cal-osha's 3203 injury and illness prevention program checklist (iipp)

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Employer: Date: Reviewer: Date: 3203 INJURY AND ILLNESS PREVENTION PROGRAM CHECKLIST (a) Written Plan (1) Identify person with authority and responsibility (actual name) Y N (2) Ensure that employees comply Y N (3) Communication Y N (4) Scheduled Periodic Inspections Y N (A) Initial Inspection Y N (B) New substances, processes, procedures, equipment Y N (C) Aware of new hazards Y N (5) Investigate Injuries and Illnesses Y N (6) Correcting hazards (employees) Y N (A) When Discovered Y N (B) Handling Imminent hazards Y N (7) Training Y N (A) Initial training Y N (B) New employees Y N (C) New job assignments Y N (D) New substances, processes, procedures, equipment Y N (E) New hazard(s) Y N (F) Supervisors Y N (b) RecordKeeping (3 years) (1) Inspections Y N (2) Training Y N (c) Labor/Management Safety Committee (optional to comply with communication requirements of 3203(a)(3)) (1) Regular meetings Y N (2) Written records Y N (3) Review inspections Y N (4) Review injury and illness investigations Y N (5) Review safety complaints Y N (6) Makes recommendations Y N (7) Verifies abatement of citations Y N Additional Comments:

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This is the checklist that OSHA inspectors use to see if your IIPP meets California's requirements (determine if yours contains all of the elements)

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Page 1: Cal-OSHA's 3203 Injury and Illness Prevention Program Checklist (IIPP)

Employer:      Date:   

Reviewer:      Date:    

3203 INJURY AND ILLNESS PREVENTION PROGRAM CHECKLIST 

(a) Written Plan 

(1) Identify person with authority and responsibility  (actual name)  Y    N  (2) Ensure that employees comply  Y    N  (3) Communication  Y    N  (4) Scheduled Periodic Inspections  Y    N  

(A) Initial Inspection  Y    N  (B) New substances, processes, procedures, equipment  Y    N  (C) Aware of new hazards  Y    N  

(5) Investigate Injuries and Illnesses  Y    N  (6) Correcting hazards  (employees)  Y    N  

(A) When Discovered  Y    N  (B) Handling Imminent hazards  Y    N  

(7) Training  Y    N  (A) Initial training  Y    N  (B) New employees  Y    N  (C) New job assignments  Y    N  (D) New substances, processes, procedures, equipment  Y    N  (E) New hazard(s)  Y    N  (F) Supervisors  Y    N  

 

(b) RecordKeeping (3 years) 

(1) Inspections  Y    N  (2) Training  Y    N  

 

(c) Labor/Management Safety Committee (optional to comply with communication requirements of 3203(a)(3)) 

(1) Regular meetings  Y    N  (2) Written records  Y    N  (3) Review inspections  Y    N  (4) Review injury and illness investigations  Y    N  (5) Review safety complaints  Y    N  (6) Makes recommendations  Y    N  (7) Verifies abatement of citations  Y    N  

 Additional Comments: