Fill and Sign the Construction Safety Plan Form

© USLegalforms.com 2006 CONSTRUCTION SAFETY AND HEALTH PROGRAM Control Number: US-00479-CPK page 1 of 25 © USLegalforms.com 2006 INTRODUCTION Why should your construction company develop a formal written safety and health program?  To comply with the General Safety & Health Provisions for construction (29 CFR 1926 Subpart C).  Developing and implementing a written safety and health program will qualify you for a “Focused Inspection” rather than a “Comprehensive Inspection” should you receive a compliance visit from OSHA.  An effective safety and health program is the best way to reduce workplace injuries. The elements of an effective program include the following: MANAGEMENT LEADERSHIP AND EMPLOYEE INVOLVEMENT Assign safety and health responsibility and authority to supervisors and employees and hold them accountable. WORKSITE ANALYSIS Identify current and potential hazards. Conduct a thorough baseline survey, to identify unsafe acts and conditions; job hazard analysis (written safe operating procedures for major tasks); a self-inspection program, a system for reporting hazards; accident and incident investigation; and analysis of injuries and illnesses. HAZARD PREVENTION AND CONTROL Hazard prevention consists of regular maintenance and housekeeping; emergency planning and preparation; first aid; and ready access to emergency care. Hazard control includes machine guards, enclosures, locks, protective equipment, safe work procedures, and placing personnel so as to minimize hazards. TRAINING Train all personnel, from managers through supervisors to employees on identifying, preventing, and controlling hazards they may be exposed to. Train managers and supervisors on how to manage the training program (e.g., enforcing rules, conducting drills). This is a generic safety and health program, and is designed to be used as a guideline for developing your own company's safety and health program. Each company is different. This program must be tailored to meet your specific needs, by adding or deleting parts of this guide. Determine your needs based on the hazards or potential hazards of your job site. The final determination of compliance with OSHA regulations, including compliance with the Written Safety and Health Program requirement under 1926.21, is made by evaluation of all factors pertaining to potential hazards at a particular worksite with respect to employee safety and health. This guide is not a substitute for any provisions of the Occupational Safety and Health Act or for any standards issued by OSHA. The standards themselves are the legal requirements to which an employer will be held. To access OSHA’s website containing Safety and Health Regulations for Construction, click on the link below: http://www.osha.gov/pls/oshaweb/owastand.display_standard_group? p_part_number=1926&p_toc_level=1 page 2 of 25 © USLegalforms.com 2006 CONSTRUCTION SAFETY AND HEALTH PROGRAM FOR (COMPANY NAME) Updated ____________ page 3 of 25 © USLegalforms.com 2006 TABLE OF CONTENTS INTRODUCTION ............................................................................................................... 2 COVER SHEET ................................................................................................................. 3 EMERGENCY RESPONSE PLAN ................................................................................. 5 EMERGENCY PHONE CONTACT NUMBERS .......................................................... 5 EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCES ................................ 6 FIRST AID ......................................................................................................................... 7 POLICY STATEMENT .................................................................................................... 8 GOALS ............................................................................................................................... 9 MANAGEMENT COMMITMENT .............................................................................. 10 SAFETY COMMITTEE AND SAFETY MEETINGS ................................................ 10 SAFETY MEETING MINUTES .................................................................................... 10 ASSIGNMENT OF RESPONSIBILITY ....................................................................... 12 SAFETY COORDINATOR ........................................................................................ 12 SUPERVISOR/FOREMAN ........................................................................................ 13 EMPLOYEES .............................................................................................................. 13 POLICIES AND PROCEDURES ACKNOWLEDGEMENTS .................................. 14 DISCIPLINE/ENFORCEMENT ................................................................................... 15 CONTROL OF HAZARDS ............................................................................................ 16 FIRE PREVENTION ...................................................................................................... 16 TRAINING AND EDUCATION .................................................................................... 17 RECORDKEEPING AND OSHA LOG REVIEW ...................................................... 18 ACCIDENT INVESTIGATION .................................................................................... 19 ACCIDENT INVESTIGATION FORM ....................................................................... 20 SAFETY RULES AND PROCEDURES ....................................................................... 23 EMPLOYEE EMERGENCY ACTION PLAN FOR FIRE & OTHER EMERGENCIES ........................................................................................................................................... 24 page 4 of 25 © USLegalforms.com 2006 EMERGENCY RESPONSE PLAN This must be filled out BEFORE beginning work on each site. FOR __________________JOBSITE CITY/LOCATION: SUBDIVISION: STREET NAME: JOB ADDRESS: JOB PHONE CONTACT: EMERGENCY PHONE CONTACT NUMBERS LOCAL FIRE DEPT/EMS AREA: AMBULANCE SERVICE: NEAREST MEDICAL TREATMENT: DIRECTIONS ( type clinic name ): DIRECTIONS TO WORKSITE: page 5 of 25 © USLegalforms.com 2006 EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCES FOR SMALL CONSTRUCTION COMPANIES NOT NORMALLY INVOLVED IN HAZARDOUS WASTE CLEANUPS THE FOLLOWING IS APPROPRIATE If any substance is found of unknown origin, company policy is to LEAVE IT ALONE! Immediately evacuate the area, and contact the nearest hazardous material response team. Do not allow employees on site until declared safe by the response team. THE FOLLOWING IS AN APPROPRIATE START IF YOUR COMPANY IS INVOLVED IN HAZARDOUS WASTE CLEANUP The employer shall determine before hand whether they will be involved in a hazardous substance cleanup. If so, the employer shall develop and implement a written safety and health program for their employees involved in hazardous waste operations. The program shall be designed to identify, evaluate, and control safety and health hazards, and provide for emergency response for hazardous waste operations. The plan shall incorporate the following:  An organizational structure  A comprehensive work plan  Site-specific safety and health plan  Safety and health training program  Employer's standard operating procedures for safety and health  Any necessary interface between general program and site specific activities. Initial Training General site worker (such as equipment operators, general laborers and supervisory personnel) engaged in hazardous substance removal or other activities which expose or potentially expose workers to hazardous substances and health hazards shall receive a minimum of 40 hours of instruction off the site, and a minimum of three days actual field experience under the direct supervision of a trained, experienced supervisor. *COMPANY NAME* WILL FOLLOW THE RULES AND REGULATIONS FROM THE 29 CFR 1910.120 PERTAINING TO HAZARDOUS WASTE OPERATIONS AND EMERGENCY RESPONSE. Employer shall also read and follow the standard in 1910.1200 NOTE: Employers should incorporate current copies of such codes and regulations into your safety and health program as resource material. page 6 of 25 © USLegalforms.com 2006 FIRST AID Arrangements must be made BEFORE starting the project to provide for prompt medical response in the event of an emergency. In areas where severe bleeding, suffocation, or severe electrical shock may occur, a 3 to 4 minute response time is required If medical attention is not available within 4 minutes, then a person trained in administering first aid must be available on the jobsite at all times. An appropriate, weatherproof first aid kit must be on site and must be checked weekly. Provisions for an ambulance or other transportation must be made in advance. A means of contact must be provided. Telephone numbers must be posted where 911 is not available. (COMPANY NAME) has designated (SAFETY PERSON OR FOREMAN) as having adequate training to render first aid in the event of a medical emergency in areas where emergency response time is in excess of 4-min. They will maintain appropriate first aid kits and check them weekly to assure they are properly stocked. First aid kits are located at the following locations: Every employee shall be trained in emergency procedures including:  Evacuation plan  Alarm systems  Shutdown procedures for equipment  Handling various types of potential emergencies It is the Employer’s responsibility to review each job sites and address all potential emergency situations. page 7 of 25 © USLegalforms.com 2006 POLICY STATEMENT Memo T o: All Employees From: [Click here and type name] Date: March 11, 2020 Re: POLICY STATEMENT It is (COMPANY NAME) belief that our employees are our most valuable asset. Preserving the Safety and Health of each employee must remain a constant consideration in every phase of our business. We aspire to provide a work environment as free from hazards as possible. All employees are responsible for working safely and productively, always remaining aware of hazards in their jobs and following recognized safe work practices, including the use of Personal Protective Equipment (PPE). It is also (COMPANY NAME) belief that any safety and health program must have total employee involvement. Therefore, this program has management’s full support, and participation. PRODUCTION IS NOT SO URGENT THAT WE CANNOT TAKE TIME TO DO OUR WORK SAFELY. page 8 of 25 © USLegalforms.com 2006 GOALS Safety begins at the top and extends to every employee throughout the company. The primary goal of (COMPANY NAME) is to continue operating a profitable business while protecting employees from injuries, illness or harm. This can be achieved in part by delegating responsibility and accountability to all involved in this company's operation. Responsibility means having to answer for activities and results. Accountability involves the actions taken by management to insure the performance of responsibilities. In other words, to reach our goal of a safe workplace everyone needs to take responsibility and be held accountable. Benefits of achieving our goals are:  Minimizing all injury accidents  Minimizing the loss of property and equipment  Eliminating fatalities  Eliminating permanent disabilities  Eliminating potential OSHA fines  Reducing workers’ compensation costs  Reducing operating costs  Having the best Safety and Health conditions possible in the work place. ENTER ADDITIONAL COMPANY GOALS AS NECESSARY page 9 of 25 © USLegalforms.com 2006 MANAGEMENT COMMITMENT The management of *COMPANY NAME* is committed to the company's safety policy, and to provide direction and motivation by:  Appointing (SAFETY PERSON) as our Safety Coordinator.  Establishing company safety goals and objectives.  Developing and implementing a written Safety and Health program.  Ensuring total commitment to the Safety and Health program.  Facilitating employees’ safety training.  Establishing responsibilities for management and employees to follow.  Ensuring that management and employees are held accountable for performance of their safety responsibilities.  Establishing and enforcing disciplinary procedures for employees.  Reviewing the Safety and Health program annually, and revising or updating as needed. SAFETY COMMITTEE AND SAFETY MEETINGS  The Committee shall consist of representatives from management and non-management employees with (SAFETY PERSON) as the chairman. The committee is a forum, created for the purpose of fostering safety and health through communication.  The responsibilities of Safety Committee Members include:  Discussing safety policies and procedures with management and making recommendations for improvements.  Reviewing accident investigation reports on all accidents and “near-misses”.  Identifying unsafe conditions and work practices and making recommendations for corrections. All employees of (COMPANY NAME) shall attend and participate in the Weekly safety meetings. The Weekly safety meeting shall be conducted by (SAFETY PERSON). Problems that have arisen or that are anticipated shall be discussed along with any other safety and health topics. The meeting shall be kept a valuable educational experience by:  Keeping the meetings moving.  Starting and Stopping on time.  Using illustrated material and demonstrations to make the point.  Discussing each topic thoroughly, providing handouts if possible.  Reviewing accidents, injuries, property losses, and “near misses.”  Evaluating accidents, injuries, property losses, and “near misses” for trends and similar causes to initiate corrective actions. page 10 of 25 © USLegalforms.com 2006 SAFETY MEETING MINUTES The Safety Coordinator shall document the meetings using the form below. Date: Job Name : Topics: Action Items: Meeting Attended By: Print Name: Signature : page 11 of 25 © USLegalforms.com 2006 ASSIGNMENT OF RESPONSIBILITY SAFETY COORDINATOR (COMPANY NAME) has designated (SAFETY PERSON) as our Safety Officer. Their cell phone and office phone numbers are: Office: (XXX) XXX-XXXX Cell: (XXX) XXX-XXXX It shall be the duty of the Safety Coordinator to assist the Supervisor/Foreman and all other levels of Management in the initiation, education, and execution of an effective safety program including the following:  Introducing the safety program to new employees.  Following up on recommendations, suggestions, etc., made at the Weekly safety meetings.  Documenting all topics of safety concerns.  Assisting the personnel in the execution of standard policies.  Conducting safety inspections on a periodic basis.  Addressing all hazards or potential hazards as needed.  Preparing monthly accident reports and investigations.  Maintaining adequate stock of first aid supplies and other safety equipment to insure their immediate availability.  Making sure there is adequate number of qualified first aid certified people on the work site.  Becoming thoroughly familiar with OSHA regulations and local and state safety codes.  Defining the responsibilities for safety and health of all subordinates and holding each person accountable for their results through the formal appraisal system and where necessary, disciplinary procedures.  Emphasizing to employees that accidents create unnecessary personal and financial losses. ENTER ADDITIONAL RESPONSIBILITIES AS NECESSARY page 12 of 25 © USLegalforms.com 2006 SUPERVISOR/FOREMAN The Supervisors and/or Foremen will establish an operating atmosphere that insures that safety and health is managed in the same manner and with the same emphasis as production, cost, and quality control. Their responsibilities include:  Regularly emphasizing that accident and health hazard exposure prevention are not only moral responsibilities, but also a condition of employment.  Identifying operational oversights that could contribute to accidents which often result in injuries and property damage.  Participating in safety and health related activities, including routinely attending safety meetings, reviews of the facility, and correcting employee behavior that can result in accidents and injuries.  Spending time with each person hired explaining the safety policies and the hazards of his/her particular work. Ensuring that initial orientation of "new hires" is carried out by (SAFETY PERSON).  Making sure that if a “Competent Person” is required, that one is present to oversee, and instruct employees when necessary.  Never short-cutting safety for expediency, nor allowing workers to do so.  Enforcing safety rules consistently, and following company's discipline and enforcement procedures.  Conducting a daily, job-site safety inspection and correcting noted safety violations. ENTER ADDITIONAL RESPONSIBILITIES AS NECESSARY EMPLOYEES It is the duty of each and every employee to know the safety rules, and conduct their work in compliance with these rules. Disregard of the safety and health rules shall be grounds for disciplinary action up to and including termination. It is also the duty of each employee to make full use of the safeguards provided for their protection. Every employee will receive an orientation when hired and receive a copy of the Company Safety and Health Program. Employee responsibilities include the following:  Reading, understanding and following safety and health rules and procedures.  Signing the Policies and Procedures Acknowledgement included in Appendix B.  Wearing Personal Protective Equipment (PPE) at all times when working in areas where there is a possible danger of injury.  Wearing suitable work clothes as determined by the supervisor/foreman.  Performing all tasks safely as directed by their supervisor/foreman.  Reporting ALL injuries, no matter how slight to their supervisor/foreman immediately, and seeking treatment promptly.  Knowing the location of first aid, fire fighting equipment, and other safety devices.  Attending any and all required safety and health meetings.  Not performing potentially hazardous tasks, or using any hazardous material until properly trained, and following all safety procedures when performing those tasks. page 13 of 25 © USLegalforms.com 2006  STOPPING AND ASKING QUESTIONS IF EVER IN DOUBT ABOUT THE SAFETY OF ANY OPERATION ENTER ADDITIONAL RESPONSIBILITIES AS NECESSARY page 14 of 25 © USLegalforms.com 2006 POLICIES AND PROCEDURES ACKNOWLEDGEMENTS I have read and understand the attached company policies and procedures and agree to abide by them. I have also had the duties of the position which I have accepted explained to me, and I understand the requirements of the position. I understand that any violation of this policy is reason for disciplinary action up to and including termination. ________________________________ ____________________ Employee Signature Date page 15 of 25 © USLegalforms.com 2006 DISCIPLINE/ENFORCEMENT The (COMPANY NAME) seeks to establish and maintain standards of employee conduct and supervisory practices which will support and promote safe and effective business operations. These supervisory practices include administering corrective action when employee safety performance or conduct jeopardizes this goal. This policy sets forth general guidelines for a corrective action process aimed to document and correct undesirable employee behavior. Major elements of this policy include:  Constructive criticism/instruction by the employee’s supervisor/foreman to educate and inform employees of appropriate safety performance and behavior.  Correcting employee’s negative behavior to the extent required.  Informing the employee that continued violation of company safety policies may result in termination.  Written documentation of disciplinary warnings and corrective action taken. Depending on the facts and circumstances involved with each situation, the company may choose any corrective action including immediate termination. However, in most circumstances the following steps will be followed: 1. VERBAL WARNING informally documented, by supervisor/foreman or safety coordinator for minor infractions of company safety rules. Supervisor/foreman or safety coordinator must inform the employee what safety rule or policy was violated and how to correct the problem. 2. WRITTEN WARNING, documented in employee’s file. Repeated minor infractions or a more substantial safety infraction requires issuance of a written warning. Every attempt should be made to re-educate the employee on the desired performance. The employee should acknowledge the warning by signing the document before it is placed in their personnel file. 3. SUSPENSION, for three (3) working days. If employee fails to appropriately respond or management determines the infraction is sufficiently serious. 4. TERMINATION, for repeated or serious safety infractions. page 16 of 25 © USLegalforms.com 2006 CONTROL OF HAZARDS Where feasible, workplace hazards are prevented by effective design of the job site or job. Where it is not feasible to eliminate such hazards, they must be controlled to prevent unsafe and unhealthy exposure. Once a potential hazard is recognized, the elimination or control must be done in a timely manner. These procedures include measures such as the following:  Maintain all extension cords and equipment.  Ensure all guards and safety devices are working.  Periodically inspect the worksite for safety hazards.  Establish a medical program that provides appropriate first aid to the site, as well as nearby physician and emergency phone numbers.  Address any and all safety hazards with employees. ENTER ADDITIONAL RESPONSIBILITIES AS NECESSARY FIRE PREVENTION Fire prevention is an important part of protecting employees and company assets. Fire hazards must be controlled to prevent unsafe conditions. Once a potential hazard is recognized, it must be eliminated or controlled in a timely manner. The following fire prevention requirements must be met for each site:  Maintain one conspicuously located 2A fire extinguisher (or equivalent) for every floor.  Maintain one 2A conspicuously located fire extinguisher (or equivalent) for every 3000 sq/ft  Maintain a conspicuously located, 10B fire extinguisher where more than 5-gallons of flammable liquids or gas are stored.  Locate generators and internal combustion engines away from combustible materials.  Keep site free from accumulation of combustible materials or weeds.  Keep exists free from obstructions or combustible materials.  Keep no more than 25-gallons of combustible liquids stored on site.  Do not store LPG containers in any buildings or enclosed spaces.  Keep fire extinguishers in the immediate vicinity where welding, cutting, or heating is being done. ENTER ADDITIONAL REQUIREMENTS AS NECESSARY page 17 of 25 © USLegalforms.com 2006 TRAINING AND EDUCATION Training is an essential component of an effective safety and health program addressing the responsibilities of both management and employees at the site. Training is most effective when incorporated into other education on performance requirements and job practices. Training programs should be provided as follows:  When the safety and health plan is developed  For all new employees before beginning work  When new equipment, materials, or processes are introduced  When procedures have been updated or revised  When experiences/operations show that employee compliance must be improved  At least annually Besides the standard training, employees should also be trained in the recognition of hazards - be able to look at a work site and identify unsafe acts and conditions. A list of typical hazards employees should be able to recognize may include:  Fall Hazards - Falls from- Floors, Roofs and roof openings,  Ladders (Straight and Step), Scaffolds, Wall openings, Tripping, Trenches, Steel Erection, Stairs, Chairs  Electrical Hazards- Appliances, Damaged cords, Outlets, Overloads, Overhead High Voltage, Extension cords, Portable Tools (broken casing or damaged wiring), Grounding, Metal Boxes, Switches, Ground fault circuit interrupters(GFCI)  Housekeeping Issues - Exits, Walkways, Floors, Trash, Storage of Materials (Hazardous and Non-Hazardous), Protruding Nails etc,.  Fire Hazards- Oily-Dirty Rags, Combustibles, Fuel Gas Cylinders, Exits (blocked) Trips/Slips Stairs, Un-even flooring, Electrical cords, icy walkways  Health Hazards- Silicosis, Asbestos, Loss of hearing, Eye injury due to flying objects Employees trained in recognizing and reporting of hazards together with supervisors/foremen trained in the correction of hazards will substantially reduce the likelihood of a serious injury. page 18 of 25 © USLegalforms.com 2006 RECORDKEEPING AND OSHA LOG REVIEW In the event of a fatality (death on the job) or catastrophe (accident resulting in hospitalization of three or more workers) contact (SAFETY PERSON). Their office and cell-phone numbers are: Office: (XXX) XXX-XXXX Cell: (XXX) XXX-XXXX The Safety Coordinator will in turn report it to the OSHA Region VIII Office at (303) 844-1600, within 8 hours after the occurrence. If an injury or accident should ever occur, you are to report it to your supervisor/foreman as soon as possible. A log entry and summary report shall be maintained for every recordable injury and illness. The entry should be done within 7 days after the injury or illness has occurred. The OSHA 300 or equivalent shall be used for the recording. An OSHA recordable injury or illness is defined as an injury resulting in loss of consciousness, days away from work, days of restricted work, or medical treatment beyond first aid. First Aid includes:  Tetanus shots  Band-aids or butterfly bandages  Cleaning, flushing or soaking wounds  Ace bandages and wraps  Non-prescription drugs at non-prescription strength (Aspirin, Tylenol, Etc.)  Drilling fingernails/toenails  Eye patches, eye flushing and foreign body removal from eye with Q-tips  Finger guards  Hot or cold packs  Drinking fluids for heat stress An annual summary of recordable injuries and illnesses must be posted at a conspicuous location in the workplace and contain the following information: Calendar year, company name-establishment name, establishment address, certifying signature, title, and date. If no injury or illness occurred in the year, zeroes must be entered on the total line. The OSHA logs should be evaluated by the employer to determine trends or patterns in injuries in order to appropriately address hazards and implement prevention strategies. page 19 of 25 © USLegalforms.com 2006 ACCIDENT INVESTIGATION Supervisors/Foreman  Provide first aid and call for emergency medical care if required.  If further medical treatment is required, arrange to have an employer representative accompany the injured employee to the medical facility.  Secure area, equipment and personnel from injury and further damage.  Contact Safety Coordinator. Safety Coordinator  Investigate the incident (injury)--gather facts, employee and witness statements; take pictures and physical measurements of incident site and equipment involved.  Complete an incident investigation report form (see below) and the necessary workers’ compensation paperwork within 24 hours whenever possible.  Insure that corrective action to prevent a recurrence is taken.  Discuss incident, where appropriate, in safety and other employee meetings with the intent to prevent a recurrence.  Discuss incident with other supervisors/foremen and other management.  If the injury warrants time away from work, insure that the absence is authorized by a physician and that you maintain contact with your employee while he/she remains off work.  Monitor status of employee(s) off work, maintain contact with employee and encourage return to work even if restrictions are imposed by the physician.  When injured employee(s) return to work they should not be allowed to return to work without “return to work” release forms from the physician. Review the release carefully and insure that you can accommodate the restrictions, and that the employee follows the restrictions indicated by the physician. page 20 of 25 © USLegalforms.com 2006 ACCIDENT INVESTIGATION FORM INCIDENT INFORMATION Date of Accident Time Day of Week  S M T W T F S Shift 1 2 3 Job Site INJURED PERSON Name: Address: Age: Phone: Job Title: Supervisor/Foreman Name: Length of Employment at Company: Length of Employment at Job: Employee Classification: Full Time Part Time Contract Temporary Nature of Injury Bruising Dislocation Other (specify) Injured Part of Body: Strain/Sprain Scratch/Abrasion Internal Fracture Amputation Foreign Body Remarks: Laceration/Cut Burn/Scald Chemical Reaction Treatment Name and Address of Treating Physician or Facility First Aid Emergency Room Dr.’s Office Hospitalization DAMAGED PROPERTY Property, Equipment, or Material Damaged Describe Damage Object or Substance Inflicting Damage: INCIDENT DESCRIPTION Describe what happened (attach photographs or diagrams if necessary) page 21 of 25 © USLegalforms.com 2006 ROOT CAUSE ANALYSIS (Check All that Apply) Unsafe Acts Unsafe Conditions Management Deficiencies Improper work technique Poor work area design or layout Lack of written procedures or policies Safety rule violation Congested work area Safety rules not enforced Improper PPE or PPE not used Hazardous substances Hazards not identified Operating without authority Fire or explosion hazard PPE unavailable Failure to warn or secure Inadequate ventilation Insufficient worker training Operating at improper speeds Improper material storage Insufficient supervisor training By-passing safety devices Improper tool or equipment Improper maintenance Guards not used Insufficient knowledge of job Inadequate supervision Improper loading or placement Slippery conditions Inadequate job planning Improper lifting Poor housekeeping Inadequate hiring practices Servicing machinery in motion Excessive noise Inadequate workplace inspection Horseplay Inadequate guarding of hazards Inadequate equipment Drug or alcohol use Defective tools/equipment Unsafe design or construction Unnecessary haste Insufficient lighting Unrealistic scheduling Unsafe act of others Inadequate fall protection Poor process design Other: Other: Other: INCIDENT ANALYSIS Using the root cause analysis list on the previous page, explain the cause(s) of the incident in as much detail as possible. page 22 of 25 © USLegalforms.com 2006 How bad could the accident have been? What is the chance of the accident happening again? Very Serious Serious Minor Frequent Occasional Rare PREVENTIVE ACTIONS Describe actions that will be taken to prevent recurrence. Deadline By Whom Complete INVESTIGATION TEAM Signature Name Position page 23 of 25 © USLegalforms.com 2006 SAFETY RULES AND PROCEDURES  No employee is expected to undertake a job until that person has received adequate training.  All employees shall be trained on every potential hazard that they could be exposed to and how to protect themselves.  No employee is required to work under conditions which are unsanitary, dangerous or hazardous to their health.  Only qualified trained personnel are permitted to operate machinery or equipment.  All injuries must be reported to your supervision/foreman.  Manufacturer’s specifications, limitations, and instructions shall be followed.  Particular attention should be given to new employees and to employees moving to new jobs or doing non-routine tasks.  All required OSHA posters shall be posted.  Emergency numbers shall be posted and reviewed with employees  Each employee in an excavation/trench shall be protected from cave-ins by an adequate protective system.  Employees working in areas where there is a possible danger of head injury, excessive noise exposure, or potential eye and face injury shall be protected by Personal Protection Equipment (PPE).  All hand and power tools and similar equipment, whether furnished by the employer or the employee, shall be maintained in a safe condition.  All materials stored in tiers shall be stacked, racked, blocked, interlocked, or otherwise secured to prevent sliding, falling or collapse.  The employer shall insure that electrical equipment is free from recognized hazards that are likely to cause death or serious physical harm to employees.  All scaffolding shall be erected in accordance with the CFR 1926.451 subpart L. Standard guardrails for fall protection and ladders for safe access shall be used.  All places of employment shall be kept clean, the floor of every workroom shall be maintained, so far as practicable, in a dry condition; standing water shall be removed. Where wet processes are used, drainage shall be maintained and false floors, platforms, mats or other dry standing places or appropriate waterproof footgear shall be provided.  To facilitate cleaning, every floor, working place, and passageway shall be kept free from protruding nails, splinters, loose boards, and holes and openings.  All floor openings, open sided floor and wall openings shall be guarded by a standard railings and toe boards or cover.  The employer shall comply with the manufacturer's specifications and limitations applicable to the operation of any and all cranes and derricks.  All equipment left unattended at night, adjacent to a highway in normal use, or adjacent to construction areas where work is in progress, shall have appropriate lights or reflectors, or barricades equipped with appropriate lights or reflectors, to identify the location of the equipment.  No construction loads shall be placed on a concrete structure or portion of a concrete structure or portion of a concrete structure unless the employer determines, based on information received from a person who is qualified in structural design, that the structure or portion of the structure is capable of supporting the loads.  A stairway or ladder shall be provided at all personnel points of access where there is a break in elevation of 19 inches or more, and no ramp, runway, sloped embankment, or personnel hoist is provided. page 24 of 25 © USLegalforms.com 2006 ENTER ADDITIONAL SAFETY RULES/PROCEDURES AS NECESSARY EMPLOYEE EMERGENCY ACTION PLAN FOR FIRE & OTHER EMERGENCIES The following emergency action plan is only appropriate for small construction sites. Larger sites should have a much more detailed plan.  Emergency escape procedures: Immediately leave the building through the closest practical exit. Meet up at the foremen’s truck.  Critical plant operations: Shut off the generator on your way out if possible.  Accounting for Employees: Foreman/Supervisor is to account for all employees after emergency evacuation has been completed and assign duties as necessary.  Means to Report fires and other emergencies : Dial 911 on the cell-phone, report the location of the emergency and provide directions to the responders.  Further Information: Contact the Safety Coordinator or further information or explanation of duties under the plan. ALARMS SYSTEMS/EVACUATION: (COMPANY NAME) establishes the call: Fire, Fire, Fire: (el fuego, el fuego, el fuego) by any employee, as the signal to immediately evacuate the building or work site. TRAINING: Before implementing the emergency action plan, a sufficient number of persons to assist in the safe and orderly emergency evacuation of employees will be designated and trained. The plan will be reviewed with each employee covered by the plan at the following times: 1. Initially when the plan is developed or upon initial assignment. 2. Whenever the employee's responsibilities or designated actions under the plan change. 3. Whenever the plan is changed. The plan will be kept at the worksite and made available for employee review. For those employers with 10 or fewer employees the emergency action plan may be communicated orally to employees and the employer need not maintain a written plan. page 25 of 25