OC Public Libraries - Safety Folder

Injuries and
Incidents

Injury - Vehicle Accident Reporting Procedures

Immediately contact County of Orange Risk Management for these:
Death – Amputation – Hospitalization – Cal OSHA visit

714-285-5500 or 714-981-6288 on weekends/after hours
 Complete each required document: Within 24 hours for injuries / 3 days for vehicle accidents.
 Explain all contributing factors that led to the incident and verify accuracy of all content.
 Scan completed docs and email to those listed. Retain all originals for five years.

First-Aid Injuries: Employee

Get and print (instructions on following pages): Occupational Injury and Illness Reporting Packet
1. F293: Conduct a Supervisors Investigation of Employee’s Injury or Illness and save for your records.
2. Skills Training: Develop and implement effective training solutions that minimize recurrence

If an injury requires treatment at a medical clinic, move onto Work Comp Clinic Injuries.

Work Comp Clinic Injuries: Employee

Get and print (instructions on following pages): Occupational Injury and Illness Reporting Packet
1. F293: Conduct a Supervisors Investigation of Employee’s Injury or Illness
2. Employee’s Report of Injury: The employee explains what happened on this document
3. DWC1: The injured completes the top portion, supervisors complete the lower portion
4. 5020: Supervisor completes and clicks to submit an Employers Report of Occupational Injury, after
clicking “Submit” look for the “View 5020 Details” to print and save a copy
5. OSHA Form 300 & 301: Supervisor updates the worksite OSHA 300 and the Form 301
6. Email #1-4 to Treg Weythman, [email protected], [email protected], OCPL
Policy Team, and OCPL DSR.
7. Email #1 (Only the Supervisors Investigation) to: [email protected]
8. Any/All Doctor Notes: Email to [email protected] and [email protected]

Volunteer Injuries: Any volunteer related injury or accident

Get directions and form (instructions on following pages): Volunteer Accident / Incident Forms
1. Volunteer’s Report of Injury Form: Complete the form
2. Email #1 to: [email protected], OCPL Policy Team, and OCPL DSR.

Vehicle Accidents: Involving any county personnel

Get report (instructions on following pages): Vehicle Collision Report
1. Vehicle Collision Report: Complete using photos and diagram
2. Email #1 to: Treg Weythman, [email protected], OCPL Policy Team, and OCPL DSR.

Public Injury / Accident: Any public related injury or accident

Get forms (instructions on following pages): Injury / Accident to Public
1. Incident Report and/or Vehicle Collision Report: Complete the report
2. Email #1 to: Gustavo Miranda, Gary Stopforth, OCPL Policy Team, and OCPL DSR.
View complete policies and procedures: Employee Injuries and Vehicle Accidents

OC Parks Injury – Accident Reporting Procedures 1.31.2018 Treg 1.31.2018

https://ocgov.sharepoint.com/Pages/default.aspx

To access up-to-date
Risk Management Forms
and Resources, you will

need to log onto the
County Intranet site.

OC Parks Injury – Accident Reporting Procedures 1.31.2018 Move your cursor over
Collaboration then click
onto Risk Management.

Treg 1.31.2018

https://ocgov.sharepoint.com/Collab/SvcAreas/GRC/Risk

Workers Compensation Injury
reporting documents are located

within Forms and Resources.

OC Parks Injury – Accident Reporting Procedures 1.31.2018 Once here, you will see:
1. Work Comp Injury docs
2. Vehicle Collision Reports
3. Public Injuries / Accidents

Treg 1.31.2018

https://ocgov.sharepoint.com/Collab/SvcAreas/GRC/Risk/Pages/OccupationalInjuryIllnessReporting.aspx

1. Carefully follow the
instructions in the
Reporting Packet. Or
view the tutorial.

2. You must complete a
5020. To do so, click
onto “New 5020
Employer’s Report”.

https://5020.yorkrsg.com/clients/login.aspx
The user name is: [email protected] and password is orange.
Password letters must be lower case. You will then be taken to a blank 5020 template.

OC Parks Injury – Accident Reporting Procedures 1.31.2018 Treg 1.31.2018

Populate each required field on the 5020.

Type your name in the “Completed by” box and click the “Submit” button. Check to make sure your 5020 was

successfully submitted. To print or save the 5020 as a PDF, click on “View 5020 Details”

Complete a full and accurate investigation. Explain all factors that contributed to the event.

1. Define Problem / Describe in a sequence of events

Who trained the employee how to do the job? What happened? Where did it happen? When did it happen?
Who was involved? Were there injuries, if so, how severe were they? Who assigned or oversees the work where
the injury occurred? What specific skills training had the supervisor provided on the job?

2. Gather Data / Evidence

Interview person involved in accident (What influenced their actions?) Interview witnesses (Was the event seen
by anyone?) Inspect site of accident (Were there other contributing factors?) Examine safety skills training
provided, policies/procedures/regulations. If available, review claims data and/or prior accident reports

3. Ask “Why”

Why were they engaged in the activity? Why were/weren’t they using a certain tool? Why did/didn’t they take a
certain route? Why did/didn’t they ask for assistance? Why did/didn’t they seek guidance?

4. Root Cause Identification

Step by step, write down the information in sequential order. Review information, is it clear. Identify the most
logical / reasonable root cause(s).

5. Recommend and Implement Solution(s)

Recommendation(s) should be as specific as possible. Recommendation(s) must be effective in addressing
problem. Recommendation(s) must be achievable and realistic. Assign responsibility for implementation of
recommendation(s) and verify resolution or completion of recommendation.

OC Parks Injury – Accident Reporting Procedures 1.31.2018 Treg 1.31.2018

CEO/OFFICE OF RISK MANAGEMENT
REPORT OF INJURY TO MEMBERS OF THE PUBLIC

(For Use by County Personnel Only)

Procedures:

1. Assess the seriousness of the incident and if necessary, call 911 for emergency (when using county phones dial 9 first).
2. Describe the problem and state what type of assistance you need (i.e., ambulance, police or sheriff, fire department,

paramedics, other).
3. If a person(s) is injured and conscious, provide “reasonable” assistance (i.e., obtain the name of the doctor to call), and treat

the person with courtesy and sympathy.
4. Do not discuss details of the incident with anyone other than the police, sheriff deputy, or CHP.
5. Do not negotiate, enter into an agreement, or make promises to any party involved or present at the scene.
6. For non-serious injuries complete this incident report and Pony Mail the Original and any attachments to Risk Management.
7. If the injury to a member of the public is serious also notify the Office of Risk Management at (714) 285-5500 or after

normal working hours at (714) 981-6288.

Indicate Type of Incident Theft Other

Bodily Injury Private Property Damage

Reported By

Reporting Agency/Department
Contact Person and Title
Phone Number
E-Mail Address
Fax Number

Incident Information Time Incident Occurred

Date of Incident
Location of Incident
Injured Party’s Name
Injured Party’s Phone Number
Daytime Phone Number
Injured Party’s Address

2

Incident Summary/Explanation (What happened, Where it happened, When it happened,
How/Why did it happen):

Witness(s) Information:
Name
Phone Number
Address

Attach witness statement to this report

Attached Information:

Police Report - Yes No

If yes, note Case Number and Reporting Agency (i.e., police dept., sheriff, fire dept,

CHP)

Photographs - Yes No
If yes, note Location of Originals

Reported by (Print Name) Date

Retain copy for your records and send copy to your department safety coordination

COUNTY OF ORANGE FOR SAFETY OFFICE
USE ONLY
VEHICLE
Reviewer’s Initial
If you should need
Email to: [email protected]

Select all that apply (OCSD Only) Agency Reference #___________________

Vehicle Collision Property Damage (Non-Collision) Non-County Vehicle Parked/unattended
Division
Please Complete Within 3 Working Days

Name of driver Department

County Work Address of driver Office Phone
Driver Employee ID # Date of Birth (m/d/yy)

Vehicle vehicle # Department Year License #
Being Make of vehicle Body type
Driven Describe damage to vehicle:

Occupant of vehicle Phone #

County Address Phone #
Passengers Occupant of vehicle

Address

Date of Incident (mm/dd/yy) Time (hour: minute am/pm)

Time Where did it occur (address or intersection)
and City
Place

State how accident / damage occurred (provide all details; if additional space is needed, attach a sheet of paper):

What
Happened,
How, Why

Vehicle license # Make of vehicle Body type

Other Name of owner Address:
Vehicle Name of Driver Address
Driver’s license # Insurance Company Name

COUNTY OF ORANGE

VEHICLE

Name Address Phone #

Persons Approximate age Nature of Injury Phone #
Injured If applicable, to what hospital was injured person taken?
Name Address Phone #
Approximate age Nature of Injury Phone #

If applicable, to what hospital was injured person taken?

Witnesses Name Address
Name Address

What, if anything, was said by driver of other vehicle:

If Applicable, what were the road conditions or hazard that contributed to the accident:
Wet Road Fog Rain Object in road Other Describe:

What direction were you traveling? On what street What speed
What speed
What direction was the other driver traveling? On what street

Where was other vehicle when you first saw it?

CHP Sheriff Police No Investigation City of

Investigated Officer's Name To Whom Badge #
by Police, What charge
CHP Was a citation given
Yes No Unknown

Diagram of Accident N
W
E

S

Additional comments, explanations: Date (mm/dd/yy) Telephone Number
What, if anything, could have been done to prevent the accident: Date (mm/dd/yy)
Driver (Print Name)
Supervisor (Print Name) Date (mm/dd/yy)
Department Head/Designee (Name)

293-FORM SAFETY 5E (revision 03/11)

Cal/OSHA 300 Log

Employer Records Of Occupational Injury Or Illness

Why complete the 300 Log?

Title 8: Chapter 7. Division of Labor Statistics And ResearchSubchapter 1.
Occupational Injury Or Illness Reports And Records
Article 2. Employer Records Of Occupational Injury Or Illness
§14300.7 General Recording Criteria
(a) Basic requirement. You must consider an injury or illness to meet the general
recording criteria, and therefore to be recordable, if it results in any of the following
as detailed in subsections (b)(2) through (b)(6) of this: death, days away from work,
restricted work or transfer to another job, medical treatment beyond first aid, or loss
of consciousness.
You must also consider a case to meet the general recording criteria if it involves a
significant injury or illness diagnosed by a physician or other licensed health care
professional as detailed in subsection (b)(7) of this section, even if it does not result
in death, days away from work, restricted work or job transfer medical treatment
beyond first aid, or loss of consciousness.

Where do I find it?
300 Logs can be found on the OC Intranet under Risk Management by clicking on
Forms and Resources

Or by going here: https://ocgov.sharepoint.com/Collab/SvcAreas/GRC/Risk

How do I do it?
Take a look at the instructional materials on the following pages.

When do I need to post the previous year’s logs in a staff area?
February 1st to April 30th

Keep 300 and 300A logs in this section of the folder

300 Logs

CEO/OFFICE OF RISK MANAGEMENT
REPORT OF INJURY TO MEMBERS OF THE PUBLIC

(For Use by County Personnel Only)

Procedures:

1. Assess the seriousness of the incident and if necessary, call 911 for emergency (when using county phones dial 9 first).
2. Describe the problem and state what type of assistance you need (i.e., ambulance, police or sheriff, fire department,

paramedics, other).
3. If a person(s) is injured and conscious, provide “reasonable” assistance (i.e., obtain the name of the doctor to call), and treat

the person with courtesy and sympathy.
4. Do not discuss details of the incident with anyone other than the police, sheriff deputy, or CHP.
5. Do not negotiate, enter into an agreement, or make promises to any party involved or present at the scene.
6. For non-serious injuries complete this incident report and Pony Mail the Original and any attachments to Risk Management.
7. If the injury to a member of the public is serious also notify the Office of Risk Management at (714) 285-5500 or after

normal working hours at (714) 981-6288.

Indicate Type of Incident Theft Other

Bodily Injury Private Property Damage

Reported By

Reporting Agency/Department
Contact Person and Title
Phone Number
E-Mail Address
Fax Number

Incident Information Time Incident Occurred

Date of Incident
Location of Incident
Injured Party’s Name
Injured Party’s Phone Number
Daytime Phone Number
Injured Party’s Address

2

Incident Summary/Explanation (What happened, Where it happened, When it happened,
How/Why did it happen):

Witness(s) Information:
Name
Phone Number
Address

Attach witness statement to this report

Attached Information:

Police Report - Yes No

If yes, note Case Number and Reporting Agency (i.e., police dept., sheriff, fire dept,

CHP)

Photographs - Yes No
If yes, note Location of Originals

Reported by (Print Name) Date

Retain copy for your records and send copy to your department safety coordination

Cal/OSHA Form 300 (Rev.7/2007) Attention: This
used in a mann
Log of Work-Related Injuries and Illnesses possible while th
programs. See C

You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days awa
You must also record significant work- related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-related injuries and illne
listed in CCR Title 8 Section 14300.8 through 14300.12. Feel free to use two lines for a single case if you need to. You must complete an Injury and Illness Incident Report (Cal/ OSHA Form 3
recorded on this form. If you’re not sure whether a case is recordable, call your local Cal/ OSHA office for help.

Identify the person Describe the case

(A) (B) (C) (D) (E)

Case # Employee's Name Job Title Date of injury or Where the event occurred Describe injury or
(e.g. welder) onset of illness (e.g. Loading dock north object/substance t

STO (month/day) end) ill. (e.g. Second

1 TREG WEYTHMAN 4/11 Walking out of the vault Pinched four fingers

2

3 Enter information as designated in
these columns and fields. Don't forget
4
to complete a Form 301 too.
5

6

7

8

9 Never man
"Page To
10
These cont
11 numbers e

12 automatica
300A, the

13

14

15

NOTE: If additional pages are required: Copy this page; Insert a new Worksheet (Sheet1,2,etc); Paste the copy in it; then Co
(columns L-Y) of this Form 300 page. This will update the Form 300A linked to this page with the most current totals. Then

s form contains information relating to employee health and must be
ner that protects the confidentiality of employees to the extent
he information is being used for occupational safety and health

CCR Title 8 14300.29(b)(6)-(10)

ay from work, or medical treatment beyond first aid. OC Parks HQ on Old Myford Road Year: 2012
esses that meet any of the specific recording criteria
301) or equivalent form for each injury or illness Irvine / California

Classify the case

(F) Using these four categories, check ONLY Enter the number of Check the "injury" column or
the most serious result for each case: days the injured or ill choose one type of illness
r illness, parts of body affected, and
that directly injured or made person worker was: (M)
d degree burns on right forearm from
(1) (2) (3) (4) (5) (6)
acetylene torch) Remained at work Injury
Skin
Job Other On the job Disorder
transfer or Repiratory
Days away transfer or recordable Away from restriction condition
Poisoning
Death from work restriction cases work (L) Hearing
loss
All other
illnesses

(G) (H) (I) (J) (K)

Dont accidently enter infodaryms ationdianysto this row.

s on left hand X 2 days 11 days X

Use an "X" and mark only days days
one cell to classify each
case indicating the most days days
serious of results for each
days days
injury.
Use
nudamysbers indays

thdaeyss e. Thedays

maximum Use an "X" to
days days classify each case
count for as "Injury" unless

edaiytsher is days its one of the
others listed.
nually enter data into the day1s 80. days
otal" cells at the bottom.
tain formulas, the "Xs" and days days
entered in each row sum
ally here and onto the Form days days
e one you post annually.
days days

days days

days days

days days

Page Totals0 1 0 0 2 days 11 days 1 0 0 0 0 0

Be sure to transfer these totals to the Summary page Injury
(Form 300A) before you post it. Skin
Disorder
Repiratory
Condition
Poisoning
Hearing
loss
All other
illnesses

Page 1 of 1 (1) (2) (3) (4) (5) (6)

opy the Page Totals from row 31
n update row 34's Page # of # on each page.

Cal/OSHA Form 300A (Rev. 7/2007)

Summary of Work-Related Injuries and Illnesses

All establishments covered by CCR Title 8 Section 14300 must complete this Annual Summary, even if n
injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are c
accurate before completing this summary.
Using the Log, count the individual entries you made for each category. Then write the totals below, mak

Never manually enter data into the cells below.added the entries from every page of the Log. If you had no cases, write “0.”
Employees, forTmhereemseplocyeeelsl,sancdothnetirareinprefsoenrtamtivueslahasveatnhedrigwhtitlol raevuietwothme Caatli/cOaSlHlAyForm 3

entirety. They also have limited access to the Cal/ OSHA Form 301 or its equivalent. See CCR Title 8 Se

populate from the "Page Totals" sums listed on the14300.35, in Cal/ OSHA’s recordkeeping rule, for further details on the access provisions for these form
Form 300, the log sheet.

Number of Cases Total number of Total number of cases Total nu
cases with days with job transfer or oth
Total number of deaths away from work restriction
record
0 1 0 cas
(G) (H) (I)
0
Number of Days (J

Total number of days away Total number of days of If you do not know
from work job transfer or restriction exact data use 2,000

2 11 multiply by the nu
(K) (L) worksite emplo

Injury and Illness Types

Total number of…
(M)

(1) Injuries 1 (4) Poisonings 0

(2) Skin Disorders 0 (5) Hearing loss 0

(3) Respiratory Conditions 0 (6) All other illnesses 0

Post this Annual Summary from February 1 to April 30 of the ye

no work- related Year: 2012
complete and

king sure you’ve Facility Information

300 in its Establishment name: OC Parks HQ
ection Street 13042 Old Myford Raod
ms. City Irvine

State CA ZIP 92602

Industry description: Orange County Parks

umber of Standard Industrial Classification (SIC) 10
her If known (e.g., SIC 3715) 20,000
dable
ses Employment Information

0 (If you don't have these figures, use the optional Worksheet to estimate)
J)
Annual average number of employees
w or have Total hours worked by all employees last year
0 hours and
umber of
oyees .

Sign here

Knowingly falsifying this document may result in a fine.

I certify that I have examined this document and that to the best of my knowledge the
entries are true, accurate, and complete.

Stacy Blackwood Executive Manager

Company executive Title

( 949 ) 555-1212 February 1, 2013

Phone Date

ear following the year covered by the form.

Cal/OSHA Form 301 You must update OSHA 300
Form 301 for every emplo
Injury and Illness Incident Report (those treated by a doctor

here will reflect your sup
accident investigati

Information about the employee

This Injury and Illness Incident Report is one of the 1) Full Name Treg Weythman
first forms you must fill out when a recordable work-
related injury or illness has occurred. Together with 2) Street 400 Harvard Drive
the Log of Work-Related injuries and Illnesses and
the accompanying Summary , these forms help the City Irvine State CA
employer and Cal/OSHA develop a picture of the
extent and severity of work-related incidents. 3) Date of birth

Within 7 calendar days after you receive 4) Date hired
information that a recordable work-related injury or
illness has occurred, you must fill out this form or 5) X Male
an equivalent. Some state workers' compensation,
insurance, or other reports may be acceptable Female
substitutes. To be considered an equivalent form, any
substitute must contain all the instructions and Information about the physician or other health care
information asked for on this form.
6) Name of physician or other health care professional
According to CCR Title 8 Section 14300.33 Cal/OSHA's Doctor on Call at WellComp Medical Walk-in Clinic
recordkeeping rule, you must keep this form on file for 5
years following the year to which it pertains

If you need additional copies of this form, you 7) If treatment was given away from the worksite, where was it
may photocopy and use as many as you need.

Facility WellComp Medical Clinic

Street 100 Jeffery Drive

City Irvine State CA

Completed by Donna Breitfeller 8) Was employee treated in an emergency room?
Yes

Title Staff Specialist, OC Parks X No
Phone
949-585-6465 Date 4/11/2012 9) Was employee hospitalized overnight as an in-patient?
Yes

X No

0s and this Attention: This form contains information relating to employee Department of Industrial Relations
oyee injury health and must be used in a manner that protects the Division of Occupational Safety & Health
r). Content confidentiality of employees to the extent possible while the
pervisors information is being used for occupational safety and health
ion. purposes. See CCR Title 8 14300.29(b)(6)-(10)

Information about the case

10) Case number from the Log 1 (Transfer the case number from the Log after you record the case.)

11) Date of injury or illness 4/11/2012

Zip 92612 12) Time employee began work 7:45 AM AM/PM

20-Jul-69 13) Time of event 9:59 AM AM/PM Check if time cannot be determined

16-Dec-11 14) What was the employee doing just before the incident occurred? Describe the activity, as well
as the tools, equipment or material the employee was using. Be specific. Examples: "climbing a
ladder while carrying roofing materials"; "spraying chlorine from hand sprayer"; "daily computer key-
entry."

e professional Treg was walking from the interior of the vault back into the hallway after
t given? placing mail in the outbound bin.
Zip
15) What happened? Tell us how the injury occurred. Examples: "When ladder slipped on wet floor,
worker fell 20 feet"; "Worker was spayed with chlorine when gasket broke during replacement";
"Worker developed soreness in wrist over time."

Treg tripped as he stepped down out of the vault. With his left hand, he
caught his fall. But just at that very moment, Donna Breitfeller had pushed the
door of the vault closing the door onto Treg's fingers.

16) What was the injury or illness? Tell us the part of the body that was affected and how it was
affected; be more specific than "hurt", "pain", or "sore." Examples: "strained back"; "chemical burn,
hand"; "carpal tunnel syndrome."

Four fingers on the left hand were severly crushed, nearly amputated

17) What object or substance directly harmed the employee? Examples: "concrete floor";
"chlorine"; "radial arm saw." If this question does not apply to the incident, leave it blank.

The door of the vault closing onto the employee's fingers.

18) If the employee died, when did death occur? Date of death

Safety
Meetings

1

Safety Meetings

Supervisors are accountable for their actions and the results of the training they provide. Vigilant, actively engaged
supervisors who set clear expectations, provide safety training with guidance, oversight and discipline will lead to
desired outcomes (i.e. Work is completed and no one gets hurt in the process); OCCR’s IIPP outlines this.

Supervisors are responsible for documented Safety Meetings using the form (page 2).
Safety meetings are to be held either monthly or quarterly.

If they are held quarterly, and a staff injury occurs at your branch requiring a 5020 being filled out, a staff member
going to the hospital due to the injury, and/or a Worker’s Compensation claim, a meeting must be held within
one month of the incident.
Utilize the Safety Training documents in this folder at your meetings.
Keep SIGNED Safety Meeting forms in this section of the folder.
1. Train employees how to accomplish the job-task and avoid injury before they are assigned the work.
2. Ensure effective Safety Meetings are scheduled, conducted and documented using this form.
3. Examine the jobs that you are doing today or those on the horizon and explore the dangers in that work.
4. Explore how jobs can be accomplished easier, faster and safer with less physical work and danger.
5. Work above the shoulders, down at ground level and those with lots of manual labor contribute to injuries.
6. When providing instruction on tools, equipment or PPE, utilize the owner’s manual along with the actual tool
or PPE to demonstrate proper effective use and the hazards of misuse, then verify employee skills.
7. All Safety Meeting forms must be properly completed, legible, organized chronologically for a minimum five
years and available for easy review and verification.

OCCR Safety Meeting Form Treg 1.12.2018

2

Safety Meeting Form DATE:

Work Order #

WORKSITE / DEPARTMENT:

Subject Discussed: Clearly print your name Sign your name Date
____
1. ____
____
2. ____
____
3. ____
____
4. ____
____
Accidents / Close-Calls Reviewed: 5. ____
____
6. ____
____
7. ____
____
8. ____
____
Suggestions & Recommendations: 9.

10.

11.

12.

Actions Taken / Assignment of Responsibility: 13.

14.

15.

16.

17.
SUPERVISOR/TRAINER: Printed name, signature and date:

OCCR Safety Meeting Form ____

Treg 1.12.2018

Job-Task / Equipment: Job-Task: Book - Doc - File Handling
Worksite: County of Orange worksites
Job Title (s): Library and Office personnel
Analyzed By: Treg Weythman
Date: March 28, 2018

Personal Protective Equipment: Best Practices

HEAD & FACE: Hard Hat if falling objects are evident. Goggles or face shield if falling, flying debris is present.
FEET: Shoes that provide optimal-balance, non-slip footing and protection from sharps and heavy objects.
BODY: Clothing that protects your skin from the dangers about the task while staying cool and comfortable on the job.
HANDS: Gloves that provide optimal protection from hot, sharp or dangerous objects that you will be handling.
Required / Recommended Safety Training (Before taking on the task):
PPE Selection: Demonstrate optimal PPE selection and how to wear it to ensure full protection against injury.
Prepare for Physical Work: Demonstrate your ability to stretch and warm-up prior to taking on physical work.
Stepping Down-Up-Over: Injury Avoidance Training. Demonstrate how to safely navigate the path you choose.
Overexertion: Injury Avoidance Training: Physical Fatigue - Heat Exhaustion – Prolonged sedentary-static postures.
Heavy Objects: Injury Avoidance Training. Demonstrate how to safely lift, move, push, pull or carry something.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE
Know what you are Create more work and expose Obtain hands-on skills training BEFORE you start any task you have
doing. Before starting more employees to injury and not been trained. Recognize and communicate any personal physical
think it through. harm over longer periods of time. limitations before starting a job that might result in you being injured.

Prepare for work. Injuries: Pulled muscles - strains. Understand the physical nature of the job. Stretch and warm up first.

PPE selection. Hand and eye injuries, Slip, trip, Protect your face, eyes and hands from sharp, hot, falling or flying
stumble and fall. Broken bones. objects. Wear comfortable shoes that provide optimal balance.

Equipment selection. Injuries result: Inadequate skills, When evaluating any job, select, inspect and understand the dangers
wrong tools or forcing a job done. in the tools you choose to complete the job while avoiding injury.

Recognize dangers & Cumulative trauma, repetitive STAY ALERT – STOP WORK at the first sign of discomfort - pain. Try to
personal limitations. strains and motion injuries. minimize uncomfortable or awkward postures, repetitive movements,
excessive reaching, use of force, sedentary and static postures or use
of poorly designed tools that don’t match your physical preference.

Recognize physical Kneeling, twisting, bending over. Limit time at task and exposure to awkward postures. Ensure every
risk factors in a job. Reaching down, out, up or over. employee is provided adequate recovery time away from the task.

Repeating the same motion over Limit time at any similar task and exposure to repetition. Ensure every
and over and over with no rest. employee is provided adequate recovery time away from the task.

Push-Pull, Lift-Carry, grasping any Limit time at tasks with exposures to excessive use of strength, force
object, tool; Pinching-Squeezing. or sudden movements. Ensure every employee is provided skills
training on tools and adequate recovery time away from the task.

Sedentary and static postures. Limit time at tasks that are sedentary or static. Prolonged exposures
to static postures are not healthy for your back and restrict blood
flow. Remember to stand, stretch and walk at least a minute or two
every 30 minutes. Moving about and stretching regularly throughout
the workday will help keep you healthy, comfortable and productive.

Evolve and Improve. No change = Same Results. Continually examine jobs: Work to Easier, More Efficient and Safer
methods.

JSA Book Doc File Handling Treg 3.28.2018

Job-Task / Equipment: Job-Task: Carts (For books and paper files)
Worksite: County of Orange worksites
Job Title (s): Office and Library personnel
Analyzed By: Treg Weythman
Date: March 29, 2018

Personal Protective Equipment: Best Practices

FACE: Goggles or face shield if falling, flying debris is present.
FEET: Shoes that provide optimal-balance, non-slip footing and protection from sharps and heavy objects.
BODY: Clothing that protects your skin from the dangers about the task while staying cool and comfortable on the job.
HANDS: Gloves that provide optimal protection from hot, sharp or dangerous objects that you will be handling.
Required / Recommended Safety Training (Before taking on the task):
PPE Selection: Demonstrate optimal PPE selection and how to wear it to ensure full protection against injury.
Prepare for Physical Work: Demonstrate your ability to stretch and warm-up prior to taking on physical work.
Stepping Down-Up-Over: Injury Avoidance Training. Demonstrate how to safely navigate the path you choose.
Overexertion: Injury Avoidance Training: Physical Fatigue - Heat Exhaustion – Prolonged sedentary-static postures.
Heavy Objects: Injury Avoidance Training. Demonstrate how to safely lift, move, push, pull or carry something.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE
Think it through Create more work and expose Obtain hands-on skills training BEFORE you start any task you have
before starting. Know more employees to injury and not been trained. Recognize and communicate any personal physical
what you are doing. harm over longer periods of time. limitations before starting a job that might result in you being injured.

Prepare for work. Injuries: Pulled muscles - strains. Understand the physical nature of the job. Stretch and warm up first.

PPE selection. Hand and eye injuries, Slip, trip, Protect your face, eyes and hands from sharp, hot, falling or flying
stumble and fall. Broken bones. objects. Wear comfortable shoes that provide optimal balance.

Equipment selection. Injuries result: Inadequate skills, Obtain hands-on skills training BEFORE you use/operate equipment.
wrong tools or forcing a job done. Carts with four, large wheels move easier. When evaluating the job,
select, inspect and understand the dangers in the tools you choose to
complete the job-task while avoiding injury.

Load- Move- Unload Overloading. Uneven distribution. Distribute loads evenly. Never pull, always push the cart. Never upend
Loads fall off. The cart breaks. the cart on two wheels. Break large loads down into smaller loads.
Use straps-ratchet to secure loads in place so they don’t topple off.

Recognize dangers & Cumulative trauma, repetitive STAY ALERT – STOP WORK at the first sign of discomfort - pain. Try to
personal limitations. strains and motion injuries. minimize uncomfortable or awkward postures, repetitive movements,
excessive reaching, use of force, sedentary and static postures or use
of poorly designed tools that don’t match your physical preferences.

Recognize physical Kneeling, twisting and bending. Limit time at task and exposure to awkward postures. Employees
risk factors in a job. Reaching down, out, up or over. must be provided adequate recovery time away from the task.

Repeating the same motion over Limit time at any task with exposure to repetitive motion. Employees
and over and over with no rest. must be provided adequate recovery time away from the task.

Push-Pull, Lift-Carry, grasping any Limit time at tasks with exposures to use of strength, force or sudden
object, tool; Pinching-Squeezing. movements. Employees must be provided adequate recovery time.

Evolve and Improve. No change = Same Results. Continually examine jobs: Work to Easier, More Efficient and Safer
methods.

JSA Cart (for books and paper files) Treg 3.29.2018

Job-Task / Equipment: Job-Task: CHAIR that matches you and the work assigned to you

Worksite: County of Orange Worksites
Job Title(s): All Employees
Analyzed By: Treg Weythman
Date: Updated: 2.15.2018

Personal Protective Equipment – Best Practices

HEAD: Hard Hat if falling/flying objects are evident. Eyewear if flying debris, hazardous fluids or lasers are present.
FEET: Shoes providing optimal-balance, non-slip footing and full protection from sharps and heavy objects.
BODY: Clothing that protects your skin from apparent dangers; chemical-thermal-electric burns or lacerations.
HANDS: Gloves that provide optimal protection from apparent dangers; hot, sharp or toxic objects handled.
Skills Verification and Safety Training (Before taking on the task):

Stepping Down-Up-Over: Injury Avoidance Training (Demonstrate physical mobility. Identify apparent trip-fall dangers).
Heavy Objects: Injury Avoidance Training (Demonstrate how to safely lift, move, push, pull or carry objects at work).
Overexertion: Injury Avoidance Training (Recognition of an individual’s personal physical capability and limitations).
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE

Base-Legs-Casters Damaged, broken or unstable Inspect the chair legs or main support cylinder and the base, casters
equipment results in pain. or foot caps to ensure secured stability and balance.

Chair Mechanism The chair doesn’t adjust or fails to Before starting work, adjust the chair to match your physical
Controls or Levers match you to the work you are preferences. Test and understand the functionality of each control
assigned resulting in pain and lever and mechanism on the chair you are provided.
discomfort.

Seat Pan Position The seat pan won’t adjust to the Adjust the seat pan height and tilt to the position where your arms
level that allows your arms and and hands are most comfortable and can easily operate the
hands to comfortably do the work equipment, tools and perform the work you are assigned.
you are assigned.

Backrest The backrests won’t adjust to a Adjust the backrest to a position that provides comfort and full back
position that provides you full support so you can easily operate the equipment, tools and perform
physical back support and the work assigned. Your buttocks should be pressed against the
comfort to perform the work you backrest and you can pass your hand between the back of your calf
are assigned. and the front of the chair.

Feet and Legs The chairs dimension or you Once the seat pan and back rest are adjusted providing you optimal
seated in it prevents easy and comfort, ensure your feet and thighs are comfortably supported and
comfortable access to the work you can easily access the work surface and operate the equipment,
surface or equipment. tools and perform the work assigned.

Arm Rests The arm rests won’t adjust to the Adjust the arm supports (if provided) to a position that you desire
level that allows your arms and with comfortable and easy access to the work surface and the ability
hands to comfortably do the work to easily operate all equipment, tools and perform the work you are
you are assigned. assigned.

Seated for longer Prolonged and uninterrupted Even if you are comfortable in your chair, prolonged static postures
than 30 minutes static posture periods without are not healthy for your back. Remember to stand, stretch and walk
without physical physical movement impacts at least a minute or two every 30 minutes. Moving about and
movement human comfort and health. stretching regularly throughout the workday will help keep you
healthy, comfortable and productive.

Poor postures Increased stress on your back, Ensure your work area is comfortable and causes the least amount
neck, arms and legs with added of stress to your spine. Confirm physical capability. Stretching and
JSA Chair amount of pressure to back warming up may help. But age and prior health history or back pain-
muscles and spinal discs. problems may prohibit your capability.

Treg 2.15.2018

JSA Chair Treg 2.15.2018

JOB-TASK / EQUIPMENT: Job-Task: Overexertion / Physical Fatigue

Worksite: County of Orange worksites
Job Title(s): All Employees
Analyzed By: Treg Weythman
Date: Updated: March 29, 2018

PERSONAL PROTECTIVE EQUIPMENT - Best Practices

HEAD: (Hearing: Ear plugs), (Eyes: goggles w/ side shields / Face shield), (Mouth: Dust mask from flying debris)
FEET: Shoes that provide optimal-balance, non-slip footing and protection from sharps and heavy objects.
BODY: Clothing that protects your skin from the dangers about the task while staying cool and comfortable on the job.
HANDS: Gloves that provide optimal protection from hot, sharp or dangerous objects that you will be handling.
SKILLS VERIFICATION SAFETY TRAINING - Before taking on the task
Overexertion: Injury Avoidance Training: Physical Fatigue - Heat Exhaustion – Prolonged sedentary-static postures.
Heavy Objects: Injury Avoidance Training. Demonstrate how to safely lift, move, push, pull or carry something.
PPE Selection: Demonstrate optimal PPE selection and how to wear it to ensure full protection against injury.
Prepare for Physical Work: Demonstrate your ability to stretch and warm-up prior to taking on physical work.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE

Know what you are Create more work and expose Obtain hands-on skills training BEFORE you start any task you have
doing. Before starting more employees to injury and not been trained. Recognize and communicate any personal physical
think it through. harm over longer periods of time limitations before starting a job that might result in injury.

Prepare for work. Injuries: Pulled muscles – strains. Recognize the physical nature of the job. Stretch and warm up first.

PPE selection. Hand and eye injuries, Slip, trip, Protect your face, eyes and hands from sharp, hot, falling or flying
stumble and fall. Broken bones. objects. Wear comfortable shoes that provide optimal balance.

Equipment selection Injuries result: Inadequate skills, When evaluating any job, select, inspect and understand the dangers
wrong tools or forcing a job done of the tools you choose to complete the job while avoiding injury

Recognize jobs that Injuries result due to a person’s Before starting physically demanding work, determine all potential
require high physical physical limitations; Strength, dangers and confirm the physical capabilities of those assigned the
capabilities. ability to push, pull, yank, lift, and job match the demands required to complete it. Recognize and
carry or use force to complete the respect each individual’s physical limitations: Ability to focus, age,
job-task. health, vision and prior back, leg and foot problems limit capability.

-Repetitive motions -Cumulative trauma injury Determine the easiest way to accomplish the job. Position your body
-Awkward postures -Pulled muscles and strains to facilitate easy of movement while avoiding excessive reaching,
-Burst of strength -Sprains / Trauma injury pulling, pushing, twisting and bending at your waist. Can you reduce
-Duration of the job -Physical and heat exhaustion the load to minimize pain by using a machine or mechanical device to
-Climate and heat -Heat exhaustion or stroke assist? Can work be divided up among several workers and
-Weights and loads -Permanent back injuries completed over time to help aid human physical recovery?

The job-task requires The object is so big you can’t see You can easily see the path and reach the destination and placement
you to handle, carry, the path. The path is difficult or area. The pathway is easily navigated and accessible. All trip hazards
lift or move a thing dangerous to navigate. It’s too are removed. There are no drop-offs or objects you might hit or
from here to there. heavy to hold comfortably. Or things that move and hit you. You have secured the pathway with
you use burst of force or strength. barricades to ensure overall safety.

Loading / Unloading Reaching down, out up or over. Get help and avoid injury. Position feet wide apart and use them to
or placing the thing Pulling - pushing things can result change directions. Maintain a good grip. Hold loads close to your
you were carrying. in overexertion, muscle strains. body. Avoid twisting. Never jump while holding onto something.

Rest - Recovery Pain, cumulative trauma, fatigue, Adequate cool-down and rest periods are implemented. At 95
muscle strain, repetitive strains degrees, workers are paired up and monitor each other for heat
and motion injuries from symptoms.
excessive exposure to labor.

JSA Overexertion Treg 9.30.2001

JSA Overexertion Treg 9.30.2001

Job-Task / Equipment: Job-Task: Reduce Employee Injuries
Worksite: County of Orange
Job Title (s): All employees
Analyzed By: Treg Weythman
Date: March 28, 2018

Personal Protective Equipment: Know and follow best practices

HEAD & FACE: Hard Hat if falling or flying objects are evident. Goggles or face shield if flying debris is present.
FEET: Shoes that provide optimal-balance, non-slip footing and protection from sharps and heavy objects.
BODY: Clothing that protects your skin from the dangers of the task while staying cool and comfortable on the job.
HANDS: Gloves that provide optimal protection from hot, sharp or dangerous objects that you will be handling.
Required / Recommended Safety Training: Before taking on a job-task
Stepping Down-Up-Over: Injury Avoidance Training. Demonstrate how to safely navigate the path you choose.
Overexertion: Injury Avoidance Training: Physical Fatigue - Heat Exhaustion – Prolonged sedentary-static postures.
Heavy Objects: Injury Avoidance Training. Demonstrate how to safely lift, move, push, pull or carry something.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE

Understand your Leadership fails to effectively All leadership must know, understand and comply with the policies
responsibilities. administer its written policies. outlined in their Injury & Illness Prevention Program (IIPP).

Implement a robust, Physical pain, injuries, lifelong Prioritize and schedule adequate time to conduct specific skills
documented skills- suffering, lost productivity and verification training. These must engage all employees with their
verification training depleted employee morale. active participation so everyone develops advanced skills. Leaders
model that grows a demonstrate how a job-task is to be accomplished while avoiding
skilled workforce. injury; then the employee physically shows what they learned.

Know and control the Poorly trained staff. Stay alert to every employee injury. Fully understand the job-task the
number of injuries. employee was involved in and implement effective control solutions.

Recognize high injury Time, resources and dollars are When high injury frequency is recognized, leadership must fully
frequency. encumbered thru work comp understand why and how those injuries occurred and then implement
processing solutions that target and effectively contain the problems identified.

Recognize high-risk If negative consequences occur, When jobs are recognized as dangerous and the scale of probability
and injury severity. the injury, lost time and all tips to unacceptable or an employee is seriously injured, leadership
related costs are debilitating. must immediately implement effective solutions to control the risk.

Engage Risk Failure to achieve compliance Communicate what is needed to help you develop better, targeted,
Management with written policies. task-specific training that is easily adapted and modified to effectively
educate employees on how to accomplish a task and avoid injury.

Acknowledge results Leaders are not held accountable Track – Monitor – Benchmark / Injury by type – Position – Frequency
that you generate. for their results. 1. Safety activities effectively attack known and potential dangers
2. Results are monitored and safety activities are adapted-updated

Clearly communicate Employees mistakenly place a Routinely engage your employees to get a complete understanding of
what is expected. higher value on getting a job the dangers associated with ALL work assigned them.
Staff are accountable done over avoiding an injury. All staff are accountable for following Safety Procedures.
for Safety Procedure Further injuries could result if
compliance procedures not followed.

JSA Reduce Employee Injuries Treg 3.15.2018

Job-Task / Equipment: Job-Task: Walking: Stepping Down-Up-Over

Worksite: County of Orange Worksites
Job Title(s): All Employees
Analyzed By: Treg Weythman
Date: Updated: 3/23/2018

Personal Protective Equipment – Best Practices

HEAD & FACE: Hard Hat if falling/flying objects are evident. Goggles/face shield if flying debris is present.
FEET: Shoes that provide optimal-balanced, non-slip footing and protection from sharps and heavy objects.
BODY: Clothing that protects your skin from hazards about the task. Do not wear loose clothing.
HANDS: Gloves that provide optimal protection from hot, sharp or dangerous objects being handled.
Skills Verification and Safety Training (Before taking on the task):
Prepare for Physical Work: Demonstrate your ability to stretch and warm-up prior to taking on physical work.
Overexertion: Injury Avoidance Training: Physical Fatigue - Heat Exhaustion – Prolonged sedentary-static postures.
Stepping Down-Up-Over: Injury Avoidance Training. Demonstrate how to safely navigate a chosen path.
Heavy Objects: Injury Avoidance Training. Demonstrate how to safely lift, move, push, pull or carry something.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE
Standing, walking, Personal physical limitations, Prior to starting any physically movement, determine all
stepping down-up health, strength and ability. potential dangers. Ensure you are physically capable and
and over. Vision, depth perception, prepared. Stretching and warming up may help. But age,
previous or developing foot, vision and prior history related to foot, ankle, leg and back
ankle, knee and back pain. pain-problems may prohibit your capability.

Use your vision at Stairs, Steep slopes, Ramps, The path you chose and location of your movement is easily
all times to confirm Uneven surface, Carpet, Mats, navigated and accessible. If dark, use lighting. Maintain grip
the path you chose Furniture, Open file cabinets, on handrails when navigating stairs. Stay alert to trip hazards.
is safe, level, free of Ground openings, Corners, Never jump down/up. Maintain clean work areas. Barricade
danger and padded Turns, Curbs, Gopher and areas when necessary to ensure public safety and that of co-
just in case you lose Potholes, Branches, Slippery workers that may not be familiar with the dangers you know
your balance. surfaces, Tools, Doorways, etc. of.

Moving from one Looking away from your path You are physically able. You have selected the safe path. Your
place to another. while in stride and falling. Pain eyes are focused on the path and you are focused on your
lacerations, broken bones, movement. There are no apparent dangers, drop-offs, objects
head injury and worse. you might hit or that might hit you.

You have to hold, Overexertion and muscle Is it on the ground, large or heavy? Does the job exceed your
lift, carry, move, strains from reaching out, capability? Position your feet wide apart and hold the load
push or pull over, down or pulling and close to your body. Turn your feet, not your waist in the
something. pushing something. direction of your path ahead. Avoid twisting and bending over
at your waist. Get a good grip.

Loading / Unloading Slip/Falls and muscle strains Is there an easier way? Do you need mechanical lift assist or a
or placing the thing from trying to hold, lift, load, ladder? Can you easily reach the destination? Plan the work as
you had to carry. push-pull or carry something best you can and position your body in a manner that
or place an object. facilitates ease of movement while avoiding excessive
reaching, pulling or pushing. Are there slip-trip-fall hazards? If
you do fall, will you be hurt? Can you minimize the pain and
danger?

JSA Walking Treg 3.17.2002

Fire
Drills

SUBJECT: Fire Drill
Branch Name: ___________________________
____ Announced (scheduled)
____ Unannounced (unscheduled)

Employee name (please type) Signature Date

Ladder Inspection

Ladders should have a tag stated they were inspected. If yours do not have a tag, notify Safety Officer
Treg Weythman to inspect them. Keep Ladder inspection completed forms from Treg in this section of
the folder.

Worksite managers must routinely inspect ladders those under their charge utilize at work.

1. Visually look at the ladder to see if they fail any of the following (below). If so, you must discard
that ladder.

2. If safety labels are not legible, you can contact the manufacturer to purchase new or throw the
ladder away.

Are all safety labels legible? Is the spreader in good condition and
attached?
Are the side rails intact without any cracks,
bends, or breaks? Are all the rungs and steps in place and
secure?
Do the rungs, cleats, or steps fit snuggly into
the side rails? Is the ladder free of paint or other opaque
coating which might obscure defects?
Do movable parts operate freely without
binding or excessive play? Are ladders with structural defects
immediately marked as defective, or tagged
Is the ladder free of corrosion? “DO NOT USE”
Are the ropes on extension ladders intact
without fraying or excessive wear? Are ladder rungs, cleats, and steps parallel,
level, and uniformly spaced when the ladder
Are the safety feet and other auxiliary is in use?
equipment free of grease and oil?
Aluminum ladders legibly marked with sign
Are the side rails and rungs free of grease reading “CAUTION-Do Not Use Around
and oil? Electrical Equipment” or equivalent wording

Are all parts free of sharp edges, cracks, Rivets and welds are secure?
burrs, and/or splinters?

Is the ladder even when opened (all four legs
flat on the ground)?

Ladder
Inspection

SDS

SDS
SAFETY DATA SHEET

Worksite managers need to make inventories of the hazardous substances used or handled by any
employee while at work.

1. Identify the hazardous substances folks in the County of Orange Libraries are handling by
worksite.

2. Utilize the document on the following page to see if any items you have in the branch have the
warning labels featured.

3. Then locate (guidance provided below), print and organize corresponding up-to-date (many
updated after 2013 with 16 sections and pictograms) Safety Data Sheet for each easily available
for ALL staff and others. Keep this material in the Safety Folder in this section.
To obtain current SDS:
1. Go to Google.
2. Enter the chemical brand name into the search field and click enter.
3. Typically, the most updated (post 2014) PDF will appear on that first page.
4. Print it and enter applicable information onto the worksite Inventory Sheet.
5. Organize all worksite SDS in a manner so individual SDS can be quickly located in
an emergency.

JSA Hazard Communication Treg 5.10.2017

JOB-TASK / EQUIPMENT: Job-Task: Hazard Communication
Worksite: OC Parks worksites
Job Title(s): All Employees
Analyzed By: Treg Weythman
Date: Updated: May 10, 2017

WARNING: Comply with all directions on
container warning labels and Safety Data Sheets.

PERSONAL PROTECTIVE EQUIPMENT - Best Practices

HEAD: (Hearing: Ear plugs), (Eyes: goggles w/ side shields / Face shield), (Mouth: Dust mask from flying debris)
FEET: Work boots that provide optimal non-slip footing and protection from sharp moving and heavy objects.
BODY: Wear clothing to cover exposed skin. Ensure your personal comfort and can be easily seen in traffic.
HANDS: Work gloves that provide optimal hand protection about the job-task and comply with safety warning labels.

SKILLS VERIFICATION SAFETY TRAINING - Before taking on the task
Equipment Selection & Use: Evaluate the job; select the right substance to accomplish the task and not get injured.
PPE Selection: Read SDS and warning labels. Comply with PPE instructions to ensure full protection and avoid injury.
Effective Safety Supervision: The employee must demonstrate competent skills on the job-task assigned them.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE
Obtain training from Using a hazardous substance for You have received formal training on the task and you fully
your supervisor and a task it is not designed for can understand what you are doing. You understand and
evaluate each job. lead to serious injury and death. respect the chemical dangers, capabilities and limitations.

Examine containers; Damaged containers and/or Container is not damaged and warning labels are legible. If
look for pictograms, missing labeling can lead to a container is damaged or labels are missing or not legible,
hazard statements. injury and environmental harm. notify your supervisor and discard immediately.

BEFORE use, read Toxic asphyxiate, suffocating or Comply with instructions on container labels and those in
container warning anesthetic fumes. Dizziness, section 8 of the Safety Data Sheet (SDS). Comply with PPE
labels / pictograms. headaches, nausea, irritation. guidance at all times and know first-aid (SDS section 4).

Using a chemical; Chemical burns, explosions, fire, Use personal protective clothing and equipment when
Read and comply toxic vapors, fumes, gases and handling chemicals (i.e. gloves, aprons, eye protection,
with labels / SDS. other effects. and N-95 paper dust masks, chemical dilution, etc.)

Apply PPE per SDS Injure yourself and others. Wear effective PPE. Ensure your safety from the dangers
and warning labels of the job-task (See warning labels and section 8 of SDS).

Load, transport and Muscle strain, back injury, Know your personal physical limitations and capability.
unload to and from. pinch, crush, falling down. Stretching-warming up may help. However, prior health
history and age may prohibit your capability.

Clear the work area Airborne contaminant, chemical Inspect the area. Know the surroundings and all possible
to ensure the safety burn, skin and eye injuries, trip- dangers. Use barricades, post warnings and use flaggers to
of others. fall, fire, explosion, others. restrict public and coworker access if necessary.

Complete the job. Flying debris, laceration, insect Position yourself to the job-task to facilitate comfortable
Know the first-aid bites, burns, tripping, falling movement. Maintain good, stable footing, no shortcuts. As
measures (SDS #4). and striking objects. Pinch and work progresses, evaluate dangers and act with caution.
crush injuries, muscle strain.

Store chemicals Toxic asphyxiate, fire, explosion Comply with storage instructions on the SDS and labelling.

JSA Hazard Communication Treg 5.10.2017

JSA Hazard Communication Treg 5.10.2017

\

JSA Hazard Communication Treg 5.10.2017

JOB-TASK / EQUIPMENT Job-Task: Ladder ‘A’ Frame (Stepladder)

Worksite: OC Parks worksites
Job Title(s): County of Orange worksites
Analyzed By: Treg Weythman
Date: Updated: April 18, 2017

Step Ladder Math
To Reach Use at least a :
10 feet 6 foot step ladder
12 feet 8 foot step ladder
14 feet 10 foot step ladder

Personal Protective Equipment – Best Practices

HEAD: Hard Hat: Falling debris from above, Eyes: goggles with side shields, Ears: Muffs and/or plugs, Mouth: Dust mask - airborne.
FEET: Work boots that provide optimal non-slip footing and protection from sharps and falling heavy objects.
BODY: Wear clothing to cover as much of your body as possible. Ensure you are comfortable and seen in traffic.
HANDS: Work gloves that provide optimal hand protection about the job-task.

Skills Verification and Safety Training (Before taking on the task):
Equipment Selection & Use: Evaluate the job; then select the best tools to accomplish the task and not get injured.
PPE Selection: How to select the right PPE and wear it to ensure full protection to avoid injury.
Effective Safety Supervision: The employee must demonstrate competent skills on the job-task assigned them.
Personal Physical Limitations: Understanding Individual mobility, balance, physical limitations and strength capabilities.
TASK SEQUENCE POTENTIAL HAZARD INJURY AVOIDANCE SOLUTION / PROCEDURE

Are you physically Falls / Lacerations / Others Prior to taking on physical or strenuous work, determine potential
capable and ready? dangers, ensure you are prepared. Stretching and warming up may
help. However, age and prior history may prohibit your ability.

Evaluate the job: Can The ladder is too short – Never Evaluate the entire job and select the best ladder. The ladder you
you position yourself step on the top two rungs. The selected allows you to accomplish the work in an easy, efficient
to the work? Get the ladder is placed on unstable or manner and avoid injury. Are you caring tools/materials? How will
right length of ladder. sloping surface. those be safely moved up/down ladder?

Inspect the ladder & Ladder is damaged or inadequate Select ladder that is the best match for the job. It allows you to safely
Follow warning labels for the job and dangerous accomplish the job and avoid injury to yourself and others.

Get/Move the ladder Lifting/moving =back/muscle pain Two-(2) people are used to get, lift, move and place the ladder.

Electrical hazards and Electrical Arc. The location of the Maintain a minimum 10 foot clearance from power lines. Secure the
unwanted traffic work is accessible to the public work area to ensure public safety and that of co-workers that may not
(disabled, children and animals). be familiar with your work assignment and the danger.

The placement of the Unstable, unleveled or slippery The area where the ladder will be placed is clean, level and restricted.
ladder is safe surfaces may result in a fall The ladder is adequate: No standing on/above the second top step.

Secure the ladder The ladder slides out or topples The ladder is placed, spreaders locked and secured from movement. A
from movement coworker is there to help hold and secure the ladder.

You are able to climb You can’t hold the rungs. You’re 3-point contact: Both hands and feet are free so you can easily go up
up/down the ladder unstable. Your body weight and and down the ladder. Tools, materials and supplies needed for the job
tools exceed posted limits do not interfere with your movement up and down the ladder.

The work: You can Reaching, Pulling or throwing Plan the work. Coworker hands you the things needed. Position the
easily reach the work items may contribute to loss of ladder and your body to facilitate ease of movement. Never reach out
and all things needed balance. The feet of the ladder or over, pulling things or other dangerous actions. The work is directly
to get the job done. slip out, ladder topples. in front of you and everything needed is very close to you.

JSA Ladder A Frame Treg 10.13.2016

Earthquake
Drill