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SAMPLESAFETYTRAININGANDINSTRUCTIONPROGRAMSAMPLESAFETYTRAININGANDINSTRUCTIONPROGRAM|ACCIDENTREPORTINGANDINVESTIGATION2ACCIDENTREPORTINGANDINVESTIGATION(EMPLOYERNAME)DISCLAIMERThissamplesafetyprogramisintendedsolelyasaguideandtemplateforemployerreferenceanduse.Thissampleprogramisnotintendedtobeimplementedasis,norisitintendedtocomplywithanyfederal,state,orlocalregulationorstatute.Rather,thesampleprogramismeanttoassisteachemployerindevelopingitsownwrittensafetyprogrambaseduponitsspecificneedsandrequirements.AnemployershouldreviewtheOSHAstandardsforspecificrequirementsapplicabletoitsoperationsandmakeadjustmentstothissampleprogrambaseduponthoserequirements.Anemployerwillneedtomodifythesamplesafetyprogrambyaddinginformationrelevanttoitsparticularjobsitesorfacilitiesinordertodevelopaneffective,comprehensiveprogram.ThefailureofanemployertodevelopitsownwrittensafetyprogramdesignedforitsownoperationsmayresultinaviolationofOSHAstandards.SAMPLESAFETYTRAININGANDINSTRUCTIONPROGRAM|ACCIDENTREPORTINGANDINVESTIGATION3ACCIDENTREPORTINGANDINVESTIGATION(EMPLOYERNAME)GENERAL:(EMPLOYERNAME)willensurethatprojectshavingapotentialforemployeeinjuryareevaluatedandcontrolled.(EMPLOYERNAME)shallmakeavailabletoemployees,therequiredtypesofprotectiveequipment,engineeringcontrolsandproceduressuitablefortheworktobeperformed.RESPONSIBILITY:(EMPLOYERNAME)isresponsibleforallfacetsofthisprogramandhasauthoritytomakenecessarydecisionstoensuresuccessoftheprogramContentsoftheAccidentInvestigationProgram1.WrittenProgram2.GeneralRequirements3.AccidentInvestigationTeam4.Purpose5.Scope6.PoliciesAndProcedureChecklist7.Training8.Checklist9.IncidentNotificationFormREGULATORYSTANDARD:OSHA-29CFR1904OSHAWebsite:www.osha.govReferenceDate:Nov.2015SAMPLESAFETYTRAININGANDINSTRUCTIONPROGRAM|ACCIDENTREPORTINGANDINVESTIGATION4ACCIDENTREPORTINGANDINVESTIGATION(EMPLOYERNAME)1.WRITTENPROGRAM.(EMPLOYERNAME)willreviewandevaluatethisstandardpracticeinstructiononanasneededbasis,orwhenchangesoccurthatpromptrevisionofthisdocument,orwhenfacilityoperationalchangesoccurthatrequirearevisionofthisdocument.Effectiveimplementationrequiresawrittenprogramforjobsafety,health,thatisendorsedandadvocatedbythehighestlevelofmanagementwithin(EMPLOYERNAME)andthatoutlinesourgoalsandplans.2.GENERALREQUIREMENTS.(EMPLOYERNAME)willestablishaccidentinvestigationprocedures,andimproveoperationalproceduresthroughtheuseofthisdocument.Preventingfutureworkplaceaccidentsinourcompanyistheprinciplepurposeofaccidentinvestigation.Thisdocumentwillprovideabasisforstudyingandrecordingthereasonsanaccidentoccurred,identifyingexistingorpotentialjobhazards(bothsafetyandhealth),anddeterminingthebestcourseofactiontotaketoreduceoreliminatethesehazards.SAMPLESAFETYTRAININGANDINSTRUCTIONPROGRAM|ACCIDENTREPORTINGANDINVESTIGATION5ACCIDENTREPORTINGANDINVESTIGATION(EMPLOYERNAME)3.ACCIDENTINVESTIGATIONTEAM.Theaccidentinvestigationteamwillbecomposedofthefollowing:ACCIDENTINVESTIGATIONTEAMMemberTitleMemberDepartmentManagerMemberSafetyOfficerMemberMedicalOfficerMemberUnionCommitteerepresentativeMemberFacilityEngineerMemberSupervisorofinjuredemployeeMemberInjuredemployee(wherepossible)Member4.PURPOSE.Toestablishuniformproceduresfortheinvestigationandcompletionofreportsregardingoccupationalaccidents,injuries,illnessesandpropertydamage.5.SCOPE.Thisprocessappliestoall(EMPLOYERNAME)facilitiesand...

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