SANTA CRUZ COUNTY
PERSONNEL ADMINISTRATIVE MANUAL

 

Topic: EMPLOYEE SAFETY SUGGESTION FORM
Section: INJURY AND ILLNESS PREVENTION PROGRAM
Number: XX.5.
Date Issued: October 15, 1992
Date Revised: Dec. 18, 1992

PURPOSE:

To provide documentation of the existence of or potential for unsafe acts or unhealthy conditions.

LEGAL BASIS

California Senate Bill 198
Cal-OSHA General Industrial Safety Orders, Title 8, paragraph 3203.

POLICY:

  1. This employee safety suggestion form is not a grievance or substitute.

  2. Any employee who believes that an unsafe act or unhealthy working condition exists is encouraged to make a report of the condition to their departmental safety liaison representative.

  3. Various Memoranda of Understanding for representation units contain safety or health and safety articles (e.g. General Representation Unit, Article 20; Law Enforcement Representative Unit, Article 6). These provisions require employees to report safety and health hazards. The mechanism to do so is the Employee Safety Suggestion form.

    Such Memorandum of Understanding provisions are grievable if the County fails to follow the process outlined therein. However, substantive issues regarding health and safety are not grievable, as these are governed and enforced under State or Federal law.

EMPLOYEE PROCEDURE:

  1. Complete upper half of the form and submit to departmental safety liaison representative (See Attachment A).

  2. You are not required to provide your name on the report.

  3. Location of condition/unsafe act - give exact location.

  4. Number of employee's exposed - How many employees are exposed to the condition.

  5. Employees Supervisor - List your Supervisor's name.

  6. Description of unsafe/unhealthful condition - Describe the unsafe act/condition fully. List any ideas or suggestions that you may have to correct or abate the condition.

  7. Distribution - Please give a copy of this report to your departmental safety liaison representative and keep a copy for yourself.

DEPARTMENTAL SAFETY LIAISON REPRESENTATIVE

  1. You are required to investigate and document any reported unsafe act/unhealthy work condition that is brought to your attention orally or in writing by an employee.

  2. You shall ensure the abatement of the unsafe act/unhealthy condition if possible.

  3. If you will be unable to correct the condition within 60 days (for example, using an outside contractor) you still need to prepare a plan which will explain the circumstances of the delay (on the Fire and Safety Inspection Report), a proposed timetable for the correction and a summary of steps being taken in the interim to protect employees from being injured as a result of the unsafe act or unhealthy working condition.

  4. Classification of hazard - This refers to the potential for a hazard to result in a highly undesirable outcome, injury, illness or extensive damage.

    1. Imminent Danger - A condition or practice with potential for loss of life or amputation, permanent disability, and/or extensive loss of structure, equipment, or material.

    2. Serious Hazards - A condition or practice with potential for serious injury or illness resulting in temporary disability or property damage that is disruptive but less severe than imminent danger.

    3. Non-serious Hazards - A condition or practice with potential for minor non-disability injury or illness or non-disruptive property damage.

  5. It is your responsibility to make the appropriate distribution as indicated.