YOUR COMPANY NAME
SAFETY PLAN TEMPLATE
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1 WORKPLACE SAFETY PROGRAM
Introduction
The enclosed sample Workplace Safety Program was created to assist employers with workplace safety program
development and compliance.
This sample program is intended to serve as the basis for an employer-integrated safety and health
management program. The program consists of these seven essential elements/sections:
1. Management's commitment and involvement
2. Safety committee operation
3. Provisions for safety and health training
4. Safety Inspections
5. Preventive Maintenance
6. First aid procedures
7. Accident investigations
8. Recordkeeping of injuries
9. Job specific safety rules and procedures
The first eight elements/sections are common to all employers. Employers may want to modify Job Specific
Safety Rules and Procedures to reflect actual work-environment practices. However, if this manual meets the
needs of your company, it may be used exactly as written. If you have previously established and are
maintaining a safety program, you can continue to use your program if these essential elements are covered.
Use of all or part of this manual does not relieve employers of their responsibility to comply with other
applicable local, state or federal laws.
Instructions
Carefully review all sections of the sample program to know your employer responsibilities; determine which
changes or modifications (if any) are necessary to have the program better accommodate your workplace. (For
example, if a safety committee meets weekly or monthly instead of quarterly, then the Safety Committee
Operation Section of the manual should be amended to accommodate the practice.) Include any safety rules,
policies or procedures appropriate to your work environment that are not listed in this document. Edit any rules
or policies that should be modified to better fit your company needs. Remember—All employees must receive
a copy of your written safety program. Your company letterhead should be used as a cover for the program.
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TABLE OF CONTENTS
1 WORKPLACE SAFETY PROGRAM ......................................................................................................... 2
2 MANAGEMENT COMMITMENT AND INVOLVEMENT .................................معرفة
ّ خطأ! اإلشارة المرجعية غير
2.1 POLICY STATEMENT ..................................................................................... .معرفة
ّ خطأ! اإلشارة المرجعية غير
3 SAFETY COMMITTEE........................................................................................................................... 6
3.1 SAFETY COMMITTEE ORGANIZATION........................................................................................................... 6
3.2 RESPONSIBILITIES ................................................................................................................................... 6
3.3 MEETINGS ............................................................................................................................................ 7
3.4 SAFETY COMMITTEE MEETING MINUTES ................................................................................................... 8
4 SAFETY AND HEALTH TRAINING .......................................................................................................... 9
4.1 SAFETY AND HEALTH ORIENTATION ............................................................................................................ 9
4.2 JOB-SPECIFIC TRAINING ........................................................................................................................... 9
4.3 PERIODIC RETRAINING OF EMPLOYEES ......................................................................................................... 9
4.4 SAFETY TRAINING DOCUMENTATION................................................................................................ 10
5 SAFETY INSPECTIONS ....................................................................................................................... 11
6 PREVENTIVE MAINTENANCE............................................................................................................. 12
7 FIRST-AID PROCEDURES ................................................................................................................... 13
7.1 MINOR FIRST-AID TREATMENT................................................................................................................ 13
7.2 NONEMERGENCY MEDICAL TREATMENT .................................................................................................... 13
7.3 EMERGENCY MEDICAL TREATMENT .......................................................................................................... 13
7.4 FIRST-AID TRAINING ............................................................................................................................. 13
7.5 FIRST-AID INSTRUCTIONS ....................................................................................................................... 14
8 ACCIDENT INVESTIGATION ............................................................................................................... 15
8.1 ACCIDENT INVESTIGATION PROCEDURES .................................................................................................... 15
8.2 ACCIDENT INVESTIGATION REPORT ........................................................................................................... 16
8.3 INSTRUCTIONS FOR COMPLETING THE ACCIDENT INVESTIGATION REPORT .......................................................... 17
9 RECORDKEEPING PROCEDURES ........................................................................................................ 18
10 SAFETY RULES, POLICIES AND PROCEDURES ...................................................................................... 19
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10.1 ALL EMPLOYEES ............................................................................................................................... 20
10.2 ALL EMPLOYEES ............................................................................................................................... 21
10.3 OFFICE PERSONNEL .......................................................................................................................... 22
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