. 2) Fire Extinguishers must be inspected & tags signed off EACH MONTH for leaks, pin placement & charging arrows in the green. 3) Employees should attempt to bring flashlights and first aid kits to the assembly point (inventory and check these items for functionality. Note

the number of flashlights & first aid kits that have been brought to the staff assembly point for inspection. FAILED FIRE DRILLS: Reasons for failure should be addressed with all building occupants and the drill should be re-accomplished and documented within the drill month. Email this report to your RSR and file a HARD COPY in Section 6 of the DBH Safety Program Binder. Reports should be forwarded later than the 22nd of month. The RSR will forward a copy to the DBH Disaster/Safety Coordinator.

DBH Safety/Disaster Coordinator 850 E. Foothill Blvd. Rialto, CA

(909) 873-4476

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Staff Accountability Roster

FIRE DRILL ROSTER Date: Clinic/Facility: (Choose ONE COLUMN ONLY for each employee)

STAFF NAME PARTICIPATED ACCOUNTED FOR

UNACCOUNTED FOR

Able, Donna X Frest, David X Goran, Janet X Smith, Abe X Stone, John X

Daleni, Sally X

SAMPLE

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Staff Accountability Roster

FIRE DRILL ROSTER DATE: Facility:

(Choose ONE COLUMN ONLY for each employee) STAFF NAME PARTICIPATED ACCOUNTED

FOR UNACCOUNTED FOR

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Section 6 Fire Drill Report

SCHEDULE OF COMPLETION: Conducted every three months - quarterly (beginning in January) CONDUCTED BY: SUPERVISOR/BLI assigns clinic staff to accomplish the drill and report REPORT FORMAT: Submit report using standard format –a sample is located in this section DOCUMENTATIN REQUIREMENTS: Maintain documentation of all corrective actions taken in this section (in designated area) SEND REPORT TO: Your Regional Safety Rep _____________ by the 22nd of the month. Methods OF SUBMISSION: Email or hard copy

Enter date submitted MONTH Jan Apr Jul Oct Date Submitted

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Fire Prevention Plan Program: Date Reviewed: Supervisor: BLI: Fire Drill Coordinator: PURPOSE The OSHA Fire Prevention Plan (FPP) regulation, found at 29 CFR 1926.24 and Subpart F do not specifically require a written plan, but do require specific program elements. This plan addresses fire emergencies in this facility. This FPP is in place at this facility to control and reduce the possibility of fire and to specify the type of equipment to use in case of fire. This plan addresses the following issues: · Major workplace fire hazards and their proper handling and storage procedures. · Potential ignition sources for fires and their control procedures. · The type of fire protection equipment or systems which can control a fire involving them. · Regular job titles of personnel responsible for maintenance of equipment and systems installed to prevent or control ignition of fires and for control of fuel source hazards. Under this plan, our employees will be informed of the plan's purpose, preferred means of reporting fires and other emergencies, types of evacuations to be used in various emergency situations, and the alarm system. The plan is closely tied to our emergency action plan where procedures are described for emergency escape procedures and route assignments, procedures to account for all employees after emergency evacuation has been completed, rescue and medical duties for those employees who perform them. Please see the emergency action plan for this information. The safety manager, (Supervisor _________________________and/or BLI ___________________________), is/are the program coordinator, acting as the representative of the facility supervisor, who has overall responsibility for the plan. The written program is kept in (location Section 6 of the DBH Safety Program Binder (Supervisor _________________________________and/or BLI ___________________________) will review and update the plan as necessary. Copies of this plan may be obtained from (Name_________________________) in room (location________________________________________). The FPP communicates to employees, policies and procedures to follow when fires erupt. This written plan is available, upon request, to employees, their designated representatives, and any OSHA officials who ask to see it. If after reading this program, you find that improvements can be made, please contact (Supervisor ________________________________ and/or BLI _______________________________________). We encourage all suggestions because we are committed to the success of our emergency action plan. We strive for clear understanding, safe behavior, and involvement in the program from every level of the facility.

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FACILITY SUPERVISOR/BLI RESPONSIBILITIES: At this DBH facility, the Facility Supervisor/BLI is responsible for the following activities. He or she must: 1. Develop a written fire prevention plan for regular and after-hours work conditions. 2. Immediately notify the (name of city fire _________________________________ and police ____________________________________________closest to your facility) fire or police departments, and (the building owner _____________________________, Director's office _850 El Foothill Blvd, Rialto, CA 92376 909-421-9340, Risk Management 909-386-8624 and Facilities Management (909) 387-2240 (after 5 PM 909-356-3805) in the event of a fire affecting the facility. 3. Integrate the fire prevention plan with the existing general emergency plan covering the building(s) occupied. 4. Distribute procedures for reporting a fire, the location of fire exits, and evacuation routes to each employee. 5. Conduct monthly fire evacuation drills to acquaint the employees with fire procedures, and to judge their effectiveness. 6. Satisfy all local fire codes and regulations as specified. 7. Train employees in the use of fire extinguishers and designate/train two employees in the application of medical first-aid techniques. 8. Keep key management personnel home telephone numbers in a safe place in the office for immediate use in the event of a fire. Distribute a copy of the list to key persons to be used in communicating a fire occurring during non-work hours. 9. Decide to remain in or evacuate the workplace in the event of a fire. 10. If evacuation is deemed necessary, the Facility Supervisor/BLI ensures that: · All employees are notified, they move immediately to the primary or secondary assembly point and a head count is taken to confirm total evacuation of all employees, consumers, and visitors. · When practical, equipment such as flashlights and first aid kits should be taken to the assembly point. In addition, the Facility Supervisor/BLI is responsible for duties unique to this facility. (enter unique responsibilities : Task Assigned to

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WORKPLACE FIRE HAZARDS It is the intent of this facility to assure that hazardous accumulations of combustible waste materials are controlled so that a fast developing fire, rapid spread of toxic smoke, or an explosion will not occur. Employees are to be made aware of the hazardous properties of materials in their workplaces, and the degree of hazard each poses. (enter your answer by reading the Haz Com Program Binder) Fire prevention measures must be developed for all fire hazards found. Once employees are made aware of the fire hazards in their work areas, they must be trained in the fire prevention measures developed and use them in the course of their work. For example, oil soaked rags must be treated differently than general paper trash in office areas. In addition, large accumulations of waste paper or corrugated boxes, etc., can pose a significant fire hazard. Accumulations of materials which can cause large fires or generate dense smoke that are easily ignited or may start from spontaneous combustion, are the types of materials with which this fire prevention plan is concerned. Such combustible materials may be easily ignited by matches such as cigarettes and similar low-level energy ignition sources. It is the intent of this facility to prevent such accumulation of materials. (enter your plan to control this hazard) Certain equipment is often installed in workplaces to control heat sources or to detect fuel leaks. If these devices are not properly maintained or if they become inoperative, a definite fire hazard exists. Again employees and supervisors should be aware of the specific type of control devices on equipment involved with combustible materials in the workplace and should make sure, through periodic inspection or testing, that these controls are operable. Manufacturer's recommendations should be followed to assure proper maintenance procedures. POTENTIAL IGNITION SOURCES Flammable or combustible materials may not ignite on their own without an external source of ignition. The following procedures are used to control known ignition sources at this facility: (enter your plan to control this hazard)

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FIRE PROTECTION EQUIPMENT Fire protection equipment in use at this facility includes the following extinguishers to protect from the various types of fire hazards. (enter the types and number of fire extinguishers maintained at your facility: A-B-C) (enter your plan to control this hazard)

Type Extinguisher Location A B C ABC OTHER

Fire extinguishers must be visually inspected and the back tag signed off monthly by the Supervisor____________________________________, BLI __________________________________ or Bldg. Manager (leased facilities) __________________________________________. In addition, (enter other fire suppression systems - sprinklers, etc. _____________________________________________________________________________________________________________________________________________________________________________________) are also present to control fires. They are located at various places throughout the facility as indicated on the building floor plan in the appendix. MAINTENANCE OF FIRE PROTECTION EQUIPMENT Once hazards are evaluated and equipment is installed to control them, that equipment must be monitored on a regular basis to make sure it continues to function properly. The following personnel are responsible for maintaining equipment and systems installed to prevent or control fires: (enter your answer):

Name Responsibility These individuals follow strict guidelines for maintaining the equipment. (describe guidelines or method for maintaining equipment):

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HOUSEKEEPING PROCEDURES Our facility controls accumulations of flammable and combustible waste materials and residues so that they do not contribute to a fire. We have identified the following potential hazards in our facility: (enter your answer)

Hazard Location The following procedures have been developed to eliminate or minimize the risk of fire due to improperly stored or disposed of materials. (enter your answer):

Procedures All personal coffee pots MUST have auto shut off features All approved personal space heaters MUST have auto shut off features when turned over Candles, coffee cup, potpourri & candle warmers are prohibited. Incense and open flames are prohibited. Chemicals must be stored properly (not mixing incompatible or highly flammable liquids together Storing highly combustible products in Explosion Proof cabinets. TRAINING 1. FIRE PREVENTION PLAN At the time of a fire, immediately evacuation all employees, consumers, and visitors. In smaller fires, a partial evacuation of non-essential employees with a delayed evacuation of others may be necessary for continued facility. Ensure employees know how to respond during a fire. This document is not one for which casual reading is intended or will suffice in getting the message across.

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If passed out as a statement to be read to oneself, some employees will choose not to read it, or will not understand the plan's importance. In addition, training on the plan's content is required by OSHA. A better method of communicating the fire prevention plan is to give all employees a thorough briefing and demonstration. Department of Behavioral Health has chosen to train employees through presentation followed by a drill. Our local fire department requires one or more fire drill(s) each year, so we cover related FPP information at that time. A better method of communicating the fire prevention plan is to give all employees a thorough briefing and demonstration. All facility supervisors must present the plan to their staffs. Training, conducted on initial assignment, includes: · How to recognize fire exists and what to do if an employee discovers a fire (at job site) · Identification and demonstration of alarm system (at job site) · Proper use of fire suppression equipment (at job site) · Evacuation routes and assembly points (at job site) · Assisting employees and consumers/visitors with disabilities (at job site) · Measures to contain fire (e.g., closing office doors, windows, etc. in immediate vicinity) (at job site) · Accountability procedures (see EAP for details) (at job site) · Return to building after the "all-clear" signal (at job site) (enter other training): Other Training: Fire Prevention and Equipment Checklist (provided at New Employee Orientation by Disaster/Safety Coordinator If the Facility Supervisor/BLI has reason to believe an employee does not have the understanding required, the employee must be retrained. The Facility Supervisor/BLI certifies in writing on the Employee Safety Training Checklist the employee has received and understands the Emergency Action Plan, Haz Com Plan and fire prevention plan training. Because failure to comply with facility policy concerning fire prevention can result in OSHA citations and fines as well as employee injury, an employee who does not comply with this program (will be disciplined). If your building houses several places of employment, set up a building-wide FPP including all employers in the building. Department of Behavioral Health has informed our employees of their duties and responsibilities under the plan to conduct DBH staff drills where co-located programs choose not to participate. Each employer in the facility has access to a copy of the standardized plan and it is accessible by affected employees.

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If your building houses several places of employment, we have devised a method to coordinate FPPs of all employers in the building to avoid confusion and conflicts during a fire. Department of Behavioral Health has informed our employees of their duties and responsibilities under the plan. 2. FIRE PREVENTION EQUIPMENT The Facility Supervisor/BLI/supervisor must provide training for each employee on the proper use fire prevention equipment (alarms, extinguishers, etc.). Employees shall not use fire prevention equipment without appropriate hands-on fire extinguisher training. Training, before an individual is assigned responsibility to fight a fire, includes: · Types of fires · Types of fire prevention equipment · Location of fire prevention equipment · How and when to use fire prevention equipment (vs. evacuation) · Limitations of fire prevention equipment · Proper care and maintenance of assigned fire prevention equipment and · (enter other training): Other Training: Employees must demonstrate an understanding of the training and the ability to use the equipment properly before they are allowed to perform work requiring the use of the equipment. Each employee will receive hands-on fire extinguisher training upon hire and annually thereafter. The following instructions will be used to schedule training at each DBH facility: POINT OF CONTACT: MIKE HUDDLESTON (COUNTY FIRE) He would like you to e-mail him [email protected] or him leave a voice mail message at (909) 876-3925 with the following information: 1. Your facility name and address 2. Number of people you need trained 3. Three alternative dates and times you be available for the training. Once he receives your voice mail, he will return your message and hopefully confirm one of the dates you chose. Staff will sign a training roster following Hands-on Fire Extinguisher Training, A copy will be kept in the facility (in Section 13 of the DBH Safety Program Binder) and a copy will be sent to the DBH Disaster/Safety

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Coordinator. If the Facility Supervisor/BLI has reason to believe an employee does not have the understanding or skill required, the employee must be retrained. The Facility Supervisor/BLI certifies in writing that the employee has received and understands the fire prevention equipment training. APPENDIX Attached to this plan are the facility floor plans, lists, samples, or procedures that ensure better understanding of our written program. 1) Attach floor plan 2) Attach primary and secondary assembly points 3) Maintain a copy of the hands on fire extinguisher training sign in sheet

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Place Copies of

Quarterly Fire Drill Reports

HERE

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SECTION: 7

AREA: Hazardous Conditions & Corrective Actions Taken 39

Safety Concerns Contact Sheet DBH Safety Binder Section 7

Provide these forms to employees & keep them readily available in the facility for reporting hazardous conditions. When a form is turned in, the supervisor/BLI must follow through to correct the discrepancy. All building corrections should be made through email requests to the Property Mgt. Office (Joe Segal) 909- 387-7572. He will determine the course of action to be taken. If the hazard is such that it could cause harm to occupants, the supervisor must take measures to limit exposure/access to the hazard and notify Property Mgt, PM, and HR immediately. The Safety Hazard form should be used to track the activity to correct unsafe conditions and most importantly to document when they have been corrected. Follow up (and documentation should be conducted MONTHLY on issues that have not been resolved. Another method for correcting more complex or long-standing safety concerns is the County Hazard Report – Found in this section and in the San Bernardino County Health & Safety Manual (pp 98-100).

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Section 7 Hazardous Conditions & Corrective Actions


1. Supervisor brief staff on reporting unsafe conditions using Safety Concern Sheet (In this section)

2. BLI brief staff on their role in correcting unsafe conditions and safety program requirements

3. BLI posts BLI signs throughout the facility (Name, Office/Cubicle # and Phone Number)

4. Make Safety Concern sheets available to all staff 5. Follow up MONTHLY on all corrective actions requests

CONDUCTED BY: SUPERVISOR, BLI, ALL Staff DOCUMENTATIN REQUIREMENTS: Maintain documentation of all corrective actions taken in this section (in designated area) SEND REPORT TO: N/A (File all documentation in this section) Methods OF SUBMISSION: Submit to DBH Property Management as per their requirements

Corrective Action Documentation

Enter date initiated/completed

MONTH Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Completed

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SSaaffeettyy CCoonncceerrnn Contact Sheet Joe Segal - Property Mgt. 909-387-7572 Gwen Morse DBH -Disaster/Safety Coordinator (909) 873-4476 Fax (909) 873-4403

Reported by:

Date/Time Reported: Phone #:

Nature of Concern: Previous Actions to Resolve: Previously reported to safety committee? YES NO

Reason:

Date reported to Property Mgt:

FOLLOW UP ACTION (DATE) FOLLOW UP ACTION:

(DATE) FOLLOW UP ACTION:





Unsafe condition corrected/resolved (DATE: ) If unable to resolve, please state reason:

Facility Name: Supervisor: BLI: Program Manager:

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Place Copies of

Safety Concern Contact Sheets

HERE

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San Bernardino County Hazard Condition Reporting Form Use this form to report unresolved safety/hazardous conditions within this facility

Submit to Risk Management

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Section 8 Injury, Illness, Accident

Reports SCHEDULE OF COMPLETION: Conducted every quarter - (beginning in January) SUBMITTED/CONDUCTED BY: SUPERVISOR/BLI REPORT FORMAT: This is emailed to all Supervisors/BLIs quarterly with the announcement of the Quarterly Regional Safety Rep Committee Meeting. Review of these reports is required by law. Submit using the format in this section – Negative replies REQUIRED (Report even if none were noted) This includes things like accidents that didn’t necessarily result in injury or loss of work, conditions that may lead to an accident, or unsafe equipment/procedures. DOCUMENTATION REQUIREMENTS: Maintain copies of submissions in this section (in designated area) SEND REPORT TO: Your Regional Safety Rep _____________ by the date below. Methods OF SUBMISSION: EMAIL ONLY


MONTH 10 Jan 06 14 Apr 06 14 Jul 06 13 Oct 06 Date Submitted

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SECTION: 8

AREA: Injury, Illness & Accident Program (IIPP) & Quarterly Injury, Accident Reports

39a

Accident, Injury, close call and Incident Report DBH Safety Program Binder Section 8

The IIPP must be completed by filling in the information specific to your program (HIGHLIGHTED IN BLUE). Staff must be trained on this program and a copy of the Staff Acknowledgement sheet will be forwarded to your RSR. The Quarterly Injury, Accident reports are used to discuss and develop safety improvement policies and procedures. They are to be emailed to your RSR and the Dept. Safety Officer EACH QUARTER one week prior to the Regional Safety Committee meeting. It should contain details of all accidents, injuries, close calls and other reportable incidents and that have occurred in the facility in the previous quarter. Steps taken to correct the problem must also be listed.

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County of San Bernardino OCCUPATIONAL ILLNESS/INJURY PREVENTION PROGRAM

SCOPE Title 8, California Code of Regulations, General Industry Safety Orders, Section 3203 requires every California employer to establish, implement and maintain an effective written injury prevention program. Policy establishes the practice of San Bernardino County relative to Section 3203. This is included in the Policy section of the County Safety Manual. Recognizing that individual departments require differing degrees of safety activity and training, this program includes minimum standards that must be implemented and maintained in all County departments. Those departments that have well established formalized safety training/injury prevention programs only need review existing procedure to ensure that the minimum standards of this program are included in existing department procedure. Departments that have not yet established or implemented a formal program to ensure the training, health and safety of employees must do so following the guidelines of this program. PURPOSE Section 3203, CCR, GISO requires the following: 1. Implementation and maintenance of an

effective written Occupational Injury and Illness Prevention Program;

2. Identification of the person or position with

authority and responsibility for implementing the "Program";

3. Systems to ensure that employees comply

with safe and healthy work practices; 4. Systems for communicating with employees

on matters relating to health and safety; 5. Systems for employees to communicate

hazardous conditions and practices to employers;

6. Periodic inspections for identifying and

evaluating work place hazards;

7. An Occupational Health and Safety Training Program;

8. Systems for investigating accidents and

"near misses"; 9. Documentation of "Program" activities

including: A. Records of inspections and

correction of unsafe conditions; B. Records of employee training

including employee name and specific training subject;

C. Records of accident investigations.

RESPONSIBILITY AND AUTHORITY County of San Bernardino Policy establishes that Assistant Administrative Officers, Department Heads and Directors of Board Governed Special Districts are the responsible individuals for implementation and maintenance of the Occupational Illness and Injury Prevention Program. THE FOLLOWING INCLUDES MINIMUM ACCEPTABLE STANDARDS REQUIRED OF ALL COUNTY DEPARTMENTS RELATIVE TO ILLNESS AND INJURY PREVENTION: 1. Each newly hired County employee

shall be scheduled for and attend an Employee Orientation Program prior to actually reporting to work. The orientation may be that scheduled by the Human Resources Department or may be departmentally developed and presented. Such orientation is to include safety and health training/accident prevention of a general nature and is to include the following subject matter:

A. Code of Safe Practices B. Workers' Compensation C. Defensive Driving - Vehicle

Safety D. Back Injuries E. Slips/Falls F. Sprains/Strains G. Cuts/Bruises

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H. Substance Exposure 2. Individual departments are to establish written

procedures consistent with other County/Department Policy and Memoranda to ensure that employees comply with all safe and healthy work practices outlined within the County Safety Manual, including this program. Such procedures shall include disciplinary activity, incentives and training/retraining programs.

Supervisors must ensure that employees

comply with all County work rules, practices and procedures. Progressive discipline up to and including termination is appropriate for those who do not. Employees are not to be subject to discipline for being injured, but may be for an unsafe act resulting in the injury.

All incentive awards, progressive discipline

and training are to be documented in employee files as well as appropriately noted in departmental or supervisor safety files.

3. Each department is to establish and implement

systems to ensure that supervisors schedule and conduct periodic safety meetings or "General Instructional Talks" (GIT's). Their purpose is to establish safety awareness among employees, to inform, to train, and to introduce new products, procedures, and equipment to the work place.

Supervisors are to schedule and maintain a calendar of these safety meetings and prepare a subject/roster record of all GIT's. GIT's are not intended to replace individual employee safety training but supplement such training as outlined hereafter. See Section 14 of the County Safety Manual for additional information relative to safety meetings.

4. Supervisors are to instruct all employees of

the "Hazard Report" as contained in Section 15 of the County Safety Manual. Supplies of these reports are to be maintained at all County locations and made freely and anonymously available to employees. Hazard Reports are to be processed strictly according to instructions on the reverse side of the form. Hazard Report forms are available through Central Stores and may be available online.

5. Supervisors are to periodically inspect the

work place for which they are responsible.

Inspections are to include an examination and evaluation of the facility, equipment, and work practices relative to safety and health. All such inspections are to be conducted using the format and information included in Section 4 of the County Safety Manual. The purpose of these inspections is to identify, evaluate, and initiate correction of, hazardous conditions and practices.

Documentation of all inspections is to

be maintained by the supervisor. Such documentation is to include notations of all corrective action and employee communication as a result of the inspection.

6. Each department is to prepare a safety

training outline or outlines specific to the activities of the department. The department outline is to be used for the purpose of initially training each new employee. These outlines must include the following elements:

A. Introduction to the workplace

and list of known potential hazards, i.e. equipment, facility, products, activities;

B. List of equipment, machinery, tools for which employee is to be trained;

C. Emergency fire and evacuation plans;

D. Hazardous Communication - see Section 2 of the County Safety Manual;

E. Respirator Protection Program - see Section 7 of the County Safety Manual;

F. Confined Space Entry - see Section 8 of the County Safety Manual;

G. Hearing Conservation - see Section 3 of the County Safety Manual;

H. Personal Protective Equipment - see Section 9 of the County Safety Manual;

I. Lock Out/Tag Out - see Section 10 of the County Safety Manual;

J. Specific illness/injury prevention training based upon department experience and/or injury frequency;

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K. Department specific work rules. The purpose of the training outline is to

provide each supervisor a guide to train employees. Supervisors are to provide outlined training to all new employees. All training is to be documented in departmental training files and the employee's personnel file.

Employee training is the key to injury/ illness

prevention, and is a supervisory responsibility. While some aspects of training may be delegated by a supervisor, follow-up, monitoring, discipline and documentation cannot be delegated.

Supervisors shall use training aids in making

employees aware of safe practices. These aids include but are not limited to audio/visual aids, department produced manuals, manufacturer product instructions, "Industry" brochures and State or Federally prepared job specific programs, such as are followed by Law Enforcement and Fire Protection personnel.

7. Each department shall establish an accident or

"near miss" investigation procedure in conformance with Section 5 of the County Safety Manual. The procedure will provide the supervisor a system to investigate accidents, injuries and illness, to evaluate the cause, correct hazards, adjust work practices, and identify training priorities.

8. Departments shall establish procedures which

ensure that occupational illness/ injury prevention activities are documented. Such documentation shall include:

A. Records of inspection, evaluation, and

correction of unsafe conditions/practices;

B. Records of employee training; C. Records of safety meetings; D. Records of accident investigations. The Appendix portion of the County Safety

Manual includes forms adopted for documentation of activities.

9. Each department shall establish a procedure to

ensure that all drivers of County vehicles attend the Risk Management Division funded Driver Awareness Program. Such procedure shall ensure that all drivers involved in

preventable vehicle accidents attend the Driver Awareness Program for retraining. Driver training/retraining may be accomplished by approved departmentally established programs.

11. Each department shall establish a

procedure to ensure that appropriately identified County employees attend the Risk Management Division Care of the Back Program. These employees shall include as a minimum, employees who suffer a back injury, employees engaged in work activities having the potential for back injury, and employees identified by the Center for Employee Health and Wellness as requiring such training.

12. All employee training completed in

conformance with this program is to be documented. The Appendix of this manual includes forms to be used in documenting employee training, safety meetings, as well as classroom training programs.

safety/docs/sftymnl/occ ill inj prev prog.doc

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DBH ILLNESS & INJURY

PREVENTION PROGRAM (IIPP)

(SITE-SPECIFIC) Reviewed and dated by: ___________________________________________ Date: _______________

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Department of Behavioral Health Program: Date Reviewed: Supervisor: BLI:

INJURY & ILLNESS PREVENTION PROGRAM (IIPP)

ABOUT THIS PROGRAM

Every California employer must establish, implement and maintain a written Injury and Illness Prevention (IIP) Program and a copy must be maintained at each worksite 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 • Record keeping

This model program has been prepared for use by employers in industries which have been determined by Cal/OSHA to be non-high hazard. You are not required to use this program. However, any employer in an industry which has been determined by Cal/OSHA as being non-high hazard who adopts, posts, and implements this model program in good faith is not subject to assessment of a civil penalty for a first violation of T8 CCR 3203. Proper use of this model program requires the IIP Program administrator of 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 record keeping 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 worker training and instruction are provided with this model program. This model program must be maintained by the employer in order to be effective.

http://www.dir.ca.gov/Title8/3203.html

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INJURY AND ILLNESS PREVENTION PROGRAM

RESPONSIBILITY The Injury and Illness Prevention (IIP) Program administrator (Name of Program Supervisor), _______________________________________________________________________ Program Administrator has the authority and the responsibility for implementing and maintaining this IIP Program for ________________________________________________________________________ Program 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.

COMPLIANCE All 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: __x___ Informing workers of the provisions of our IIP Program. __x__ Evaluating the safety performance of all workers. __x__ Recognizing employees who perform safe and healthful work practices. __x__ Providing training to workers whose safety performance is deficient. __x__ Disciplining workers for failure to comply with safe and healthful work practices.

COMMUNICATION

All managers and supervisors are responsible for communicating with all 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. Our communication system includes one or more of the following checked items: __x___ New worker orientation including a discussion of safety and health policies and procedures. __x___ Review of our IIP Program. __x___ Training programs. __x___ Regularly scheduled safety meetings/presentations (monthly). __x___ Posted or distributed safety information. __x__ A system for workers to anonymously inform management about workplace hazards. _____ Our establishment has less than ten employees and communicates with and instructs employees orally about general safe work practices and hazards unique to each employee's job assignment.

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HAZARD ASSESSMENT

Periodic inspections to identify and evaluate workplace hazards shall be performed by a competent observer in the following areas of our workplace: Quarterly and Annual inspections are performed according to the following schedule:

1. When we initially established our IIP Program; 2. When new substances, processes, procedures or equipment which present potential new hazards are

introduced into our workplace; 3. When new, previously unidentified hazards are recognized; 4. When occupational injuries and illnesses occur; and 5. Whenever workplace conditions warrant an inspection.

ACCIDENT/EXPOSURE INVESTIGATIONS

Procedures for investigating workplace accidents and hazardous substance exposures include:

1. Interviewing injured workers and witnesses; 2. Examining the workplace for factors associated with the accident/exposure; 3. Determining the cause of the accident/exposure; 4. Taking corrective action to prevent the accident/exposure from reoccurring; and 5. Recording the findings and actions taken.

HAZARD CORRECTION

Unsafe or unhealthy work conditions, practices or procedures shall be corrected in a timely manner based on the severity of the hazards. Hazards shall be corrected according to the following procedures:

1. When observed or discovered; and 2. When an imminent hazard exists which cannot be immediately abated without endangering

employee(s) and/or property, we will remove all exposed workers from the area except those necessary to correct the existing condition. Workers who are required to correct the hazardous condition shall be provided with the necessary protection.

TRAINING AND INSTRUCTION

All workers, including managers and supervisors, shall have training and instruction on general and job-specific safety and health practices. Training and instruction is provided:

1. When the IIP Program is first established; 2. To all new workers, except for construction workers who are provided training through a construction

industry occupational safety and health training program approved by Cal/OSHA; 3. To all workers given new job assignments for which training has not previously provided; 4. Whenever new substances, processes, procedures or equipment are introduced to the workplace and

represent a new hazard; 5. Whenever the employer is made aware of a new or previously unrecognized hazard;

9/00 22

6. To supervisors to familiarize them with the safety and health hazards to which workers under their immediate direction and control may be exposed; and

7. To all workers with respect to hazards specific to each employee's job assignment.

General workplace safety and health practices include, but are not limited to, the following:

1. Implementation and maintenance of the IIP Program. 2. Emergency Action (EAP) and Fire Prevention Plan. 3. Provisions for medical services and first aid including emergency procedures. 4. Prevention of musculo skeletal disorders, including proper lifting techniques. 5. Proper housekeeping, such as keeping stairways and aisles clear, work areas neat and orderly, and

promptly cleaning up spills. 6. Prohibiting horseplay, scuffling, or other acts that tend to adversely influence safety. 7. Proper storage to prevent stacking goods in an unstable manner and storing goods against doors, exits,

fire extinguishing equipment and electrical panels. 8. Proper reporting of hazards and accidents to supervisors. 9. Hazard communication, including worker awareness of potential chemical hazards, and proper

labeling of containers. 10. Proper storage and handling of toxic and hazardous substances including prohibiting eating or storing

food and beverages in areas where they can become contaminated.

RECORDKEEPING

We have checked one of the following categories as our record keeping policy.

___X__ Category 1. Our establishment has twenty or more workers or has a workers' compensation experience modification rate of greater than 1.1 and is not on a designated low hazard industry list. We have taken the following steps to implement and maintain our IIP Program:

1. Records of hazard assessment inspections, including the person(s) conducting the inspection, the unsafe conditions and work practices that have been identified and the action taken to correct the identified unsafe conditions and work practices, are recorded on a hazard assessment and correction form; and

2. Documentation of safety and health training for each worker, including the worker's name or other identifier, training dates, type(s) of training, and training providers. are recorded on a worker training and instruction form.

Inspection records and training documentation will be maintained according to the following checked schedule:

__X__ For one year, except for training records of employees who have worked for less than one year which are provided to the employee upon termination of employment; or

_____ Since we have less than ten workers, including managers and supervisors, we only maintain inspection records until the hazard is corrected and only maintain a log of instructions to workers with respect to worker job assignments when they are first hired or assigned new duties.

9/00 23

_____ Category 2. Our establishment has fewer than twenty workers and is not on a designated high hazard industry list. We are also on a designated low hazard industry list or have a workers' compensation experience modification rate of 1.1 or less, and have taken the following steps to implement and maintain our IIP Program: 1. Records of hazard assessment inspections; and 2. Documentation of safety and health training for each worker. Inspection records and training documentation will be maintained according to the following checked schedule: _____ For one year, except for training records of employees who have worked for less than one year which are provided to the employee upon termination of employment; or _____ Since we have less than ten workers, including managers and supervisors, we maintain inspection records only until the hazard is corrected and only maintain a log of instructions to workers with respect to worker job assignments when they are first hired or assigned new duties.

_____ Category 3. We are a local governmental entity (county, city, district, or and any public or quasi-public corporation or public agency) and we are not required to keep written records of the steps taken to implement and maintain our IIP Program.

9/00 24

HAZARD ASSESSMENT AND CORRECTION RECORD

(Use County/DBH Forms & Procedures)

Date of Inspection: Person Conducting Inspection:

Unsafe Condition or Work Practice:

Corrective Action Taken:





9/00 25



9/00 26

ACCIDENT/EXPOSURE INVESTIGATION REPORT (Use County & DBH Forms & Procedures)

Date & Time of Accident:

Location:

Accident Description:

Workers Involved:

Preventive Action Recommendations:

Corrective Actions Taken:

Manager Responsible: Date Completed:

(Use DBH Forms & Procedures)

9/00 27

WORKER TRAINING AND INSTRUCTION RECORD

Worker's Name Training Dates Type of Training Trainers

9/00 28

QUARTERLY

DBH ILLNESS, INJURY

& INCIDENT REPORTS

Page 29 of 212C:\Users\d1212\Downloads\DBH_Safety_Program_Binder.doc

SAMPLE REPORTQuarterly Injury, Incident, Accident & Hazard Reports

Date: 4 Jul 04

Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned LUCERNE VALLEY CLINIC 32700 Old Woman Springs Rd

STAFF MEMBER ALMOST FELL IN THE BREAKROOM BECAUSE OF A WET FLOOR. (WATER COOLER WAS LEAKY)

PUT CARPET DOWN UNDER COOLER TO ABSORB WATER –

PENDING WATER COOLER REPLACEMENT.

PHEONIX BLDG 4 700 E. Gilbert St

CLIENT WALKED INTO PLATE GLASS DOOR (INJURED FOREHEAD/NOSE) ICED INJURIES

PUT DECALS ON DOOR

NEEDLES CLINIC 1300 Bailey Ave.

NUEVA VIDA 290 N. 10th St.

PASSAGES 1330 Cooley Dr.

NONE TO REPORT N/A

SPAN 9500 Etiwanda Blvd

STARLITE 9500 Etiwanda Blvd

STAFF MEMBER WAS VERBALLY ACAUSTED BY A CONSUMER IN THE HALLWAY OUTSIDE THE OFFICE.

CONDUCTED A STAFF DISCUSSION OF THE INCIDENT


Quarterly Injury, Incident, Accident & Hazard Reports Date: _____________ Use these forms to report your injuries, accidents, hazards and near misses to the Dept. Safety Committee. Complete the form and forward to your

RSR at least ONE WEEK prior to the department safety meeting (See schedule in section 1 of this binder) Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned ACCESS Cottage # 4

ADS Admin Bldg # 6

ADS TX (BHRC)

ADS TX (VV)

Agewise (BHRC)

ARS (BHRC)

ASG (Gilbert St)

ASG (Cottage 4)

ASOC (BHRC)

ASOC PM 850 E. Foothill Blvd.

BARSTOW CNSLG 805 E. Mt. View

BOYS & GIRLS CLUB 1180 W 9th St

N/A N/A

BLDG 2 700 E. Gilbert St

BLDG 3. 700 E. Gilbert St

N/A N/A


Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned BLDG 5 700 E. Gilbert St

BLDG 6 700 E. Gilbert St

CASA RAMONA 1543 W. 8th St.

CALWORKS - Barstow

CALWORKS - Fontana

CALWORKS - Hesperia

CALWORKS - Rancho

CALWORKS - Redlands

CALWORKS - SB

CALWORKS - VV

CCICMS (BHRC)

CCRT (BHRC)

CHAS (BHRC)

CHINO CLINIC 6180 Riverside Dr.

COMPLIANCE UNIT (BHRC)


Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned CONREP 1330 Cooley Dr.

CONSERVATOR Pgm DES. Mt REG/ ADM 112625 Hesperia Rd

DISCOVERY EMPLOYMENT Pgm. Mill St. EVRC 820 Gilbert St. HOMELESS Pgm Mill St. Housing Program Mill St. HOSPITAL AFTERCARE 12625 Hesperia Rd. VV

JETS Rancho Cucamonga JJOP 900 E. Gilbert St. JMHS 9500 Etiwanda Blvd LUCERNE VALLEY CLINIC 32700 Old Woman Springs Rd MESA CLINIC (BHRC) MEDICAL RECORDS (BHRC) MHSA (EVRC) NEEDLES CLINIC 1300 Bailey Ave. Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned


NUEVA VIDA 290 N. 10th St. PASSAGES 1330 Cooley Dr. PATIENT’S RIGHTS (Cottage 4) PAYROLL/HR (Bldg. 6) PERINATAL TX (BHRC) PERINATAL TX (VV) PHEONIX BLDG 4 700 E. Gilbert St

PORTALS (BHRC) RESEARCH & EVAL (Bldg. 6) SPAN 9500 Etiwanda Blvd STAR 9500 Etiwanda Blvd STARLITE 9500 Etiwanda Blvd TAP (BHRC) TEAM HOUSE (Mill St) TRONA BHC UPLAND COUNSELING 934 North D St.


Clinic /Facility Injuries, Incidents, Accidents, Hazards, Near Misses Corrective Actions Taken or Planned UPLAND HOSPITAL AFTERCARE 934 North D St.

UPLAND COUNSELING VISTA COUNSELING (Fontana) VV ADS 12625 Hesperia Rd VV BHRC 12625 Hesperia Rd VV Perinatal Services 11951 Hesperia Rd, Hesperia

VV HOSPITAL AFTERCARE 12625 Hesperia Rd


Place copies of the facility

QUARTERLY

INJURY, ACCIDENT REPORTS

HERE



SECTION: 9

AREA: Inspections (Quarterly & Annual, Fire Marshall & CARF)

Inspections & Checklist Requirements 20

Quarterly Building Inspection Safety Checklists Section 9

This quarterly inspection checklist is found in the San Bernardino County Safety Manual in section 4, pages 63 and 64. It should be completed QUARTERLY, with a copy sent to the DBH Safety Coordinator at Bldg. 2. Follow up action(s) taken to resolve safety issues should be clearly documented on the form. All efforts to correct a safety problem should be documented. All requests for repair, etc, must be coordinated by E-MAIL through Property Management, Reference San Bernardino County Health & Safety Manual, Section 4 (Page 33)

20a

Quarterly HIPAA Security Checklists Section 9

This checklist is required to be completed with the quarterly safety inspection and forwarded to the DBH Disaster/Safety Coordinator. Issues regarding HIPAA Security should be directed to the HIPAA Committee through the DBH HIPAA Compliance Officer. 2006 - Chris Ebbe, PhD

21

Annual Building Inspection Safety Checklists Section 9

A DBH staff member NOT from your facility conducts this annual inspection using the Administrative and physical plan checklists in this section. Supervisors must file a corrective action plan with the DBH Disaster/Safety Coordinator at BHRC within two weeks of the inspection. Follow up action(s) taken to resolve safety issues should be clearly documented and maintained in SECTION 7 of this binder.

22

Fire Marshall Inspections Section 9

If your facility is MediCal certified, you will need to contact COUNTY FIRE for this inspection. Their report should be kept SECTION 9 of this binder.


Section 9 Inspection Reports

(Quarterly, HIPAA Security, Annual Inspection, Corrective Action Plan & Corrective Action Plans) SCHEDULE OF COMPLETION:

1. Quarterly Inspection– 22nd of the month 2. HIPAA Security Checklist – 22nd of the month 3. Annual – Between 1 August & 30 September (annually) 4. Corrective Action Plan (Annual Inspection) no later than 30 October (annually) 5. Fire (as per your facility schedule)

SUBMITTED/CONDUCTED BY: SUPERVISOR/BLI REPORT FORMAT:

1. Quarterly – Use the format provided in this section 2. HIPAA Security Checklist – Use the format provided in this section 3. Annual – Use the format provided in this section 4. Corrective Action Plan (Annual Inspection) Can be written in memo form or answered on original report 5. Fire - per fire marshal requirements

DOCUMENTATION REQUIREMENTS: 1. Use the standardized formats included in this section 2. Maintain copies of submissions in this section (in designated area) and forward as described below

SEND REPORT TO:

1. Quarterly Safety Inspection– Your Regional Safety Rep _____________ 2. Quarterly HIPAA Security Checklist – Your Regional Safety Rep _____________ 3. Annual Safety Inspection– Your Regional Safety Rep _____________ and Gwen Morse 4. Corrective Action Plan (Annual Inspection) Your Regional Safety Rep ____________ and Gwen Morse 5. Fire Marshal- Maintain in this section

Methods OF SUBMISSION: EMAIL or HARD COPY


MONTH Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Quarterly Insp. HIPAA Security Annual Insp. Corrective Action Plan Fire Marshal


Quarterly Safety

Inspection &

HIPAA Security Checklists


Quarterly Safety Inspection Checklist - COUNTY OF SAN BERNARDINO LOCATION:

INSPECTION DATE:

DEPARTMENT

BEHAVIORAL HEALTH INSPECTED BY:

DESCRIPTION O. K. CORRECTIVE ACTION NEEDED/INITIATED DATE

WALKING SURFACES

Aisles/halls correctly established and clear

No tripping hazards in evidence

Floors clean, dry, free of hazards

Carpets and rugs secure, good repair

Outside walkways, parking areas, in good repair

STAIRWAYS, RAMPS, STORAGE AREAS

Adequate lighting suitable for work to be done

Ramps have non-slip surface

Stairways clear – non cluttered – good repair

Emergency lighting in place, functioning

Handrails/guardrails installed and in good condition

Hazardous storage appropriate – containers labeled

Cabinets, shelves, racks – secured against tipping

DOCUMENTS/RECORDS

OSHA 200/300A longs available

Hazardous Communication/MSDS available

Training/meeting documentation maintained

Required procedures, notices, rules posted

EQUIPMENT, MACHINES, TOOLS

Equipment/machines secured, guards in place

Drawers closed when not in use

Equipment furniture in good mechanical condition

Fans guarded, secure from falling or tipping

Paper cutter equipped with guard; blade spring functioning

Safe step stools/ladders used when needed(non-rolling type)

Protective equipment available

Supplies, material, safely stacked

Knives, scissors, other sharp tools used/stored correctly

ELECTRIC HAZARDS

Machines and equipment grounded

Extension cords – isobar type only

Condition of equipment cords (not patched or spliced)

Condition of plugs and wall outlets

Electric switch panels clear (at least 30” open area)

Circuits not overloaded

Coffee pots (commercial/industrial type only)

Appliances include safety switches

FIRE PREVENTION

Fire extinguishers properly located, marked, inspected

Emergency/evacuation plan posted

Fire escapes clear – exits marked

Fire doors not blocked open

Sprinkler heads not blocked (24” ceiling clearance)

Excess paper and trash removed

SANITATION, WATER SUPPLY, PERSONAL PROTECTION

Drinking water available

Condition of toilet facilities

Condition of approved eating areas

Food scraps, peels, wrappings disposed of daily

First-aid kit and supplies available

USE REVERSE SIDE OF FORM FOR DEPARTMENT/SITE SPECIFIC INSPECTION ELEMENTS


INSPECTION DATE:

BEHAVIORAL HEALTH INSPECTED BY:

DESCRIPTION O. K. CORRECTIVE ACTION NEEDED/INITIATED

DATE

Panic Alarms Functioning

Coffee pots have auto shut-off feature

Incense, candles and open flame items removed from facility

Space heaters have auto-shut off feature

Fire extinguishers inspected & signed off

Emergency lighting inspected


HIPAA BASELINE PRIVACY & SECURITY WALKTHROUGH AUDIT (Conducted w/ quarterly safety inspection (BY THE BLI/SUPERVISOR) - forwarded to RSR. (Maintain a copy in Section 9 of the DBH Safety Binder)

Location/Program/Dept. Phone Indicators: C = Compliant, P = Partial Compliance, N = Not Compliant, NA = Not Applicable

Manager/Supervisor/BLI Date C P N NA Comments/References/Violation(s) 1 Physical Layout – Computers & Confidential Information Secure 2 PC Screens turned away from public view or privacy screen in place 3 Access controls in place and properly functioning (locks/passwords, etc.) 4 Storage Rooms and/or medical/medication rooms secure 5 Staff are trained in privacy & security responsibilities & policies 6 All PCs logged off or locked when not in use 7 Badges worn at all times, not turned around 8 Transportation & storage of physical records secure 9 Printers secure, proper handling procedures in place

10 Staff have unique Ids & passwords for PC access - (no sharing) 11 Shred-it containers used properly 12 Fax machines are securely managed (fax is physically secured and used correctly) 13 Public access is restricted in secure areas 14 Standard Practice Manuals are updated and policies are in place 15 Patient schedules, charts, and information is turned over or protected/secured 16 Procedures are in place to safeguard patient charts – charts are not stacked on counters 17 Doctors/staff are aware of and are compliant with HIPAA policies and procedures 18 Privacy & Security training completed on a regular basis 19 Documentation of Policies & Procedures is easily located and up-to-date 20 Speaking/communicating about patient information in public areas is strictly prohibited

Corrective Action Plans/Corrections due 30 days from receipt of assessment. Forward to Dr. Chris Ebbe OFFICE USE ONLY

Auditor Name: ________________________ Corrective Action Plan Required Y N Due Date: _________________________ Copy provided to Manager Y N Assessment copy sent to Dept Head Y N Follow up: Corrective Action Plans/Corrections must be completed/received within 30 days from receipt of the assessment. Notify Association Admin if CAP/Corrections are delinquent. CAP: Received (Date) __________________ Delinquent reminder notice sent – Date: _________________ CAP Completed/Adequate? Y N Additional Assessment Required? Y N Remediation may be required for areas marked as partially compliant Remedial/Corrections: ______________________________________________________________________________________________ _________________________________________________________________________________________________________________


Annual Building Inspection Checklists


2006 ANNUAL BLDG. SAFETY INSPECTIONS

(Info for: FOR INSPECTORS)

INSPECTOR RESPONSIBILITIES: BEFORE THE INSPECTION

• Attend the pre-inspection training in July 2006. • Conduct all inspections between 1 Aug and 30 Sep 06 by a Supervisor not affiliated with the facility. • Confirm the inspection date with the supervisor 2 weeks in advance. (Arrange a time when ALL

rooms will be available for inspection and someone will be available with a master key to assist you.) Once you have confirmed an inspection date, email Gwen Morse with the date/time you will be inspecting.

• Request a point of contact (Clinic Supervisor or BLI) for coordination and to access locked areas of the facility.

• Be familiar with the inspection checklist (Pages _____ through _____ of this section)

INSPECTION DAY

NOTE: For a small facility, your inspection should take a MINIMUM of 2-3 hours. For a medium to large facility, it can take 4+ hours to complete.

• Bring copies of the inspection checklists (pages ___ through ___ in this section) to conduct the inspection.

• Review all manuals, (Safety Program drill, inspection and training documentation, physical plant, and medical waste management) for required documentation and note missing documentation on the checklist(s) and conduct the walk-through inspection of the facility, noting items out of compliance with the safety program.

• Inspect all assigned vehicles using the vehicle Inspection Checklist • If the program provides injection medications, conducts TB testing, or dispenses sample medication,

you will also need to inspect their MEDICAL /PHARMECEUTICAL WASTE PROGRAM (MWMP) Binder and use the inspection checklist for MWMP (pages ___ through ___ in this section).

• Leave copies of all hand-written inspection checklists with the supervisor prior to departing the facility (keep a copy for your records and send a copy of the entire report to the regions Regional Safety Rep (RSR) and Gwen Morse, DBH Disaster/Safety Coordinator.

AFTER THE INSPECTION

• Follow up with clinic supervisor to collect the Corrective Action Plan (should be received within 2 weeks of the original inspection date)

• Forward a copies of the Corrective Action Plan to the Regional Safety Rep & DBH Safety Coordinator.


2006 ANNUAL BLDG. SAFETY INSPECTIONS

(Info for: FOR CLINIC SUPERVISOR/BLI)

INSPECTED FACILITY STAFF RESPONSIBILITIES:

BEFORE THE INSPECTION • Review the facility’s compliance using the inspection checklist and correct discrepancies in the facility

PRIOR to the official inspection (Insure all the facility meets safety standards)

INSPECTION DAY • Attend the Pre-inspection training in July 06. (Review the Power Point Pre-inspection training slide

show and safety inspection checklists)

• Inspection day: have documentation & binders readily available for your inspector • Assign a staff member (BLI) to assist the inspector, answer questions, find missing documents and

open locked doors throughout the facility. Including the Medical Waste Management Program (MWMP) - if applicable.

• You will be given a report of any findings

• Submit your CORRECTIVE ACTION PLAN within 2 weeks of the inspection to the inspector and

Regional Safety Rep for your area and the DBH Safety Coordinator (Gwen Morse).

AFTER THE INSPECTION

• Write the Corrective Action Plan and forward copies to the inspector & DBH Safety Coordinator

(submit within 2 weeks of the original inspection date) • Arrange Make with Property Management to correct physical plant hazards identified in the inspection

ASAP (within 3 months of the inspection)

• Document the final date each corrective action was completed


DDBBHH AAnnnnuuaall BBuuiillddiinngg IInnssppeeccttiioonn NNoottiiccee ((22000066)) Inspector’s Name: ___________________________________________________________ I will be visiting (Program) ______________________________________________to conduct your annual DBH Annual Facility Safety Inspection on (date/time) __________________________________________. 1. To prepare for this inspection, please assemble the following manuals/documents for the inspection:

DBH 2006 Safety Binder DBH 2006 Hazard Communication Binder DBH Medical Waste Management Binder DBH Disaster Program Binder(expected issued date - Apr 06) San Bernardino County Employee Health & Safety Program Manual CalOSHA (BLI) training manual Vehicle Inspection Records

• Please assemble all current documentation in the appropriate section of each binder. • Identify a staff member (BLI) to assist me with documentation and access to all areas of the facility. • I will also need access to ALL vehicles assigned to your program

2. At the conclusion of your inspection, I will leave you with hand-written copies of the checklists and will send copies to the following individuals:

• Your Regional Safety Rep (RSR) • DBH Disaster/Safety Coordinator • Your PM

3. Physical plant inspection: among other things, I will be checking to insure there are no:

a. Blocked exits & hallways f. Clocks, pictures not properly secured to walls b. Unauthorized extension plugs g. File Cabinets not properly bolted to the wall c. Non-UL Approved electric appliances h. Unsecured items on shelves (over 5’) d. Coffee pots & space heaters without auto-shut off i. Improper chemical storage or labeling features e. Excessive storage (fire hazards) j. Burnt-out lighting on EXIT signage

k. Other trip/fall or safety hazards

4. I will need to review the following documentation: Fire drills, fire extinguisher training, Assaultive Behavior Drills, monthly safety training, quarterly building & HIPAA Security compliance inspections, (previous) annual building inspection/corrective action response, vehicle safety program training & inspections, Hazard Communication Program, Disaster Plan & disaster supplies, Emergency Action Plan, County Employee Safety Manual and all other related safety binders. Please refer to the attached checklist for details on these programs.

3. If there are any findings at your facility identified on the inspection, please submit the following Requirement Submit to Due by Corrective Action Plan PM

RSR DBH Safety Coordinator

2 weeks after the inspection date (not later than 31 Oct 06)

Safety hazards must be mitigated within a reasonable amount of time (but no longer than 3 months). Please keep all documentation on actions taken to correct safety hazards and document when the problem has been corrected in Section 7 of your DBH Safety Program Binder. If you have any questions concerning my visit, please contact me at the following number: NAME: _________________________________________ _PHONE: (______)_____________________

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PPrriioorriittyy ## 11 –– 22 wweeeekkss PPrriioorriittyy ## 22 –– 11 mmoonntthh PPrriioorriittyy ## 33 –– 33 mmoonntthhss


EMERGENCY EQUIPMENT & SIGNAGE CHECKOFF SHEET (for annual inspections)

An X in a block indicates the sign or equipment IS on hand. A block WITHOUT an X indicates MISSING signage and/or equipment (2006)

EMERGENCY EQUIPMENT ACTIVITY All On Hand ROOM MISSING

Blood Spill Kits(2 1 per site) Breathing Devices (2 per site) Disaster Supplies (Max capacity X 3 days) Food & Water

Flashlights (each office/group room) First Aid Kits (1 per 10 employees – 1 min. kept in reception area) Nitrile Gloves (At reception and exam rooms) Fire extinguishers (75’ apart or line if sight)

SIGNAGE Bio-hazard Signs (Med Waste Programs only) BLI Signs CalOSHA signs (in high traffic areas) Disaster Supplies (on door/drawer where kits are located) Emergency Phone Numbers (under each phone in the facility) Evacuation floor plans (throughout internal facility) Exit Signs (light bulbs) Fire Extinguisher Locations (above all fire extinguishers) First Aid Kit locations (on door/drawer where kits are located) First Aid Logs (in FA kits and on bulletin board) Med Waste Generator’s Permit (Posted on wall where medical waste is generated)

Microwave in Use signs (posted at entryways)

No Smoking Signs (in building lobby and outside areas)

Restroom signs (Handicapped signs) on all ADA restrooms Room numbers (each room in the facility) Surveillance cameras in use (at entryways - if applicable_ Whistleblower Poster (in high traffic areas)


Area of Inspection Non-compliant ROOM NUMBER COMMENTS

Switches and Plugs broken ADA Compliance Restroom signs Hallways wide enough Facility not clean/sanitary Flashlights/batteries Approved Surge protector Electrical Wires (Bundled/Serviceable) Emergency exit lights working Emergency Phone Numbers (page under all phones) Exit lights working burnt out Hazardous items secured Kiln Hazardous materials not stored properly


Signage Area of Inspection Non-compliant ROOM NUMBER COMMENTS

BLI Posters (throughout bldg.) CalOSHA (empl. bulletin bd.) Disaster Supply Kits (at site of kit) Evacuation Plans (in all hallways) Exit Signs (illuminated) Fire Extinguisher (at exting. site)

First Aid Log First Aid Kits (at site of kit) Wheelchair signs (on ADA restrooms) No Smoking (at all entrances) Room Numbers (on all rooms) Room Capacity (in group rooms)


Date: Inspector: FACILITY:

Medical Waste Management Program Inspection Checklist

Area of Inspection In Compliance COMMENTS

YES NO N/A Containment, Storage & Training (Medical Waste Binder Documentation)

1. Medical Waste generator permit is POSTED in the room where medical waste is generated

1a. Medical Waste Mgt. BINDER is clearly marked and readily accessible. 1b. Medical Waste Mgt. BINDER contains Stericycle removal calendar. 1c. Medical Waste Mgt. BINDER contains the documentation of any medical waste exposure incidents.

1d. Medical Waste Mgt. BINDER contains Stericycle removal receipts. 1e. Medical Waste Mgt. BINDER contains the documentation of ANNUAL Blood Borne Pathogens training for the DBH staff responsible for the generation of medical waste.

1f. Medical Waste Mgt. BINDER contains the name of the DBH staff responsible for the generation of medical waste.

1g. Medical Waste Mgt. BINDER contains the documentation of logged and destroyed medications.

1h. Medical Waste is segregated at the point of origin and during storage.

1i. Medical Waste Mgt. BINDER contains the County and DBH Blood Borne Pathogens program guidelines.

2. Bio-hazardous waste is contained in red biohazard bags and labeled “Bio-hazardous Waste” or with the international biohazard symbol and the work “BIOHAZARD”

3. Sharps waste is contained in sharps containers, labeled “Sharps Waste” or with the international biohazard symbol and the word “BIOHAZARD”

4. Storage containers are properly labeled “Biohazardous waste” or with the international biohazard symbol and the word “BIOHAZARD”


Medical Waste Management Program Inspection Checklist Date: Inspector: FACILITY:

Area of Inspection In Compliance COMMENTS YES NO N/A 5. Medical waste containers are leak-resistant, have tight-fitting lids, are clean, and in good repair

5a. Pharmeceutical waste container has tight-fitting lid and is marked FOR INCINERATION ONLY

6. Biohazardous waste is stored no longer than specified in the code ( days)

7. Medical waste is stored in a secure area to deny unauthorized persons access and to protect against natural elements, animals, and vermin

8. Appropriate warning signs are posted around the storage area 9. Reusable medical waste storage containers are thoroughly decontaminated after use unless protected against contamination by disposable liners.

10. Trash chutes are not used to transfer medical waste Treatment & Disposal 1. Medical waste is treated, either on site or off site, incineration, autoclave, microwave technology or other Department of Health Services approved method.

2. Medical waste is treated prior to disposal X 3. Medical waste is picked up by a licensed hauler for transport to a licensed treatment facility

4. If medical waste is transported by staff, a Limited Quantity Hauling Exemption has been obtained from the Division of Environmental Health Services, as the waste is transported to a permitted facility for treatment or consolidation.

X

Medical Waste Mgt. 1. If the facility treats medical waste on site or produces 200 lbs. Or more in any month of a 12-monthy period, registration forms and a complete Medical Waste Management Plan is filed with the Division of Environmental Health Services.

X

2. If a facility generates less than 200 lbs. A small quantity generator fee has been paid and a Medical Waste Mgt. Plan is completed by need not be with the Divisions of Environmental Health Services.

3. Treatment operating records are maintained for the treatment unit for three years if applicable.


DBH HAZARD COMMUNICATION PROGRAM BINDER CHECKLIST (2006) Section CIRCLE ONE

1 Laws & Regulations (As applicable)

ON HAND

NOT ON HAND

2 Individual Inventory Worksheets

(Completed by ALL staff including common areas – highlight those items requiring MSDS –not household use/size)

ON HAND

NOT ON HAND

3 Master Inventory List (All products highlighted from Individual Inventory Sheets - requiring MSDS)

ON HAND

NOT ON HAND

4 MSDS Sheets

(from manufacturers in this section – alphabetical & date of MSDS highlighted) ON

HAND NOT ON HAND

5 Staff Training & Acknowledgement Sheets

(Sign in rosters w/date signed by ALL employees) ON

HAND NOT ON HAND

6 Facility Floor Plan (Layout of inside floor plan with MSDS products highlighted on map)

ON HAND

NOT ON HAND

7 Discontinued MSDS Sheets (All discontinued MSDS for

discontinued products or on former inventory) ON

HAND NOT ON HAND



SAMPLE

BASIC BUILDING

SAFETY PROGRAM

INFORMATION FOR BLDG.

OCCUPANTS


Welcome to the new East Valley Resource Center (EVRC) Your Building Location Inspector is: GWEN MORSE Room 135 Please to e-mail me any safety concerns you may have. In order to insure we all have a safe workplace, please follow these guidelines as you get settled in: 1. YOUR EVRC SAFETY TEAM We are all a team when it comes to safety; however, a formal safety group is Gwen Morse and George Sweikas. We are here to assist you with safety concerns in the EVRC to see that unsafe conditions are corrected as soon as possible. 2. REPORTING BUILDING PROBLEMS (WARRENTY ISSUES) Building defect issues (such as broken locks, leaks, poor air circulation, other structural problems) must be e-mailed to ________. 3. REPORTING BUILDING PROBLEMS (SAFETY HAZARDS – NON-WARRENTY ISSUES) Report (by e-mail) unsafe work conditions/hazards to the Building Location Inspector(s) Gwen Morse (others TBA). 4. EMERGENCY EVACUATION PROCEDURES: We will conduct quarterly building fire drills (evacuation drills) beginning in the month of April. Please insure you are familiar with the procedures for exiting the building and report directly to the Primary Assembly Point. This is the newer parking lot located Southeast of Bldg. 840 (Information Systems Building -in the back corner of the EVRC parking lot - where the dumpsters are parked). has been designated as our PRIMARY EVACUATION point for fire drills and other emergencies. If for some reason, we are unable to use that primary location, a SECONDARY LOCATION: the grassy area on this side of the old Chapel has been designated as the secondary assembly point. You will soon receive more training on the Emergency Action Plan, but for any immediate evacuations, you should proceed directly to the primary location unless directed to the secondary one and check in with your supervisor for accountability of all staff. 5. TRASH (EMPTIED) and JANITORIAL SERVICES The janitorial staff are usually in the building by 5:00 AM, but may not be around to collect trash until 9:30 – 10:30. If you will be in session (or don’t want this type of interruption), please place your trash can OUTSIDE your door for pick up.


6. RESTROOM DOOR LOCKS For the safety of employee and consumers, employee restrooms have been outfitted with locks that require key access. Please CLOSE the door when exiting (DO NOT leave the bolt mechanism open). NOTE: When the restroom bolt is locked, the door cannot be unlocked with a key from the outside. 7. BLOOD/BODY FLUID SPILLS In the event of a body or blood spill, blood spill kits are available in the nurse’s office (Room # 123 or in Michele Finn-Creterola’s office (# 171). The 10% bleach solution is located in the Med Room # 126, in the cabinet, under the sink. 8. USE OF TAPE ON WALLS We have found that tape removes the paint from the walls, consequently, we have been asked to NOT use tape to affix anything to the walls. 9. PICTURES/OTHER WALL DECORATIONS: Affix items to the walls using sturdy earthquake-proof hooks/hangars and/or putty/double back tape. 10. OVERHEAD HAZARDS: Keep items OFF high surfaces directly above/around your work space (plants or other heavy objects should be placed below head-level when seated, and should not be placed on the tops of overhead bins) 11. WIRES/ELECTRICAL: Bundle/fasten cords (electrical, phone, and computer) push as far away from your sitting work space as possible (Use wire ties other material to bundle wires together). Don’t string wires across the wall/floor (creating a tripping or shock hazard). Also be sure not to use daisy chain or use TOO MANY power blocks/extension cords and use only POWER BLOCKS (preferably with surge protection). 12. FURNITURE PLACEMENT: Make sure you have easy access into and out of your office. There should be no furniture or other object blocking the exit path and there should be a clear path not less than 36” at the exit point. 13. PERSONAL SPACE HEATERS Because the electrical system will overload - causing blown circuits, the use of personal space heaters in the buildings is PROHIBITED.


14. EMERGENCY PHONE NUMBERS: Please fold in two and place Form 4 under your desk phone. It contains the most commonly used emergency phone numbers. You may have others you want to add to the second side. 14. HAZARD COMMUNICATION: Everyone has a “right to know” the hazards associated with the EVRC. Usually in our environment, this means cleaning chemicals, office solvents/liquids, etc., and pharmaceutical waste. There may however also be hidden hazards you identify on your own that can be communicated to others. We will establish a Hazard Communication Program (Binder) encompassing the entire building, but we will need your help to complete the assessment. Here’s how you can help: Your supervisor will given you an inventory sheet (Form 1). Please return this form to your supervisor no later than 30 Apr 04.

1

PERSONAL INVENTORY: Please conduct a THOROUGH inventory of your work area (overhead bins, desk drawers, etc.) documenting ALL chemicals (if you shouldn’t eat/drink it, you should write it down) office supplies, ink jet cartridges, printer toner, white out, cleaning solvents, lubricants (WD40), spray cleaners, air fresheners, etc. (FORM 1)

Thanks for your cooperation, Gwen Morse, EVRC Safety Coordinator (909) 873-4476


Accident Reporting and Investigation Plan

Purpose

An accident reporting and investigation plan prescribes methods and practices for reporting and investigating accidents that can be read and understood by all managers, supervisors, and employees. No matter how conscientious the safety effort in the department, accidents are going to happen sometimes due to human or system error.

This written Accident Reporting and Investigation Plan is intended to demonstrate Department of Behavioral Health 's compliance with the requirements in 29 CFR 1904 by:

• prescribing methods and practices for reporting and investigating accidents, and • providing a means to deal with workplace accidents in a standardized way.

In addition it is the policy of Department of Behavioral Health to comply with all workers' compensation laws and regulations.

The requirements of this plan apply to all operations and departments at Department of Behavioral Health. Administrative Duties

Human Resources and Payroll are responsible for developing and maintaining this written Accident Reporting and Investigation Plan. This person is solely responsible for all facets of the plan and has full authority to make necessary decisions to ensure the success of this plan. They are qualified, by appropriate training and experience that is commensurate with the complexity of the plan, to administer or oversee our accident reporting and investigation program and conduct the required evaluations.

This written Accident Reporting and Investigation Plan is kept at the following location: Section 8 of the DBH Safety Program Binder located in ________________________________ in this facility. Accident Reporting Procedures

Employees injured on the job are to report the injury to their supervisor as soon as possible after the incident/accident. Near miss accidents or incidents (when an employee nearly has an accident but is able to avoid it) should be reported on the: quarterly injury, illness and incident report and forwarded to the DBH Safety Coordinator. The supervisor must immediately notify payroll (enter name: _____________________________) when an incident/accident occurs. If (enter name: ______________________________) is not available, (enter name ____________________________________________ Phone : ( ) ______-___________ should be notified instead.


Any employee witnessing an accident at work is to call for emergency help (phone: ________________________________) or whatever assistance appears to be necessary. In addition, the employee is immediately to report the accident to his or her supervisor and take part in answering questions related to the Accident Report and Accident Investigation.

Accident Investigation Procedures Accidents will be investigated thoroughly by: (Name: the Supervisor: _______________________________ or _________________________________. Thorough investigation of all accidents will lead to identification of accident causes and help:

• reduce economic losses from injuries and lost productive time; • determine why accidents occur, where they happen, and any trends that might be

developing; • employees develop an awareness of workplace problems and hazards; • identify areas for process improvement to increase safety and productivity; • note areas where training information or methods need to be improved; and • suggest a focus for safety program development.

For all accident investigations, (enter name: ____________________________________) will perform the following duties:

• Conduct the accident investigation at the scene of the injury as soon after the injury as safely possible.

• Ask the employee involved in the accident and any witnesses, in separate interviews, to tell in their own words exactly what happened.

• Repeat the employee's version of the event back to him/her and allow the employee to make any corrections or additions.

• After the employee has given his/her description of the event, ask appropriate questions that focus on causes.

• When finished, remind the employee the investigation was to determine the cause and possible corrective action that can eliminate the cause(s) of the accident.

• Complete an accident investigation report with the employee and review data with employee for accuracy. This will provide information to put into database format.

The accident investigation report is used to:

• track and report injuries on a monthly basis; • group injuries by type, cause, body part affected, time of day, and process involved; • determine if any trends in injury occurrence exist and graph those trends if possible; • identify any equipment, materials, or environmental factors that seem to be commonly

involved in injury incidents; • discuss the possible solutions to the problems identified with the safety team and

superiors; and • proceed with improvements to reduce the likelihood of future injuries.


Injury/Medical Issues

If a workplace accident results in injury or illness requiring hospitalization of three or more employees or a fatality of one or more employee, Risk Management Office via. (enter name: _________________________________, Human Resources Officer or Risk Management, via. Yvonne Armstrong who reports the incident within eight hours by phone or in person to the nearest OSHA office, at 2100 East Katella Ave., Ste. 125 Anaheim, CA 92806 (714) 939-8611.

If an injured person is taken to a doctor, a statement from the doctor will be attached to the Accident Report form.

Employees with workplace injuries resulting in time off work will be put in the company's Return-to-Work Program (see that program's requirements) to facilitate their full recovery and resumption of original work.

Weekly compensation for workplace injuries or illnesses requiring time off work, as indicated by law, applies after the third day of wage loss. (Sundays are not included in the three-day waiting period, unless the employee ordinarily works on Sunday.)

If the disability continues for more than seven calendar days, workers' compensation goes back to day one.

On the day of injury, the company will cover the time loss due to doctor and/or emergency room visits or inability to work, up to a maximum of _________ hours.

Any time an associate is away from work because of an accident on-the-job, it should be recorded on the time sheet as follows: sick time.

Group health and dental coverage will continue for ______________ months. The company and disabled employee will each continue to pay their share of the premium during this time. If the medical disability period extends for a longer period, the company will pay _________ percent of its previous contribution level for up to _________ additional months.

Refer to the San Bernardino County Employee Health and Safety Manual, Section 17 (Record Keeping) RECORD KEEPING

(enter name: _________________________________ is responsible for maintaining the following records and documentation:

• OSHA 300A log of injuries and illnesses • Accident investigation reports • Training records


TRAINING

This plan is an internal document guiding the action and behaviors of DBH employees, so they need to know about it. To communicate the new accident reporting and investigation plan, all employees are given a thorough explanation as to why the new plan was prepared and how individuals may be affected by it.

The information and requirements of this written plan are presented to employees at orientation prior to assignment at worksite (enter name of facility _______________________________).

PROGRAM EVALUATION The accident reporting and investigation program is evaluated and updated by (enter name of HRO _________________________________) according to the following schedule to determine whether the plan is being followed and if further training may be necessary annually.

APPENDICES The following appendices are attached to ensure a better understanding of this plan:


AB 1127 (IMPLEMENTATION PLAN)

Final Permanent Cal/OSHA Civil Penalty Regulations

On 6 October 1999, Governor Davis signed Assembly Bill 1127, authored by Assembly member Steinberg into law (Chapter 615, Statutes of 1999). AB 1127 makes changes to twelve (12) sections of the California Labor Code. Save for one statutory change to Labor Code Section 98.7, all of AB 1127's changes involve the California Occupational Safety and Health Act (Labor Code Section 6300 et seq.).

The purpose of this memorandum is to describe the regulatory and policy changes that the Division of Occupational Safety and Health has made in order to implement the provisions of AB 1127 for Cal/OSHA inspections and investigations commencing on or after 1 January 2000.

REGULATORY CHANGES

Four provisions of AB 1127 require regulatory changes to 8 CCR Section 334 or to Section 336. These AB 1127 changes to the Labor Code, with their corresponding Section 334 or 336 regulatory sections, are as follows:

(1) Labor Code Section 6428 was amended to require that if a violation is serious, the employer shall be assessed a civil penalty of up to $25,000 for each violation. See 8 CCR Section 336(c)(1).

(2) Labor Code Section 6429 was amended to require that any employer who repeatedly violates a standard shall not receive any penalty adjustment for good faith or for history. See 8 CCR Section 336(d)(12).

(3) Labor Code Section 6430 was amended to require that if a violation is for failure to abate a violation, the employer shall be assessed a civil penalty of not more than $15,000 for each day during which failure to abate continues. See 8 CCR Section 336(f).

(4) Labor Code Section 6432 was amended to redefine serious violation. See 8 CCR Section 334(c).

Emergency Cal/OSHA Civil Penalty Regulations

http://www.dir.ca.gov/dosh/AB1127FinalRegs.htm


In order that the four provisions of AB 1127 outlined above can be enforced on 1 January 2000, the Division submitted to the Office of Administrative Law (OAL) a rulemaking package containing changes to 8 CCR Section 334(c), 336(c)(1), 336(d)(12) and 336(f) and requested that the four changes be promulgated on an "emergency" basis. OAL approved the Division's request and filed the "emergency regulations" with the Secretary of State on 16 December 1999.

The four (4) provisions of the "emergency" Cal/OSHA Civil Penalty regulations are enforceable for all inspections and investigations commencing on or after 1 January 2000 together with the eight (8) which are enforceable without the need for regulatory changes.

§334. Classification of Violations and Definitions.

§336. Assessment of Civil Penalties.

Permanent Cal/OSHA Civil Penalty Regulations - 45 - Day Notice

The emergency Cal/OSHA Civil Penalty regulations remain in effect for 120 days and will expire on 1 May 2000. During the period of time from 1 January through 1 May 2000, the Division will submit to OAL for final approval a set of permanent Cal/OSHA civil penalty regulations which will make the changes contained in the emergency regulations permanent. Adoption of permanent Cal/OSHA Civil Penalty regulations requires that the Division conduct a hearing to receive public comment on the new Cal/OSHA Civil Penalty regulations. A public hearing is scheduled for 22 February 2000 at 10:00 a.m. in the Auditorium of the Hiram Johnson State Building in San Francisco.

Proposed Permanent Cal/OSHA Civil Penalty Regulations.

15 - Day Notice

As a result of comments received by the Division during the 45-day Notice for the Proposed Permanent Civil Penalty Regulations, the Division has made revisions to the Proposed Regulations.

15 Day Notice and Text of Revised Proposed Permanent Regulations ( .pdf document, size 91 KB)

Permanent Cal/OSHA Civil Penalty Regulations - Final

After reviewing comments from the 45-Day and 15-Day Notices, the Division of Occupational Safety and Health finalized its proposed amendments to Sections 334 and 336 of Title 8 and forwarded the final

http://www.dir.ca.gov/dosh/AB1127REgs.htm#1

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http://www.dir.ca.gov/dosh/NOPH.htm

http://www.dir.ca.gov/dosh/NOPH15DayNotice.pdf


civil penalty package to the Office of Administrative Law (OAL) on 13 April 2000 for approval. On 11 May 2000, OAL approved the amendments to Sections 334 and 336 and filed the amendments with the Secretary of State the same day. The AB 1127 regulatory changes are now effective on a permanent basis.

Final Permanent Cal/OSHA Civil Penalty Regulations POLICY CHANGES The Division has revised several sections of the Volume II (Compliance) of its Policy and Procedures Manual to enable compliance personnel to be able to enforce the provisions of AB 1127 applicable to the Division for all inspections and investigations commencing on or after 1 January 2000. The sections of the Volume II (Compliance) of the Division's Policy and Procedures Manual which have been revised to incorporate the AB 1127 changes are: P&PC-1, 1B, 1C, 2, 7, 10, 11, 13, 15, 23, 24 and 90. The following is a summary of the twelve AB 1127 changes to the Labor Code, indicating which P&P C sections have been revised and what the revisions are. (1) AB 1127 Change to Labor Code Section 98.7 Section 98.7 extends the period of time for any person to file a Cal/OSHA discrimination complaint with the Division of Labor Standards Enforcement from 30 days to 6 months. P&P C-11, Section B., has been changed to reflect the extension of the time to file a Cal/OSHA discrimination complaint. In addition, in P&P C-7, Letters "a," "d," "e," "f," "h" and "m" have been modified to reflect the new time of six months to file a Cal/OSHA discrimination complaint. In P&P C-11, a non-AB 1127 change was also made in that the requirement for compliance personnel to complete a Cross-Jurisdictional Questionnaire (Cal/OSHA 11) under specified circumstances was eliminated, as was the Cal/OSHA 11. Information about an employer's workers' compensation coverage will continue to be gathered and documented on the Cal/OSHA 1. (2) AB 1127 Change to Labor Code Section 6304.5 Section 6304.5 is amended and now includes a provision relating to the testimony of DOSH employees. P&P C-24, Section B., has been changed to reflect new procedures affecting DOSH employee participation in depositions and administrative and civil trial proceedings. (3) AB 1127 Change to Labor Code Section 6309 Section 6309 is amended with regard to the following three issues pertaining to complaints: a. Defines "employee representative" as "including, but not limited to, an attorney, health or safety professional, union representative; or representative of a government agency…"

http://www.dir.ca.gov/dosh/AB1127FinalRegs.htm

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P&P C-7, Section D., has been changed to reflect the new definition of employee representative, and inclusion of representative of a government agency as a complainant as opposed to a person who makes a referral. b. Requires that the Division attempt to determine the period of time in the future that the complainant believes that the unsafe condition may continue to exist and to allocate inspection resources so as to respond first to those situations where time is of the essence. P&P C-1, Section B. 2.b.(2), has been changed to reflect that, for all formal complaints, informal serious complaints and serious referrals, the Division will attempt to determine the period of time the complainant believes that the unsafe condition will exist and to allocate inspection resources so as to respond to those situations where time is of the essence. c. Requires that when a complaint alleging a serious violation is received from a state or local prosecutor, the complaint must be investigated within 24 hours of receipt. P&P C-1, Section B.2.b.(1), has been changed to reflect a first level inspection priority (24 hours) for a complaint made by a state or local prosecutor alleging a serious violation. (4) AB 1127 Change to Labor Code Section 6400 Section 6400 is amended to codify the Division's multi-employer worksite regulation (8 CCR Section 336.10) into statute. P&P C-1C has been finalized from its longstanding "draft" format. (5) AB 1127 Change to Labor Code Section 6423 Section 6423 is amended to increase fines and prison sentence that a court may impose for certain Title 8 violations charged by a district attorney. Section 6423 goes into effect on 1 January 2000 without need for regulatory or policy changes by the Division. (6) AB 1127 Change to Labor Code Section 6425 Section 6425 is amended to increase the fines and prison terms that a court may impose for willful violations causing an employee's death or permanent or prolonged impairment of the body charged by a district attorney. Section 6425 goes into effect on 1 January 2000 without need for regulatory or policy changes by the Division. (7) AB 1127 Change to Labor Code Section 6428 Section 6428 is amended to increase the maximum statutory civil penalty for a serious violation to $25,000. The Division's emergency Cal/OSHA Civil Penalty regulations have made changes to 8 CCR Section 336(c)(1) as follows: "Any employer who violates any occupational safety and health standard, order, or special order, and such violation is determined to be a Serious violation (as provided in section 334c(1) of this article) shall be assessed a civil penalty of up to $25,000 for each such violation. Because of the

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extreme gravity of a Serious violation an initial base penalty of $18,000 shall be assessed." Thus, for all inspections and investigations commencing on or after 1 January 2000, the new initial base penalty to be used as a starting point for calculating the proposed civil penalty for a serious violation is $18,000. P&P C-10, Section B.3.b. and Attachment B, have been changed to reflect the new higher penalties for serious violations. In addition, P&P C-2, Section A.2.c. (2), has been revised to increase the monetary level at which a proposed civil penalty must have upper management review prior to issuance from $50,000 to $75,000. Similarly, P&P C-23, Section G.4.b., has been revised to increase the monetary level at which a proposed case disposition, which results in a change of the proposed civil penalty of $25,000 or more, must receive Administration approval before finalization. (8) AB 1127 Change to Labor Code Section 6429 Section 6429 is amended in two ways: (a) Section 6429(b) prohibits adjustment of the proposed civil penalty for a repeat violation for anything other than Size. The Division's emergency Cal/OSHA Civil Penalty regulation made changes to 8 CCR Section 336 (d)(12) as follows: "For any employer who commits a repeat violation (as provided under section 335(d) of this article), the penalty shall not be subject to adjustment pursuant to this subsection, other than for Size as set forth in part (1) of this subsection." Thus, for all inspections commencing on or after 1 January 2000, the proposed civil penalty for a repeat violation shall not be adjusted except for Size. P&P C-10, Section b.4.(a), has been changed to reflect the prohibition against adjusting the penalty for a repeat violation for anything other than for Size. (b) Section 6429(c) requires the Division to preserve and maintain records of its investigations, inspection and citations for a period not less than seven (7) years. In P&P C-1, Section D.5. has been added to reflect the new retention requirement for records of Cal/OSHA inspections, investigations and citations. (9) AB 1127 Change to Labor Code Section 6430 Section 6430 is amended in two ways:


(a) Section 6430(a) requires that if a violation is for failure to abate a violation, the employer shall be assessed a penalty of not more than $15,000 for each day during which the failure to abate continues. The Division's emergency Civil Penalty regulations have made changes to 8 CCR Section 336(f) as follows: "The daily additional penalty for failure to abate a violation shall not exceed $15,000." P&P C-2, Attachments H (Sample 161 Reminder Letter) and J (Sample 161 Reminder Letter After Final Order) have been changed to reflect the new higher penalty for a failure-to-abate violation. P&P C-10, Section B.7.b., and P&P C-15, Section C.1., have also been changed to reflect the new higher penalty for a failure-to-abate violation. (b) Section 6430(c) is amended to provide that any employer who submits a signed statement of abatement, and is found by the Division not to have abated the violation is guilty of a public offense punishable in court by a fine or imprisonment. Even though the new "public offense" of submitting a fraudulent statement of abatement is enforceable by a district attorney, new Section C.4. has been added to P&P C-15 to require that if compliance personnel determine that an employer has submitted a fraudulent statement of abatement, they shall make a referral to the Bureau of Investigations (BOI). P&P C-90, Section C. 5. c.(2), has been changed to add a new grounds for a mandatory referral to the BOI, i.e., submission of a fraudulent statement of abatement, and the 90B has also been changed to reflect the new referral category. (10) AB 1127 Change to Labor Code Section 6432 Section 6432 is amended to provide a revised definition of serious violation. The Division's emergency Civil Penalty regulations made changes to 8 CCR Section 334(c)(1), (2) and (3) as follows: (1) A "serious violation" shall be deemed to exist in a place of employment if there is substantial probability that death or serious physical harm could result from a violation, including, but not limited to, circumstances where there is a substantial probability that either of the following could result in death or great bodily injury: (A) A serious exposure exceeding an established permissible exposure limit or (B) A condition which exists, or from one or more practices, means, methods, operations, or processes which have been adopted or are in use, in the place of employment.


(2) Notwithstanding subsection (c)(1), a serious violation shall not be deemed to exist if the employer can demonstrate that it did not, and could not with the exercise of reasonable diligence, know of the presence of the violation. (3) As used in subsection (c)(1), "substantial probability" refers not to the probability that an accident or exposure will occur as a result of the violation, but rather to the probability that death or serious physical harm will result assuming an accident or exposure occurs as a result of the violation." P&P C-1B, Section D.3., has been changed to reflect the revised definition of serious violation. Although AB 1127 places the burden for demonstrating lack of knowledge of a violative condition on the employer, P&P C-1B will continue to require compliance personnel to determine through investigation the employer's knowledge of violative conditions. (11) AB 1127 Change to Labor Code Section 6434 Section 6434 is amended to delete the longstanding statutory exemption for governmental entities from imposition of Cal/OSHA civil penalties. Effective 1 January 2000, governmental entities will no longer be exempt from civil penalties, including failure-to-abate penalties. The Note to the Policy Statement at the beginning of P&P C-10, stating that "civil penalties shall not be proposed for employers that are governmental entities," has been deleted and a statement that governmental entities are not exempt from the imposition of civil penalties has been added to P&P c-10, Section C.6.. In place of the former governmental entity exemption, new Section 6434(a) provides that the civil penalties arising from citations issued to any governmental educational entities (as enumerated) shall be deposited in the Workplace Health and Safety Revolving Fund. Furthermore, new Section 6434(b) provides that civil penalties paid by governmental educational entities (as enumerated) can be refunded by the Department of Industrial Relations (DIR) if the governmental entities meet three specified conditions. P&P C-15, Section C.3., sets forth the three conditions under which civil penalties can be refunded to a governmental educational entity and instructs Districts to refer all refund requests to DIR Accounting. (12) AB 1127 Change to Labor Code Section 6719 Labor Code Section 6719 is a new section of the Labor Code and it reaffirms the Legislature's concern over the prevalence of repetitive


motion injuries and the Standards Board's continuing duty to carry out Labor Code Section 6357. Although the Division does not have to make any regulatory or policy changes in response to Labor Code Section 6719, it is relevant to point out here that the P&P C-13 (formerly P&P C-173) has been finalized and retitled "Enforcement of 8 CCR Section 5110." SUMMARY AB 1127 makes many changes to the Cal/OSHA Enforcement Program and represents a challenge for all of Cal/Osha to implement. AB 1127 not only makes statutory, regulatory and policy changes to the Cal/OSHA Enforcement Program, it also will have a significant resource impact. The increase in the number of complaints which must be categorized as formal, the effect of the increases in civil penalties for serious, repeat and failure-to-abate violations, the ending the exemption for governmental entity exemption from civil penalties, and the requirement to allocate resources where time is of the essence, will cumulatively have a sizeable resource impact. To meet the challenge of effectively implementing the provisions of AB 1127, the Cal/OSHA Program will need to augment its compliance personnel resources at the District level in 2000. in addition to bringing many new challenges for the Program, AB 1127 also has the potential to greatly increase the effectiveness of Cal/OSHA's enforcement efforts and, in doing so, to increase the safety and health protections afforded to California's workers.

January 1, 2000


SB 796 CHAPTER 906 An act to add Part 13 (commencing with Section 2698) to Division 2 of the Labor Code, relating to employment. [Approved by Governor October 12, 2003. Filed with Secretary of State October 12, 2003.] LEGISLATIVE COUNSEL’S DIGEST SB 796, Dunn. Employment. Under existing law, the Labor and Workforce Development Agency and its departments, divisions, commissions, boards, agencies, or employees may assess and collect penalties for violations of the Labor Code. This bill would allow aggrieved employees to bring civil actions to recover these penalties, if the agency or its departments, divisions, commissions, boards, agencies, or employees do not do so. The penalties collected in these actions would be distributed 50% to the General Fund, 25% to the agency for education, to be available for expenditure upon appropriation by the Legislature, and 25% to the aggrieved employee, except that if the person does not employ one or more persons, the penalties would be distributed 50% to the General Fund and 50% to the agency. In addition, the aggrieved employee would be authorized to recover attorney’s fees and costs and, in some cases, penalties. For any violation of the code for which no civil penalty is otherwise established, the bill would establish a civil penalty, but no penalty is established for any failure to act by the Labor and Workplace Development Agency, or any of its departments, divisions, commissions, boards, agencies, or employees. Existing law provides an exclusive remedy under workers’ compensation for an employer’s liability for compensation for an employee’s injury or death arising in the course of employment. This bill would not affect that exclusive remedy. The people of the State of California do enact as follows: SECTION 1. The Legislature finds and declares all of the following: (a) Adequate financing of essential labor law enforcement functions is necessary to achieve maximum compliance with state labor laws in the underground economy and to ensure an effective disincentive for employers to engage in unlawful and anticompetitive business practices. Ch. 906 —2— 90 (b) Although innovative labor law education programs and self-policing efforts by industry watchdog groups may have some success in educating some employers about their obligations


under state labor laws, in other cases the only meaningful deterrent to unlawful conduct is the vigorous assessment and collection of civil penalties as provided in the Labor Code. (c) Staffing levels for state labor law enforcement agencies have, in general, declined over the last decade and are likely to fail to keep up with the growth of the labor market in the future. (d) It is therefore in the public interest to provide that civil penalties for violations of the Labor Code may also be assessed and collected by aggrieved employees acting as private attorneys general, while also ensuring that state labor law enforcement agencies’ enforcement actions have primacy over any private enforcement efforts undertaken pursuant to this act. SEC. 2. Part 13 (commencing with Section 2698) is added to Division 2 of the Labor Code, to read: PART 13. THE LABOR CODE PRIVATE ATTORNEYS GENERAL ACT OF 2004 2698. This part shall be known and may be cited as the Labor Code Private Attorneys General Act of 2004. 2699. (a) Notwithstanding any other provision of law, any provision of this code that provides for a civil penalty to be assessed and collected by the Labor and Workforce Development Agency or any of its departments, divisions, commissions, boards, agencies, or employees, for a violation of this code, may, as an alternative, be recovered through a civil action brought by an aggrieved employee on behalf of himself or herself and other current or former employees. (b) For purposes of this part, ‘‘person’’ has the same meaning as defined in Section 18. (c) For purposes of this part, ‘‘aggrieved employee’’ means any person who was employed by the alleged violator and against whom one or more of the alleged violations was committed. (d) For purposes of this part, whenever the Labor and Workforce Development Agency, or any of its departments, divisions, commissions, boards, agencies, or employees has discretion to assess a civil penalty, a court is authorized to exercise the same discretion, subject to the same limitations and conditions, to assess a civil penalty. (e) For all provisions of this code except those for which a civil penalty is specifically provided, there is established a civil penalty for a violation of these provisions, as follows: Ch. 906 —3—90

(1) If, at the time of the alleged violation, the person does not employ one or more employees, the civil penalty is five hundred dollars ($500).

(2) If, at the time of the alleged violation, the person employs one or more employees, the civil penalty is one hundred dollars ($100) for each aggrieved employee per pay period for the initial violation and two hundred dollars ($200) for each aggrieved employee per pay period for each subsequent violation.


(3) If the alleged violation is a failure to act by the Labor and Workplace Development Agency, or any of its departments, divisions, commissions, boards, agencies, or employees, there shall be no civil penalty. (f) An aggrieved employee may recover the civil penalty described in subdivision (e) in a civil action filed on behalf of himself or herself and other current or former employees against whom one or more of the alleged violations was committed. Any employee who prevails in any action shall be entitled to an award of reasonable attorney’s fees and costs. Nothing in this section shall operate to limit an employee’s right to pursue other remedies available under state or federal law, either separately or concurrently with an action taken under this section. (g) No action may be maintained under this section by an aggrieved employee if the agency or any of its departments, divisions, commissions, boards, agencies, or employees, on the same facts and theories, cites a person for a violation of the same section or sections of the Labor Code under which the aggrieved employee is attempting to recover a civil penalty on behalf of himself or herself or others or initiates a proceeding pursuant to Section 98.3. (h) Except as provided in subdivision (i), civil penalties recovered by aggrieved employees shall be distributed as follows: 50 percent to the General Fund, 25 percent to the Labor and Workforce Development Agency for education of employers and employees about their rights and responsibilities under this code, available for expenditure upon appropriation by the Legislature, and 25 percent to the aggrieved employees. (i) Civil penalties recovered under paragraph (1) of subdivision (e) shall be distributed as follows: 50 percent to the General Fund and 50 percent to the Labor and Workforce Development Agency available for expenditure upon appropriation by the Legislature. (j) Nothing contained in this part is intended to alter or otherwise affect the exclusive remedy provided by the workers’ compensation provisions of this code for liability against an employer for the Ch. 906 —4—90 compensation for any injury to or death of an employee arising out of and in the course of employment.



SECTION: 11

AREA: Safety Committee Minutes (Internal & Department)

16

DBH Regional Safety Committee Meetings (Regional Safety Reps and Clinic/Facility Supervisors) DBH Safety Binder (Section 11)

Effective 22 Jan 06, all BLIs are required to attend the quarterly DBH Safety Committee meeting and clinic/facility supervisors are encouraged to attend. The committee discusses injuries and incidents, then develops policy and procedures to minimize the potential for repeat incidents. impact to the Department. All safety concerns, injuries, and safety hazards existing in the facility must be forwarded to the RSRs no later than the 5th of the each meeting month (Jan, Apr, Jul and Oct – See Section 8 for this report format). Distribution, implementation and compliance with safety programs will be the responsibility of the Clinic/Facility Supervisor and Regional Safety Representatives. All minutes and documents from this meeting must maintain in this section and all new program requirements must be implemented as specified. Assistance with safety issues should be sought from your RSR. RSRs are in turn, responsible for assisting supervisors and BLIs within their designated regions to comply with all safety program requirements.


Place copies of


HERE

JAN 2006


Place copies of


HERE

APR 2006


Place copies of


HERE

JUL 2006


Place copies of


HERE

OCT 2006


Place copies of

INTERNAL PROGRAM SAFETY COMMITTEE

MINUTES

HERE


Section 12 DBH Safety Positions

SCHEDULE OF COMPLETION: Update as changes occur – review annually (Jan ) SUBMITTED/CONDUCTED BY: SUPERVISOR/BLI REPORT FORMAT: Email changes to BLI assignments to your Regional Safety Rep _______________ and Gwen Morse. DOCUMENTATION REQUIREMENTS: Document BLI assignment changes in this section of the manual (Below) SEND REPORT TO: See above. Methods OF SUBMISSION: EMAIL ONLY

Completed

Supervisor Name Date Assigned

BLI Name Date Assigned


CLINIC SAFETY PROGRAM ACTIVITY PLAN – Place this form in SECTION 12 of your 2006 DBH Safety Program Binder. SHARE THE WEALTH - ALL DBH STAFF WILL SHARE IN THE SAFETY PROGRAM BY BEING ASSIGNED SPECIFIC TASKS & RESPONSIBILITIES All DBH Staff will be required to assume some duties of the Safety Program. Tasks will be assigned and rotated each year (January – December). Some activities are pre-assigned and must be accomplished as indicated below. In smaller facilities, staff must be assigned to multiple tasks to insure equitable distribution of assignments (for example: one staff may have fire drills & Quarterly inspections or Hazard Communication Program & Emergency Action Plan or Monthly Safety Training). The supervisor and/or BLI must train staff members on their assigned safety duties (see the section in the respective binder: Safety, Haz Com or Medical Waste Management). Insure the staff member understands the tasks assigned. The supervisor/BLI remain responsible for those tasks indicated below (Quarterly Injury, Illness, Accident, Hazard Reports and Safety Committee Meeting attendance). Safety Program Activity Staff Member Name and

Date Assigned Due Date

Assaultive Behavior Drills Section 1 – DBH Safety Binder)

22nd of the month Jan, Apr, Jul & Oct (Refer to the schedule - front of the Safety Binder)

CalOSHA Reports Section 2 – DBH Safety Binder)

Supervisor/BLI Post 1 Feb – 30 Apr 06. 1 May – transfer to Section 2 of DBH Safety Binder

Driver’s Awareness Safety Section 3 – DBH Safety Binder)

Supervisor Initial assessment of all staff and then with new staff or after accidents

Emergency Action Plan Section 4 – DBH Safety Binder)

Due 22 Apr 06. (Refer to the schedule - front of the Safety Binder)

Ergonomics Section 5 – DBH Safety Binder)

Supervisor When an ergo injury occurs or an ergo assessment is requested.

Fire Drill Reports Section 6 – DBH Safety Binder)


Hazardous Conditions & Corrective Action Documentation Section 7– DBH Safety Binder)

When a problem exists that poses a hazard to clients/staff and/or is identified/reported to supervisor/BLI.

¼ Illness, Injury, Accident Rpts Section 8 – DBH Safety Binder)

Supervisor/BLI Due prior to the Safety Committee Meeting in Jan, Apr, Jul & Oct (Refer to the schedule - front of the Safety Binder)

Inspection (¼ Safety) Section 9 – DBH Safety Binder)

BLI/Supervisor MUST conduct HIPAA portion of this inspection


Inspection (Annual) Section 9 – DBH Safety Binder)

Supervisor Conducted between 1 Aug & 30 Sep 06 – Action Plans due by 31 Oct 06 (Refer to the schedule- front of the Safety Binder)

Regional Safety Committee Meetings Section 11 – DBH Safety Binder)

BLI Place minutes in Safety Binder (Refer to the schedule- front of the Safety Binder)

Monthly Safety Training Section 13 – DBH Safety Binder)


Fire Extinguisher (hands on) Training Section 13 – DBH Safety Binder)

Due by 31 Oct 06 (Refer to the schedule- front of the Safety Binder)

Medical Waste Management Inspections See– DBH Med Waste Binder)

Supervisor/BLI/Medical Staff ONLY

Due by Jan 22nd & 22 Jun 06 (Refer to the schedule- front of the Safety Binder)

Hazard Communication Program See– DBH Haz Com Binder)

Due by Jan 22nd 06 (Refer to the schedule- front of the Safety Binder)


DBH Safety Program Org Chart

BLIs

Mike SchertellRSR

West End

BLIs

Tina EntzRSR

Forensics & Homeless

BLIs

Deanna JaglowskiRSR

Desert Region

BLIs

Lucille CruzRSR

BHRC

BLIs

VacantRSR

Gilbert St Complex

Gwen MorseDBH Disaster/Safety Coordinator

DeAnna Avey- MotikeitAssistant Director

Allan RawlandDirector

DEPUTY DIRECTORS & PROGRAM MANAGERS

Regional Safety Rep

Quarterly

Safety Committee


DBH SAFETY COORDINATOR ROSTER (BUILDING LOCATION INSPECTORS)

REGIONAL SAFETY REPS (RSR) Please consult with and send all safety reports/inspections to your RSR.

Lucille Cruz

909-421-9435

Mike Schertell

909-854-3458

Tina Entz

909-463-5234

Deanna Jaglowski

760-955-7417

Gilbert St Complex

Program Address & Phone Supervisor BLI ACCESS 700 E. Gilbert Cottage # 4

San Bernardino 92415 (909) 386-0763

Phyllis Rattely Don Neely

ADS Admin 700 E Gilbert bldg#6 SB 92415

(909) 387-0477

Joyce Lewis (Temp)

No one Assigned

ADS/ Rialto 850 E. Foothill Blvd Rialto, 92376

(909) 421-9465

Cheryl Long

Tammy Dickey

ADS/ VV 12625 Hesperia Rd Victorville 92392 (760) 955-1777

Charlene Daniels George Pope

Adult Res.Care 850 E Foothill Blvd Rialto 92376

(909) 421-9495

Ben Cooley Barbara Smith

Agewise 850 E. Foothill Blvd Rialto 92376

(909) 421-9365

Arvita Crabtree Janie Case

ASOC 850 E Foothill Blvd Rialto 92376

(909) 421-9435

Maria Coronado Lucille Cruz

Barstow Clinic 805 E. Mt. View Barstow 92311 (760) 256-5026

Rosaline Tanishita Paul Howard

BHRC Admin 850 E Foothill Blvd Rialto 92376

Ralph Ortiz Lucille Cruz

Boys & Girls Club

1180 W. 9th SB 92411

(909) 388-4295

Elaine Holzer No one assigned

Building #3 700 E Gilbert St SB 92415

(909 387-7577

Kris Letterman Joe Segal

CalWORKS – Barstow

1300 E Mountain View Barstow, 92311 760-256-4303

John Luther Sandra Chavez

CalWORKS – Colton

850 Via Lata Ste. 100 Colton 92324 909-872-1633

No longer a DBH Clinic N/A

CalWORKS - Fontana

16370 Arrow Rialto 92335

909-854 -4085

Linda Charkins Mardi Godinez

CalWORKS - Hesperia

15980 Main Street Hesperia 92345 760-948-8704

John Luther Jennifer Garcia

Program Address & Phone Supervisor BLI


CalWORKS – Rancho

10825 Arrow Rt 2nd Fl Rancho 91730

909-945 - 0926

Linda Charkins Mardi Godinez

CalWORKS-SB 8088 Palm Lane San Bernardino 92401

909-386-5029

Marsha Workman Linda Hernandez

CalWORKS- VV 12219 2nd Ave. 2nd Fl Victorville 92392

760-955-3668

John Luther Tiffany Montgomery

Casa Ramona 1543 West 8th St Ste B San Bernardino 92408

909-386-5415

Elaine Holzer Becky Valenzuela

CCICMS 850 E. Foothill Blvd Rialto 92376 909-421-9382

VACANT Ivette Coronel

( Starts in Jan.) CCRT 850 E. Foothill Blvd. Rialto 92376

909-421-9233 Andy Gruchy Ivette

Coronel (Starts in Jan.)

Centralized Hospital After-Care Services

850 E. Foothill Blvd. Rialto 92376 909-421-9365

Arvita Crabtree Janie Case

Chino Multiple Diagnosis

6180 Riverside Dr., Suite H. Chino 91710 909-590-5355

Tim DeChenne Dan Bielher

Compliance Unit (QM)


John Griffith

Cheryl Placide

CONREP 1330 Cooley Drive Colton 92324 909-423-0750

Munir Sewani Susan Heisler

Director’s Office 850 E. Foothill Blvd. Rialto 92376 909-873-4479

Allen Rawland Betty Schneider

Conservatorship Unit


Ben Cooley Barbara Smith

Employment 201 West Mill San Bernardino 92408

Bob Sudol Doug Castle

EVRC 820 E. Gilbert St. San Bernardino 92415

909-387-7739

Jeff Wirth Lise’ Lieberman

Hesperia Clinic 14628 Main Street Hesperia 92345 760-244-0576

Gary Bastajian Angela Smith

Homeless 202 E. Mill St. San Bernardino 92408

909-388-4133

Bob Sudol Doug Castle

Housing 202 Mill Street San Bernardino 92408

909-388-4178

Jerry Dowdall

Doug Castle

ISD – Gilbert St 700 E. Gilbert St San Bernardino, CA 92415

909-463-5234

Michael Day Pam Terral

JMHS 9500 Etiwanda Blvd. Rancho Cucamonga 91739

909-463-5234

Tina Entz Tina Entz


Program Address & Phone Supervisor BLI

JETS 9478 Etiwanda Ave. Rancho Cucamonga

91739 909-463-7624

Domingo Rodriguez (Temp)

Allison Ellis – Williams

JJOP 900 E. Gilbert St.

San Bernardino 92415 909-387-6942

Domingo Rodriguez

Betty Williams

Lucerne Valley Clinic

32786 Old Woman Springs Rd. #C Lucerne Valley 92356

760-248-6612

Rosaline Tanishita

Jane Padilla

Medical Records 850 E. Foothill Blvd. Rialto 92376 909-421-9355

Gary Gleason Barbara Adkins

Mesa Clinic 850 E. Foothill Blvd. Rialto 92376 909-421-9460

Sherwin Farr

Diane Bokkin

Needles Clinic 1300 Bailey Avenue Needles 92363 760-326-9313

John Luther

Lori Jones

Nueva Vida Clinic

290 N. 10th St. Suite 102, Colton 92324 909-825-6188

Elaine Holzer Carey Jackson

Patients’ Rights 700 E. Gilbert San Bernardino 92415

909-421-9389

Phyllis Rattley Don Neely

Payroll/HR (Bldg 6)

700 E. Gilbert San Bernardino 92415

909-387-7303

Yvonne Cervantes No one Assigned

Perinatal – Rialto

850 E. Foothill Blvd Rialto 92376 909-421-9209

Cynthia Curbow Cheryl Limbrick

Perinatal – VV 11951 Hesperia Rd. Hesperia 92345 760-956-6780

Michele Finn-Cretarola

C. Lisa Nelson

Phoenix Clinic 700 E. Gilbert St Building #4 San Bernardino 92415

909-387-7000

Tim Webber

Shana Mays

PORTALS 850 E Foothill Blvd Rialto, 92376 909-421-9201

Bob Varenelli

Barbara Smith

Research & Evaluation

700 E. Gilbert (Bldg. 6) San Bernardino 92415

909-387-7754

Keith Harris No one Assigned

STAR 1300 Cooley Drive Colton 92324 909-423-0750

Ron Smith

Susan Heisler

TAPP 850 E. Foothill Blvd Rialto 92376

James Entz Barbara Smith

TEAM House 201 West Mill San Bernardino 92408

Bob Sudol

Doug Castle

Upland Comm. Counseling

934 N. Mountain Ave. Upland 91786 909-579-8100

Carol Michelson

Yolanda Martinez

Vista 17216 Slover Avenue, Bldg L Fontana 92337 909-854-3420

Mike Schertell

Mike Schertell

VVBH 12625 Hesperia Road Hesperia 92392 760-955-2839

Kerry Turner

Paul Howard


Safety Responsibility Descriptions

11)) CClliinniicc//FFaacciilliittyy SSuuppeerrvviissoorr

The clinic supervisor is ultimately responsible for the safety program in his/her facility. He/she must implement the basic safety program at the facility and/or appoint a member of the facility to accomplish these tasks (Building Location Inspector – BLI). The supervisor assumes responsibility for sending a BLI to attend quarterly Regional Safety Committee meetings, getting information from that meeting and coordinating corrective actions to mitigate unsafe conditions. EACH location where DBH staff are housed, a safety program must exist (this includes shared facilities where DBH staff are tenants – CalWorks, JMHS, etc). Supervisors must coordinate with “host facility safety coordinators” to insure the staff safety is compliant. The Clinic Supervisor or an individual must be assigned to oversee day-to-day safety issues for DBH staff assigned in these tenant situations. Employees are responsible for notifying their BLI, immediate supervisor, Regional Safety Representative (RSR), Program Manager and Department Safety Coordinator of unabated safety hazards and long-term, complex safety problems. Involve your Regional Safety Rep (RSR) with hazards and request intervention. (See RSR roster at the front of the DBH Safety Binder)

2) RReeggiioonnaall SSaaffeettyy RReepprreesseennttaattiivvee ((RRSSRR))

This individual is appointed by the PM to assist supervisors and BLI’s with safety issues at facilities

within their regions (See RSR roster at the front of the DBH Safety Binder). He/she collects all required drills and reports (See the roster in the front of the DBH Safety

Binder for a complete list), forwards those documents to the DBH Safety Coordinator and provides intervention for complex safety concerns. RSRs attend the quarterly Department Safety Meeting and report injury/accident/hazardous conditions to the committee based on feedback from EACH operating facility and disseminate safety information from those meetings to the Supervisors and BLIs.

3) BBuuiillddiinngg LLooccaattiioonn IInnssppeeccttoorr ((BBLLII))

This individual is by direction of the Board of Supervisors, the facility/program supervisor. If

duties are delegated, this individual(s) should be given the resources, time and support required to conduct safety program activities. (See next page for a list of responsibilities.

The BLI must attend one department BLI training (conducted in January, April, July and Oct) and the County Risk Management CalOSHA 3-module course within 3 months of the new assignment.

and safety inspections as well as monthly safety presentations, This position also maintains

Driver’s Safety Program, Hazard Communication Program, and OSHA 300 A (old CalOSHA 200) files. He/she also trains or coordinates training for staff on procedures for building evacuation, and hands on fire extinguisher use. He/she reports hazardous conditions and coordinates corrective actions for these issues and insures proper signage is posted (Fire Extinguishers, First Aid Kits, OSHA posters, No smoking signs, room numbers/capacity signs, handicapped signs, BLI Notice, etc.)


Building Location Inspector (BLI) Responsibilities 1) AAssssaauullttiivvee BBeehhaavviioorr DDrriillllss – Drafts a bi-monthly schedule for staff

and coordinates the assaultive behavior drill and insures the report is accomplished using the standard format in the DBH SPM. Forwards the master copy of this report to the DBH Safety Coordinator no later than the 25th of the reporting month and maintains a copy at the facility.

2) SSaaffeettyy PPrreesseennttaattiioonnss – These monthly presentations are short (5-10 minutes) work-related, mini-safety presentations. They can be accomplished at regular staff meetings or held independently, and they must be DOCUMENTED on a separate sign in sheet (See attached). An Assaultive Behavior may be substituted for the safety presentation, but a separate sign in sheet must be completed along with the regular drill report format.

3) QQuuaarrtteerrllyy BBuuiillddiinngg IInnssppeeccttiioonnss – Conducts quarterly building

inspections IAW the DBH and County procedures and DOCUMENTS them on DBH standard checklist forms . The master copy of this report is sent to the DBH Safety Coordinator and a copy is maintained at the facility. Inspections should be accomplished BEFORE the 25th of each reporting month. All actions taken to resolve a safety issue are to be documented and final mitigation date must be included.

4) QQuuaarrtteerrllyy FFiirree DDrriillll–– Conducts quarterly fire drills IAW the DBH

and County procedures and DOCUMENTING them using the DBH standard report format . The master copy of this report is sent to the Regional Safety Rep and the PM. The Regional Safety Rep sends a copy to the DBH Safety Coordinator and a copy is maintained at the facility. Failed drills must be documented, training given to staff on failed areas, and the drill must be repeated.

2


Regional Safety Rep (RSR) Responsibilities

1) SSaaffeettyy PPrreesseennttaattiioonnss – Insure MONTHLY Safety Presentations are being conducted and documented/maintained in your represented facilities on the Safety Training Roster.

2) BBuuiillddiinngg IInnssppeeccttiioonnss – Collect quarterly building inspections from all represented facilities and forward copies to the DBH Disaster/Safety Coordinator, BHRC. Inspections should be accomplished BEFORE the 22nd of each reporting month – see schedule in the front of the DBH Safety Binder for deadlines. All actions taken to resolve a safety issue are to be documented and final mitigation date must be included. (Place reports in Section 9 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

3) BBuuiillddiinngg IInnssppeeccttiioonnss –– Coordinate annual building inspections with clinic/facility supervisors and forward copies of reports and corrective action plans to the DBH Disaster/Safety Coordinator, BHRC. Inspections should be accomplished BETWEEN 1 Aug and 30 Sep each year. – see schedule in the front of the DBH Safety Binder for deadlines. All actions taken to resolve a safety issue are to be documented and final mitigation date must be included. (Place reports in Section 9 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

44)) SSaaffeettyy PPrreesseennttaattiioonnss ––IInnssuurree aallll pprrooggrraammss aarree pprroovviiddiinngg mmoonntthhllyy ssaaffeettyy ttooppiicc ttoo AALLLL aassssiiggnneedd ssttaaffff aanndd hhaavvee ssttaaffff ssiiggnn tthhee ttrraaiinniinngg rroosstteerr.. ((SSiiggnn iinn rroosstteerrss aarree ppllaacceedd iinn sseeccttiioonn 1133 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

55)) SSaaffeettyy PPrroobblleemm IInntteerrvveennttiioonn –– Provide intervention and guidance to any represented facility experiencing difficulty resolving safety hazards. ((PPllaaccee ddooccuummeennttaattiioonn ooff aaccttiioonnss iinn sseeccttiioonn 77 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

66)) AAssssaauullttiivvee BBeehhaavviioorr DDrriillllss – Collect bi-monthly Assaultive Behavior Drill reports from all represented facilities and forward copies to the DBH Disaster/Safety Coordinator, BHRC no later than the 22nd of the reporting month and maintains a copy at the facility. ((PPllaaccee tthhee rroosstteerr iinn sseeccttiioonn 11 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

7) QQuuaarrtteerrllyy FFiirree DDrriillll–– Collect quarterly fire drills and forward to the DBH Safety Coordinator no later than the 22nd of the reporting month and forward copies to your RSR ((PPllaaccee tthhee rroosstteerr iinn sseeccttiioonn 66 ooff tthhee DDBBHH SSaaffeettyy BBiinnddeerr..))

8) Hazard Information – Collect information from represented facilities quarterly to bring to the DBH Regional Safety Committee Meetings and report/discuss these issues and mitigation activities within the committee.

9) Regional DBH Safety Committee Meetings - Attend quarterly Regional DBH Safety Committee Meetings at the BHRC (Library). Meetings will be conducted January, April, July and October from 1:30 – 3:30 PM and insure ALL information is disseminated to program supervisors & BLIs.

10) Create/update DBH Safety SPMs and other Safety procedures – Following the identification of safety issues/hazards in the quarterly safety meetings (from the injury report review or other incidents) RSRs will be assigned to create safety procedures to mitigate unsafe conditions. RSRs will also be assigned to review outdated existing SPMs

11) Information Distribution - Distribute information from Safety Committee meetings to represented facilities and insure implementation of programs and procedures at same.

12) BLI Training – Provide hands-on training to any new BLI at a represented facility using this file/checklist as a guide to insure he/she understands the BLI functions and establishes the necessary files, binders, and manuals required by Federal, State, County, and Department guidelines.

13) Annual Bldg. Inspections - Participate in the coordination & accomplishment of annual DBH Facility inspections.

14) Other Safety Activities as assigned

2A



SECTION: 13

AREA: TRAINING (List of required Training, Hands-on Fire Extinguisher Training & Monthly Safety Presentations, Safety for Supervisors & BLI- CalOSHA.) 17

Monthly Safety Training Documentation (all staff) DBH Safety Binder (Section 13)

This monthly training is MANDATORY for all DBH staff and should be presented by supervisors or BLIs. Some topics that can be used: 1. Location of and instructions for utility shut off, 2. disaster response tasks, 3. Location of PPE, disaster/emergency equipment & supplies, 4. Fire Evacuation/Drill Procedures, 5. Emergency Action Plan, 6. HIPAA Security Rule, 7. Results of quarterly/annual building inspections, 8. Season-specific precautions, 9. Haz Com Program training, 10. Hands -on fire extinguisher training, 11. Safety program & BLI responsibilities/reporting hazards, 12. Important info from Safety Committee meetings or you may create your own training on a relevant safety topic or use the monthly safety topic sent out by the DBH Safety Coordinator. Insure all staff sign the training roster and place the sign in roster in Section 13 of the DBH Safety Program Binder. DO NOT document this training in staff meeting minutes. (Use attached sign in roster) You may also use topics from the Supervisor’s Safety Training Manual to fill this requirement. More information on this requirement can be found in the San Bernardino County Employee Safety & Health Manual, Policy 09-03 (Page 3); Policy 09-02, (Page 9); Page 13; and Page 113. In the DBH SPM 7-2.10, para. 4.

19

Hands on Fire Extinguisher Training Documentation DBH Safety Binder (Section 13)

This training is required ANNUALLY between August & September. Arrange your on-site training in accordance with the instruction sheet by e-mailing Mike Huddleston at the County Fire Dept or contact him at (909) 386-8411. Training is usually conducted some time between April and June each year. Use the attached sign in sheet to document the training. Forward a copy of the sign in roster to your RSR & DBH Disaster/Safety Coordinator, BHRC.

42

CALOSHA (#-module) Course (Risk Mgt.) BLI’s & Regional Safety Reps ONLY DBH Safety Binder (Section 13)

This course is REQUIRED of all BLI’s and should be scheduled within 2 months of assuming the safety rep responsibilities. It is provided by the Risk Management Dept. To schedule yourself for this training, contact PAM FELTS at (909) 386-8624. Please e-mail the DBH Safety Coordinator with the dates of your training.

44

Safety for Supervisors SUPERVISORS ONLY DBH Safety Binder (Section 13)

This course is for supervisors and is mandatory. The supervisor will be trained on CalOSHA requirements for the facility and will be given the new SB Co. Employee Health and Safety Manual. To schedule a supervisor for this training look up the dates on Outlook – public folders under safety, then contact PERC/Risk Mgt. to schedule. The list has the names (provided by Risk Mgt.) of DBH supervisors who have attended and their manual numbers (See item # 1 above).


Suggested Training Topics

You may use these or your own training materials to meet your safety program training requirement each month.

Month Topic Month Topic January Hazard Communication

Program July SUMMER WEATHER CAR

CARE

February Emergency Equipment Location

August Hands-on Fire Extinguisher Training

March CalOSHA 200 & 300A Logs

September Workplace Safety

April Staff Disaster Response Tasks

October

May Office Housekeeping November Ergonomics

June Care of the Back December Holiday Décor Safety

1. Print out the pages (Enough copies for all staff) 2. Review the material before presenting (You’re welcome to do more extensive

research on any topic if you like.) 3. Present topic to staff w/handouts 4. Have staff sign the roster 5. File roster in this section of your DBH Safety Binder

Insert copies of


COMPLETED

STAFF TRAINING ROSTERS

Here


January 2006 Hazard Communication Program Purpose: To inform employees of the hazardous materials and conditions that exist in the workplace and procedures for safe operations.

Here is what you need to do:

1) Conduct a thorough inspection of your facility for hazards and chemicals (includes medical waste mgt.)

2) Document all hazards/chemicals and their locations 3) Obtain MSDS for chemicals 4) Establish a Hazard Communications Binder (listing all hazards and MSDS sheets) MSDS sheets

MUST be kept in a central location for all staff to access. 5) Inform all staff by memo or training about your HCP 6) Update the HCP annually

Hazard Communication Program Haz Com Binder Section 1

This is a federal/state-mandated program. It is the employer’s responsibility to notify all employees of the “hazards” that exist in the work center and to post information about those hazards for easy-access to all employees. A binder should be located in an area of the facility that is readily available to all employees. It should identify all chemical hazards in the facility to include printer toner, office supplies and cleaning products that contain any ingredient that would cause harm to humans. This binder should contain: 1) Personal MSDS Inventory Worksheets 2) Facility Master MSDS Inventory Sheets 3) Current MSDS from the manufacturer 4) Documentation of mitigation of MSDS 5) Haz Com Orientation documentation to staff See the Haz Com Program for detailed instructions and forms. Reference the San Bernardino County Health & Safety Manual, Section 1 (Page 18); Section 2. (Pages 5 – 8) . See attached DBH program & worksheets for compliance with this program.


Individual Chemical Identification Data Collection Sheet for MSDS Haz Com Binder Section 2

EVERY staff member must complete an individual inventory form – scouring their work area. Staff are responsible for providing the inventory sheet and MSDS sheets for any products maintained in his/her personal work area to the supervisor no later than 31 Dec each year. The complete

review, collection of MSDS forms and staff training must be forwarded to the Regional Safety Rep (RSR) by the last

Friday of January each year. See the Haz Com Binder for instructions on ordering Material Safety Data Sheets (MSDS).

Master Inventory List for MSDS Haz Com Binder Section 3

These forms should be a consolidated list of ALL hazardous chemicals in the facility. They should be completed by the Clinic/Facility Supervisor or BLI and reviewed/updated ANNUALLY. If a new materials is a Brought into the facility, a new MSDS should be acquired. See the packet for how to acquire Material Safety Data Sheets (MSDS). The HAZCOM Binder should be kept in a location readily accessible to ALL STAFF.

MSDS Sheets Haz Com Binder Section 4

These forms contain information on products used in your work center that may pose a health hazard to humans if ingested. They contain information on first aid, storage requirements, flashpoint, and much more. The Hazard Communication Program consists of 1. An assessment of the hazards (and chemicals/compounds, etc); 2. Collection of the Material Safety Data Sheets (MSDS) that describe the product; 3. Training for staff. MSDS can be requested directly from the manufacturer, through Central Stores, or one of the websites/800 number listed in Section 1 of this binder. These important chemical information sheets must be kept available in the event of an exposure/ingestion incident. Conduct annual updates reviews of discontinued/upgraded items. Maintain CURRENT MSDS and for all discontinued items – file in section 7 - must be kept for 30 years.


Monthly Safety Training

Maintain a copy of this training in THIS Section (Have staff sign the Staff Acknowledgement Sheet and maintain in the HAZ COM Program Binder - Section 5)

Facility Topic: Hazard Communication Pgm

DATE: ____ Jan 06

Training Conducted By:

Employee Name Signature


February 2006 Emergency Equipment Locations Purpose: To inform employees on the locations of emergency equipment and supplies in the facility. Suggested Activity: Conduct a tour with staff – walk the building and make note of the following: ___CalOSHA posters (Familiarity with information) ___Disaster Supplies (Location& access, contents/expirations, signs leading to these kits) ___Flashlights (Check availability, battery life & bulbs) ___First aid kits (inventory contents, check for signs leading to kits) ___Fire extinguishers (location, overhead signs and access(locks & glass cabinets?) ___Fire alarm pull stations (locations & activation method.) ___Emergency phone numbers (list placed under EVERY DBH PHONE) ___Emergency exits (familiarity with location, clear & accessible) ___Utility shut off locations (turn off locations, procedures and required tools)


Monthly Safety Training Maintain a copy of this training in your DBH Safety Binder (Section 3)

Facility Topic: Emergency Equipment

DATE: ____ Feb 06



March 2006


CalOSHA 300A and First Aid Log Purpose: To inform staff about the purpose of the CalOSHA 300A report and importance of using the First Aid Log Cal/OSHA Form 300A CalOSHA 300A reports (Annual Summary of Work-Related Injury and Illnesses) are posted in your worksite from February 1 to 30 Apr each year. The reports must be displayed in a conspicuous location where notices to employees are customarily posted. A copy of the summary must also be made available to employees who move from worksite to worksite and employees who do not report to any fixed establishment on a regular basis. On 30 Apr 06, the summary should be taken down and kept in the DBH Safety Binder, Section 2 (for a period of five years following the year to which it pertains. The information on the Form 300A summarizes data from the Cal/OSHA Form 300 (work-related injuries and illnesses) for the previous year. During the year, employers are required by law to record information on the Form 300 about every work-related death, injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work or medical treatment beyond first aid. They must also report significant work-related injuries and illnesses diagnosed by a physician or licensed health care professional. The DBH Safety Committee discusses these injuries/illness each quarter to propose changes to procedure/policy that will act to reduce the instances of these injuries and their impact to staff. Submitting quarterly injury/illness and near miss reports to the committee is vital the success of our safety program. For more information about the CalOSHA 300A, contact your Regional Safety Rep (RSR) or the DBH Safety Coordinator. Submit your suggestions to improve safety in your workplace to the Safety Committee (through your RSR). First Aid Log First Aid Logs must be posted on official bulletin boards (and should be kept in all first aid kits). Entries should be make when employees suffer minor injuries/illness that requires minor attention (small scratches, punctures, “bandaidable” injuries, minor strains, sprains or other minor injuries). Documenting these injuries on the First Aid Log will establish a baseline (time line) in the event the injury worsens, leads to an infection, time off of work or results in a worker’s comp case being filed. You should always notify your supervisor of injuries, no matter how small or insignificant they may appear.


http://www.qklinkserver.com/lm/rtl3.asp?si=19903&k=first%20aid

http://www.qklinkserver.com/lm/rtl3.asp?si=19903&k=health%20care

http://www.qklinkserver.com/lm/rtl3.asp?si=19903&k=health%20care


Facility Topic: CalOSHA 300A & FA Log

DATE: ____ Mar 06



April 2006

Know your responsibilities in disaster


Purpose: To train employees on their specific responsibilities during disaster (sheltering in place). (Facility Disaster Plans must be reviewed once a year- each April). Staff must be prepared to take on special tasks in preparation for or following an emergency or disaster event. Required Handouts: A CURRENT copy of the Facility Disaster plan fore each employee. Suggested Activity: Using your facility’s disaster plan, review each member’s assignment and answer the following: ___ * Designate rooms for sleeping quarters ___ * Designate room/areas for sanitation (toilets) ___ * Designate rooms for congregating – daytime ___ * Designate rooms for operations/management – daytime ___ * Designate rooms for supply control ___ * Designate rooms for temporary storage of deceased ___** Who will conduct the headcount to account for occupants? ___** Who will care for medical emergencies? ___** Who will transport injured or information from the facility? ___** Who will conduct the initial damage assessment? ___** Who will turn off unsafe utilities? ___** Who will assess clinic service/operational status? ___** Who will assess communication capabilities? ___** Who will conduct family welfare notifications? ___** Who will collect, maintain & issues supplies? ___** Who will provide basic security for staff and the facility? ___** Who will provide counseling services to survivors? ___Do staff have their own personal emergency kits *Identify primary and secondary choices in the event the room is not habitable **Identify primary and secondary staff in the primary staff member is unable to perform these duties


Staff Personal Disaster Preparedness Kit Inventory (Optional) Completed by Staff Member: __________________________________________ Recommended Items:

Item On hand 1 Food (* high protein/fat content, non-perishable – replace every 6 months) 2 Water (* 1 ga. @ day for 3 days – replace every 6 months) 3 Clothes, walking shoes 4 Personal items 5 Radio 6 Flashlight 7 Fresh batteries 8 Medical Information/Medications (* check regularly for expiration) 9 Emergency Family Contact Information & Reunification Plan 10 Emergency Cash (* not kept in kit) 11 Large garbage bags (* for sanitation and other uses - 30 gal. 1 box) 12 Toilet tissue 13 Games, books, other form of diversion (* batteries as needed) 14 Blanket/pillow (* small blanket, inflatable pillow) 15 Other: 16 Other: 17 Other: 18 Other: 19 Other: 20 Other: 21 Other: * Recommended


Monthly Safety Training Maintain a copy of this training in this section of the DBH Safety Binder – have staff sign the Acknowledgement sheet and maintain in Section ___ of the Disaster Binder)

Facility Topic: Facility Disaster Plan Roles

DATE: ____ Apr 06




May 2006

Office housekeeping and safety go hand in hand Purpose: To stress the importance of how good workspace and workplace housekeeping can help get the job done safely and properly.

Neatness Does Count Good housekeeping is at least as essential in the workplace as it is in your own home. When your workspace is clean, orderly,

and free of obstructions, you can get the job done safely and properly. A messy work area, on the other hand, promotes accidents because it hides hazards. These hidden hazards can cause you and others illness and injury. Don’t accept the sight of paper, debris, and spills as a normal working condition. If you consider this as normal you may begin to think of worse dangers as acceptable as well.

Effective housekeeping takes an ongoing effort, not just hit-and-miss attempts to clean up once in a while. Periodic cleanups aren’t enough to reduce workplace accident rates. Don’t begin a drive to clean up and then let things slide after a week or two. Set your work area in order and keep it that way. A lasting result is the only meaningful one.

While we are not expected to clean up for others unless that is the job we have been hired for, as adults we can help clean up after ourselves and keep our own work area neat and in order. That is an understood part of our job description.(On the other hand, it would not be very adult to notice a hazardous situation and do nothing about it just because it waist within our own area.)

Here are some specifics to be mindful of.

• Keep the floor around you clean and clear of waste. If your job is one in which debris is created, you can attend to the immediate floor area every once in a while as you work.

• Keep your workstation cleared of personal items such as clothing and lunch boxes. These should be stacked neatly in a locker or an assigned storage spot.

• Keep stairways, passages, and gangways free of obstructions. Don’t place materials on the stairs or in aisles as you work. Bundle hoses and cables when not in use.

• Be aware of protruding nails, sharp corners, open cabinet drawers, and trailing electric wires in the work area. Either correct the unsafe condition if you are able and it is safe to do so, or notify the person responsible for overall maintenance of the space that something should be done.

• Wipe up spills as soon as they occur. Use proper procedures as described in the material safety data sheet if the substance is a hazardous one and put on any personal protective equipment that is required. Dispose of used rags or towels in the proper manner.

• Keep your tools and equipment clean and in good shape. If equipment is damaged, report it and follow up to make sure that the equipment has been adjusted before using it again. After finishing a job, place tools and unused materials in the spot where they belong.

Good housekeeping is also an important part of fire prevention. Make sure that you don’t keep more combustible and flammable materials at your workstation than you need for the job at hand—and keep these liquids in safety cans. Place oily or greasy rags in metal containers. Place all other trash and scrap in the receptacles provided for them. Don’t reach into waste containers—dump trash into another container or remove the bag.

It is also your responsibility to smoke only in designated areas and at designated times—if you must smoke at all—and to dispose of matches and butts in the receptacle provided.

Let working in an orderly fashion become second nature to you. It is one of the most important ingredients in doing things right and keeping yourself and others safe on the job.

Maintain a copy of this training in your DBH Safety Binder (Section 3)

Facility Topic: Workplace Housekeeping

DATE: ____ May 06



June 2006 Watch your back! Purpose: To remind employees on the importance of safe lifting and chair position.

Protect Your Back One out of every five workers in this country who is hurt and off the job for a day or more has a back problem. One out of every five workers who becomes disabled because of a work-related injury is the victim of a problem back. Because these numbers are so high, it's important for us to discuss how to keep your back healthy and strong.

Back maintenance begins off the job. Your back is a full-time worker, involved in all your daily activities and requiring 24-hour-a-day attention. A good diet and moderate exercise, including gentle stretching of your legs and back and toning of the stomach muscles, are important in keeping your back free of pain. But watch out if you are just starting on a regimen of stomach exercises. Don't strain your back trying to stay in shape. Keep your lower back against the floor while doing sit-ups and don't pull from your neck—pull from the stomach.

Sleep is another important off-the-job activity that has a lot to do with your back's comfort. A too-soft mattress can cause you pain when you wake up, so can sleeping on your stomach; don't do it. Lying on your side is the easiest posture for your back to take, but lying on your back is okay, too. Small pillows can help as well when placed in stress spots, such as under or between the knees.

A lot of lifting is done off the job as well as on. Don't forget, for instance, that children can be heavy. When picking up a child, bend your knees. When lifting a garage door, bend your knees. When taking groceries out of the trunk, put one foot on the bumper to get closer to the load.

When driving, sit with your back against the seat, legs bent, and with knees higher than the seat.

When you are on the job, of course, you will have to be doubly careful if you do work that may strain your back. It's important that you know and respect your limitations. Don't try to convince yourself that you are a superhero. Don't lift loads that are too heavy for you. And, consider: The weight of the load itself may not be too much for you, but the number of times you have to lift similar loads may make it too heavy. Although you may be able to lift 30 or 40 pounds easily, if you have to lift all day, the top weight should be about 14 pounds.

How much you can lift without injury also has to do with how far away from your body you have to lift. A worker who lifts parts over a workbench to put them on a conveyor two feet away may only be able to lift a five-pound load without back damage. Know your limits and give yourself a break. Allow your body to tell you when it is being stressed. If you're used to carrying 30 pounds of lead, you may not understand why carrying 30 pounds of a bulky substance can be much more difficult. But it is more difficult, so let your back decide, not your mind.

In some instances, you may need equipment to help you lift a load. Or, in other cases, you may have to ask someone else on the job to give you a hand. Go ahead and ask. Get help. If you don't get help today for five minutes, that other person may have to do your job—and his or hers—for the five days you are out with a back strain. Don't let that happen.

Of course, as you know, there is a right way to lift so you don't hurt your back. Most importantly, don't twist at the waist when lifting or carrying a load. Instead, move your feet to turn your body. Be sure of a firm grip on the load—which you have first checked to make sure there are no sharp edges or nails. Don't lift or carry the load to one side of your body—use both hands. Never lift from an unbalanced posture. Don't lift from one knee for instance. Watch your footing. Make sure the bundle you carry isn't blocking your view.

To stay healthy and strong, eat well, exercise, rest, and use good judgment. That way, you can keep the 400 muscles, 1,000 tendons, 31 pairs of nerves, and 33 vertebrae of your back pain-free and in working order.

Monthly Safety Training Maintain a copy of this training in this section of the DBH Safety Binder – Supervisors and employees who suffer a back injury must attend the Care of the Back course provided by PERC)

Facility Topic: Care of the Back

DATE: ____ June 06



July 2006 SUMMER WEATHER CAR CARE Purpose: To insure employees can help themselves properly inspect and maintain vehicles (county and private) to minimize mechanical failure in the hot months of summer. HOW TO HANDLE AN OVERHEATING VEHICLE:

Imagine yourself driving home under a searing sun in the middle of bumper-to-bumper traffic when the heat gauge climbs to "Hot" or the temperature warning light flashes red. For persons who might run into this problem, the following tips are worth remembering:

• Don't panic. • Turn off the air conditioner; this will take a load off the cooling system of the car. • Turn on the heater to drain some of the heat away from the engine. • Put the transmission in neutral and race the engine for a moment or two. This increases

the fan speed and moves more air through the coils of your radiator. • If the above does not work, pull off the road and stop the car. • Raise the hood and wait for the engine to cool. • If necessary, call for assistance and stay a safe distance from the vehicle

MAINTENANCE REMINDERS:

• Engines overheat for a number of reasons and a quick check while you're waiting might help you spot the problem:

• Loose or broken fan belts and leaky hoses are the main causes of overheating. • Water alone can't keep a car cool; cars need the proper amount of coolant--an ethylene

glycol mixture. • Too much heat can cause a vapor lock. This develops when heat build-up around the

engine vaporizes gasoline in the gas line. Since vapor can't be pumped, the carburetor gets no fuel

• If possible, put a wet rag on the fuel pump and fuel line to speed cooling.

Monthly Safety Training Maintain a copy of this training in this section of the DBH Safety Binder

Facility Topic: SUMMER WEATHER CAR CARE

DATE: ____ July 06



August 2006 Hands-on Fire Extinguisher Training Purpose: To provide DBH staff with training – the goal - to reinforce staff confidence in their ability to extinguish small fires via getting hands training under the supervision of the County Fire Department.

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Mandatory annual requirement for all DBH staff. This training should be completed between 1 Aug and 31 Oct annually.

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by e-mailing him = [email protected] or leave a voice mail message at (909) 386-8411 with the following information:

1. Your facility name and address 2. Number of people you need trained 3. Three alternative dates and times you be available for the

training. He will return your message and confirm a date for training. 44.. TTRRAAIINNIINNGG CCOONNTTEENNTT:: The training is usually conducted OUTSIDE your facility and (depending on how many staff you have) consists of 10 – 15 minutes of instruction on the techniques of using the extinguishers, followed by a question and answer period and then the hands on training with gasoline fires. Staff may choose no to participation in the hands on portion of training; however, they must remain at the training location to observe others extinguishing fires. MATERIALS NEEED: Sign In Rosters, pens. You need not bring anything else to the training; however, be sure you have selected an acceptable area outside of your facility to conduct the training. It should be in an open area, far enough from buildings and other businesses/cars so as to not cause problems. If you are on a leased facility, it is a good idea to obtain consent from the building owner prior to the training.FFoorrwwaarrdd aa ccooppyy ooff yyoouurr ttrraaiinniinngg rroosstteerr ttoo GGWWEENN MMOORRSSEE,, DDBBHH

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Please forward the original of this roster to the DBH Disaster/Safety Coordinator, BHRC, 850 E. Foothill Blvd, CA 92376

(Maintain a copy of this roster in Section 13 of your DBH Safety Manual)

September 2006 Workplace Safety

Purpose: To alert staff to appropriate (safe) workplace behavior and their role in identifying and correcting unsafe conditions.

DBH Injury Statistics


Facility Topic:

Workplace Safety DATE: ____ Sept 06



September 2006 Workplace Safety

Purpose: To alert staff to appropriate (safe) workplace behavior and their role in identifying and correcting unsafe conditions. DBH Injury Statistics - 2004 # of reportable cases 41 Illness 35 Poisoning 0 Respiratory

Conditions 0

Skin disorders 0 All others *14 *Several were multiple cases DBH days lost or restricted work due to injury/illness - 2004 # days away from work 596 # days restricted work 0 Suggested Activity: Review the statistics and hand out. Conduct a walkabout - informal assessment of their facility, workstations and common areas - looking for problems in the six categories below or anything else that stands out:

Working Safely in the Office Most office accidents fall into one of six categories:

• Slipping, tripping, and falling

• Faulty or improperly used equipment

• Collisions or obstructions

• Falling objects

• Fire and electricity

• Horseplay and accidents that do not fit into other categories

The greatest number each year are in the slips, trips, and falls category, and the majority of them could have been prevented with a little extra care and effort. For example:

Walking surfaces need to be clean, well-lighted, dry, and free of clutter that could cause a trip. Splintered wood, broken tile, or pitted concrete should be repaired or replaced as soon as possible. Highly polished surfaces should be coated with a slip-resistant finish. Even carpeting can cause problems if it is allowed to deteriorate. Spills need to be cleaned up promptly; stairways must have handrails and antislip treads; and slip-resistant mats need to be placed in building entrances in bad weather.

Telephone lines and other electrical equipment cords are obvious tripping hazards and should be covered by furniture or taped to desks or the floor. Desks, file cabinets, and storage cupboards should be arranged so that their drawers and doors don’t open into aisles and walkways—and they should not be left open. Many a fall has been caused, too, by tilting back too far on a chair with wheels—or by using that or any chair as a ladder.

Office machinery can be hazardous if used for other than its intended purpose—or if not properly maintained. If you are ever unsure of how to operate copiers, printers, and so on properly, ask! Most of these need to be grounded. Smaller appliances such as coffeemakers should be unplugged by the last person to leave.

Proper grounding and careful checking for damaged electrical cords (and replacing them promptly) will avoid not only electrical hazards but the risk of fire. Also essential is proper storage of flammable materials—in locked, preferably fireproof cabinets. In case of a fire, you have been instructed of proper escape routes to safety, and we have occasional drills to practice calm but swift evacuation of the building.

Collisions are likely when two-way traffic patterns include blind corners or intersections. It shouldn’t be a problem, however, if each of you will watch where you’re going, walk to the right, and slow down at intersections. If you’re carrying material, make sure you can see over the load. You’ll avoid being struck by falling objects if you remember not to store heavy materials, such as card files, books, and boxes on top of file cabinets. No flower pots, vases, etc., on window sills or ledges, either.

Obviously, horseplay is always a no-no, but there are also some minor hazards around the office that can cause painful if not life-threatening injury: staplers, paper cutters (and paper cuts), and even pens and pencils (store them point down). To protect yourself from back strain when lifting boxes and other materials, remember the correct lifting procedures we have stressed in training sessions.

Always remember, if you should have any injury—from a minor scrape to a fall—notify your supervisor at once and get appropriate first-aid treatment.

Office Traffic:

• Wet floors may be slippery, so walk on them with extra care.

• Walk—never run.

• Passageways should be kept clear of tripping hazards such as wastebaskets, cartons, electric cords, open drawers, ladders, and personal belongings.

• Torn carpets, lose or curled mats, liquids spilled on floors, light failures, or any other condition that could cause tripping or slipping should be reported immediately to your supervisor.

Stairways:

• Use handrails. Take one step at a time, keep to the right, and do not hurry.

• Do not store or throw anything on steps or stairways. Even a piece of paper, a paper clip, a cellophane wrapper, or a match can create a slipping hazard.

Elevators:

• Walk—do not run—for an elevator.

• Watch your step when entering or leaving your car because the car may not be completely level with the ground when the doors open.

• Do not attempt to stop automatic elevators with your hand. Wait for the next elevator.

File Cabinets:

• File drawers as well as desk and cabinet drawers should be closed when not in use.

• Files should be placed far enough away from doors or passageways so they do not interfere with exit routes.

• Place the heaviest load in the lower drawers.

• Open only one file drawer at a time.

• When shutting a drawer, grasp the handle to avoid finger injuries.

Paper:

• Use caution when folding or handling paper—it can cut.

• Use paper clips or staples to fasten papers together. Be sure staples are fully closed.

• Use a staple remover to remove staples.

Electrical Equipment:

• Electrical outlets should be located so that cords do not cross aisles or passageways.

• Electrical equipment should be properly grounded to prevent shock.

• Electrical devices should be periodically inspected for safety. Damaged or worn electric cords should be replaced immediately.

• Never tamper with electric equipment.

Machines and Equipment:

• Machines with exposed moving parts must have appropriate guards.

• Do not operate a machine until you are properly trained. If you operate a machine, dress suitably for the job. Loose sleeves, neckties, even long hair can get caught in moving machinery.

• Properly constructed paper cutters in good condition require common-sense precautions. Keep your fingers away from the knife when it comes down. Keep the knife in the down position when not in use. Loose guards or springs should be repaired immediately.

• When using or refilling staplers, keep your fingers away from the operating part.

• Typewriters should be securely mounted so they do not "crawl" because of the vibration. On a sidewell desk, be certain that the typewriter shelf is firmly supported when the typewriter is in use.

Storage:

• Use a suitable ladder or platform for reaching high objects. Do not stand on a chair , carton, or other substitutes.

• Heavy objects should be stored near floor level.

• Anything worth keeping should be stored in an appropriate place. Store materials in cabinets or rooms designed for this purpose, and keep them orderly.

• Knives and scrapers should be sheathed before being placed in drawers. Razor blades should not be used as substitutes.

• Pointed objects, such as scissors, should face away from you.

• In general, flammable liquids and paint should not be stored in office areas. Flammable liquids necessary for various document-reproduction methods should be limited in quantities and must be stored in approved metal containers and kept away from heat.

Housekeeping:

• Good housekeeping should be emphasized as a vital safety and health measure.

Pedestrians:

• If your job calls for travel on plant roadways, be especially alert for vehicle traffic. When leaving a building, look both ways before entering the roadway.

• Always walk to the side of the road. Walk—do not run.

• Round blind corners cautiously. Obey barricades and caution signs.

• Remember, a backing vehicle has obstructed vision.

• Do not jump from loading docks, platforms, or other elevations.

Miscellaneous:

• Turn on the lights before entering a dark room or corridor. Report locations that are inadequately lighted.

• To avoid falling, do not tilt back in a straight chair, do not lean back too far in a swivel chair, and do not overreach.

• Do not lift beyond your strength. When heavy items are to be moved, arrange for necessary help and proper trucks or other material-handling equipment. If an object to be handled may cause cuts or splinters, wear gloves.

• All sharp edges, splinters, slivers, and burrs on furniture or equipment should be removed promptly. Protruding nails should be removed or turned down.

• Do not carry pencils behind your ear or between your fingers with the point toward the palm of your hand.

• Do not remain at your desk or workplace when overhead work is being performed.

• Horseplay can cause injury and should not be tolerated.

• If work assignments require you to enter plant areas, be certain that you wear eye protection and any other protective equipment required.

SUGGESTED ACTIVITY This topic will lend itself very well to a "walkabout." Have everyone take a pen and paper to make notes

as you tour the facility (inside and out). Have them jot down everything they spot as a definite, probable, or possible hazard. Then discuss—and fill in anything they should have noted but didn’t. It might be worth asking for input here as to why these things weren’t recognized as possible hazards.

You may also be surprised by having certain potentially risky conditions noticed by the group that you hadn’t spotted yourself. Don’t let this bother you; just be glad it will boost their self-esteem and their determination to remain alert.

Obviously there will be a certain part of office danger that they have not seen while "on tour." That is the behavior of office personnel. You won’t, for example, have seen anyone climbing on a rolling chair to reach something from a high shelf—and yet using something other than a stepladder for this task has caused many office accidents.

As a check on how much was learned, and retained, perhaps you would want to schedule another office safety "inspection" with the same group a month or so later.


Facility Topic:

Workplace Safety

DATE: ____ Sep 06



OCTOBER TRAINING

OPEN TOPIC


Facility Topic:

DATE: ____ Oct 06



Ergonomic Training for Staff

HOW TO USE THIS TRAINING:

5. Print out all pages and make copies of pages 3-5 for employees 6. (BLI/SUPERVISOR) Familiarize yourself with the background Information

(Page 1) 7. Hand out the materials and provide the training at a staff meeting 8. Have all employees in attendance sign the roster (page 2) and place the roster

in Section 3 of your DBH Safety Program Binder.

What is the purpose of ergonomics in the workplace?

The goals of ergonomics are to:

Decrease risk of injury/illness Enhance worker productivity Improve quality of work life

Subchapter 7. General Industry Safety Orders

Group 15. Occupational Noise Article 106. Ergonomics

§5110. Repetitive Motion Injuries(RMIs)

(3) Training. Employees shall be provided training that includes an explanation of: (A) The employer's program; (B) The exposures which have been associated with RMIs; (C) The symptoms and consequences of injuries caused by repetitive motion; (D) The importance of reporting symptoms and injuries to the employer; and (E) Methods used by the employer to minimize RMIs. Please not: Supervisors are required to attended the ERGONOMICS FOR SUPERVISORS course through Risk Mgt (PERC). If you are a new supervisor, have not attended, or would like a refresher on supervisors' responsibilities to this program, please watch the PERC schedule to schedule yourself for this course. You can view the Risk Mgt schedule for the course at this site: http://countyline/PERC/training/frameWholeTraining.htm

http://countyline/PERC/training/frameWholeTraining.htm

Ergonomic Training Acknowledgement Roster I have received information on the importance of proper ergonomic workstation adjustments, the assessment process and I aware of the my option to have my workstation assessed by my supervisor and/or Risk Management for ergonomic issues. I have been instructed to inform my supervisor and/or BLI immediately if I suspect I’ve experienced any negative affect from by workspace/equipment.

Title of Training ERGONOMICS Date: Nov 06 Presenter: Name of Employee (Please Print) Signature

Maintain this roster in this section of the DBH Safety Manual (Section 13). Page ___ of ___

DBH Monthly Safety Training

ERGONOMICS made SIMPLE (Employee Training Handout)

Millions of people work with computers every day. This illustrates simple, inexpensive principles that will help you create a safe and comfortable computer workstation. There is no single “correct” posture or arrangement of components that will fit everyone.

However, there are basic design goals, some of which are shown in the accompanying figure, to consider when setting up a computer workstation or performing computer-related tasks. Consider your workstation as you review the checklist to see if you can identify areas for improvement in posture, component placement, or work environment. This checklist provides suggestions to minimize or eliminate identified problems, and allows you to create your own "custom-fit" computer workstation.

Is your workstation is ERGO FIT? Have your supervisor review the checklist (Attachment 1) with you at your workstation.










Ergonomic Checklist for Supervisors (Attachment 1) WORKING POSTURES–The workstation is designed or arranged for doing computer tasks so it allows your Y N 1. Head and neck to be upright, or in-line with the torso (not bent down/back). If "no" refer to Monitors, Chairs and Work Surfaces.

2. Head, neck, and trunk to face forward (not twisted). If "no" refer to Monitors or Chairs. 3. Trunk to be perpendicular to floor (may lean back into backrest but not forward). If "no" refer to Chairs or Monitors.

4. Shoulders and upper arms to be in-line with the torso, generally about perpendicular to the floor and relaxed (not elevated or stretched forward). If "no" refer to Chairs.

5. Upper arms and elbows to be close to the body (not extended outward). If "no" refer to Chairs, Work Surfaces, Keyboards, and Pointers.

6. Forearms, wrists, and hands to be straight and in-line (forearm at about 90 degrees to the upper arm). If "no" refer to Chairs, Keyboards, Pointers.

7. Wrists and hands to be straight (not bent up/down or sideways toward the little finger). If "no" refer to Keyboards, or Pointers

8. Thighs to be parallel to the floor and the lower legs to be perpendicular to floor (thighs may be slightly elevated above knees). If "no" refer to Chairs or Work Surfaces.

9. Feet rest flat on the floor or are supported by a stable footrest. If "no" refer to Chairs, Work Surfaces.

10. Backrest provides support for your lower back (lumbar area). 11. Seat width and depth accommodate the specific user (seat pan not too big/small). 12. Seat front does not press against the back of your knees and lower legs (seat pan not too long). 13. Seat has cushioning and is rounded with a "waterfall" front (no sharp edge). 14. Armrests, if used, support both forearms while you perform computer tasks and they do not interfere with movement.

"No" answers to any of these questions should prompt a review of Chairs. 15. Keyboard/input device platform(s) is stable and large enough to hold a keyboard and an input device.

16. Input device (mouse or trackball) is located right next to your keyboard so it can be operated without reaching.

17. Input device is easy to activate and the shape/size fits your hand (not too big/small). 18. Wrists and hands do not rest on sharp or hard edges. "No" answers to any of these questions should prompt a review of Keyboards, Pointers, or Wrist Rests. 19. Top of the screen is at or below eye level so you can read it without bending your head or neck down/back.

20. User with bifocals/trifocals can read the screen without bending the head or neck backward. 21. Monitor distance allows you to read the screen without leaning your head, neck or trunk forward/backward.

WORK AREA–Consider these points when evaluating the desk and workstation. The work area is designed or arranged for doing computer tasks so the Y N 22. Monitor position is directly in front of you so you don't have to twist your head or neck. 23. Glare (for example, from windows, lights) is not reflected on your screen which can cause you to assume an awkward posture to clearly see information on your screen.

"No" answers to any of these questions should prompt a review of Monitors or Lighting/Glare.




























http://www.osha.gov/SLTC/etools/computerworkstations/wkstation_enviro.html

24. Thighs have sufficient clearance space between the top of the thighs and your computer table/keyboard platform (thighs are not trapped).

25. Legs and feet have sufficient clearance space under the work surface so you are able to get close enough to the keyboard/input device.

26. Document holder, if provided, is stable and large enough to hold documents. 27. Document holder, if provided, is placed at about the same height and distance as the monitor screen so there is little head movement, or need to re-focus, when you look from the document to the screen.

28. Wrist/palm rest, if provided, is padded and free of sharp or square edges that push on your wrists.

29. Wrist/palm rest, if provided, allows you to keep your forearms, wrists, and hands straight and in-line when using the keyboard/input device.

30. Telephone can be used with your head upright (not bent) and your shoulders relaxed (not elevated) if you do computer tasks at the same time.

"No" answers to any of these questions should prompt a review of Work Surfaces, Document Holders, Wrist Rests or Telephones.

31. Workstation and equipment have sufficient adjustability so you are in a safe working posture and can make occasional changes in posture while performing computer tasks.

32. Computer workstation, components and accessories are maintained in serviceable condition and function properly.

33. Computer tasks are organized in a way that allows you to vary tasks with other work activities, or to take micro-breaks or recovery pauses while at the computer workstation.

"No" answers to any of these questions should prompt a review of Chairs, Work Surfaces, or Work Processes.

If you need a more thorough assessment of an employee’s workstation, contact Risk Management for an official ergonomic study (employee-specific).

(Don’t wait until painful problems develop into incapacitating conditions.)




http://www.osha.gov/SLTC/etools/computerworkstations/components_telephone.html





Holiday Season Decorating Safety Tips

It's that festive time of year again - Time to string the lights, hang decorations, put up Christmas trees, and bring out the

candles to celebrate the holidays. To keep the holiday season a merry one, the U.S. Consumer

Product Safety Commission (CPSC) has decorating safety tips for consumers.

"No matter how people plan to celebrate the holidays, special care should

be taken when decorating," said CPSC Chairman Hal Stratton. "Following CPSC's safety tips can help prevent holiday traditions from turning into

tragedies." Each year, hospital emergency rooms treat about 12,800 people for falls, cuts,

shocks, and burns due to incidents involving faulty holiday lights, dried-out Christmas trees and other holiday decorations.

Christmas trees are involved in about 300 fires annually, resulting in an average of 10 deaths, 40 injuries and about $7 million in property damage and loss. In

addition, there are more than 15,000 candle-related fires each year, which result in 140 deaths and $307 million in property loss, but consumers should still take

precautions with their lights and other holiday products. To prevent incidents associated with holiday decorations, CPSC monitors holiday lights and other decorations sold at stores and on the internet. CPSC works with the Bureau of Customs and Border Protect ion to identify and prevent unsafe holiday light sets posing fire risks from being distributed in the U.S. Trees and Decorations:

• When purchasing an artificial tree, look for the label "Fire Resistant". Although this label does not mean the tree won't catch fire, it does indicate the tree is more resistant to burning.

• When purchasing a live tree, check for freshness. A fresh tree is green, needles are hard to pull from branches and do not break when bent between your fingers. The bottom of a fresh tree is sticky with resin, and when tapped on the ground, the tree should not lose many needles.

• When setting up a tree at home, place it away from fireplaces and radiators. Because heated rooms dry live trees out rapidly, be sure to keep the stand filled with water. Place the tree out of the way of traffic, and do not block doorways.

• Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals. Leaded materials are hazardous if ingested by children.

• In homes with small children, take special care to avoid sharp or breakable decorations, keep trimmings with small removable parts out of the reach of children who could swallow or inhale small pieces, and avoid trimmings that resemble candy or food that may tempt a child to eat them.

• To avoid eye and skin irritation, wear gloves when decorating with spun glass "angel hair." • To avoid lung irritation, follow container directions carefully while decorating with artificial snow

sprays.

http://www.qklinkserver.com/lm/rtl3.asp?si=19903&k=special%20care

Lights:

• Indoors or outside, use only lights that have been tested for safety by a nationally-recognized Testing Laboratory, such as UL or ETL/ITSNA. Use only newer lights that have thicker wiring and are required to have safety fuses to prevent the wires from overheating.

• Check each set of lights, new or old, for broken or cracked sockets, frayed or bare wires, or loose connections. Throw out damaged sets.

• If using an extension cord, make sure it is rated for the intended use. • Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty

lights, and a person touching a branch could be electrocuted. • When using lights outdoors, check labels to be sure they have been certified for outdoor use and plug

them in only ground-fault circuit interrupter (GFCI) protected receptacles. • Turn off all holiday lights when you go to bed or leave the house. The lights could short out and start a

fire.

Candles: (Not permitted in DBH facilities)

• Keep burning candles within sight. • Keep burning candles away from items that can burn easily. • Always use non-flammable holders and keep away from children and pets. • Keep lighted candles away from trees, other evergreens, and decorations. • Extinguish all candles before you go to bed or leave the house.

Fireplaces: (Home)

• Use care with "fire salts," which produce colored flames when thrown on wood fires. They contain heavy metals that, if eaten, can cause intense gastrointestinal irritation and vomiting. Keep them away from children.

• Do not burn wrapping papers in the fireplace. Wrappings can ignite suddenly and burn intensely, resulting in a flash fire.

• Place a screen around your fireplace to prevent sparks from igniting nearby flammable materials.


Facility Topic: Holiday Décor Safety

DATE: ____ Dec 06



Page ____ of ____


SECTION: 14

AREA: SIGNAGE Sign Location Details ADA Signs Restroom doors Biohazard Signs Posted on entry doors/drawers (For Medical Waste Generators) Must be posted on the outside door and drawer or cabinet and/or refrigerator where medical waste is

generated/stored. BLI Signs Posted in break areas, in hallways and next

to CalOSHA posters throughout the facility. Should contain the name, phone number and office/cubicle number of the BLI.

CALOSHA Posters Posted in break areas, and common areas throughout the facility

CAN NOT be blocked or hidden by open doors/other obstacles. MUST BE CURRENT – As of 02/06, the most current poster date is 02/05. May e obtained by contacting the DBH Disaster/Safety Coordinator or Risk Management. (909) 386-8624.

CALOSHA Whistleblower Posted in break areas, and common areas throughout the facility NEXT TO CALOSHA POSTERS

CAN NOT be blocked or hidden by open doors/other obstacles. MUST BE CURRENT –May e obtained by contacting the DBH Disaster/Safety Coordinator or Risk Management. (909) 386-8624.

Cameras in use Posted at all public entryways Facilities with surveillance camera systems must state this on entryway doord. Capacity Limits Posted on walls in rooms Must be calculated by fire marshal or contact DBH Safety Coordinator Disaster Supply Posters Posted on door/cabinet where supplies are

stored Signage should be posted to direct staff to supplies. Supplies should not be stored behind locked doors – to allow for emergency access.

Emergency Phone Numbers Posted UNDER EACH DBH PHONE This page should contain all emergency numbers and those local numbers used by the facility Evacuation Floor Plans Posted on internal walls and in

group/meeting rooms in facility These signs should mark YOU ARE HERE, emergency equipment, alarm stations, and disaster supplies. Only the two closest exits should be highlighted on each individual floor plan – depending where it is posted in the facility.

Exit Signs (w/light bulbs) As required to direct occupants to nearest exits

BOTH lights (if applicable) must been working – replace both bulbs when one burns out.

Fire Extinguisher Location signs Attached to wall above each fire extinguisher.

Preferably signage protrudes from walls making it easier to identify down long corridors.

First Aid Kit Locations Posted on door/cabinet where supplies are stored

Signage should be in large letters with an emblem easily identifying the item as a first aid kit

First Aid Logs Posted on bulletin boards and/or in First Aid Kits

Locate copies inside kits – include the CA poison control number 800-222-1222

Med Waste Gen. Permit

Posted on office/med room door and drawer, cabinet and/or refrigerator where medical waste is generated/stored.

(For Medical Waste Generators)

Microwave in use Posted at all public entryways Posted at all entryways No Smoking Posted at all entryways & near windows Must have the required language: No smoking within 20’ of any entryway, intake, or window Room Numbers Posted on doors or walls Mount on doors/walls outside ALL rooms & cubicles to include restrooms, store rooms, break rooms, and cubicles

http://countyline/riskmanagement/_content/SafetyManual/EmployeeSafetyFull.pdf