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Ambulatory Injury & Illness Prevention Program

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Per California Code of Regulations, Title 8, Section 3203, UCLA Health has incorporated an Injury and Illness Prevention Plan (IIPP).  This program ensures a safe working environment and helps reduce the number and severity of workplace injuries. One of the fundamental tenants of an IIPP is that workers have a right to a safe and healthful workplace and the employer is responsible for providing the safe and healthful workplace. This is incorporated in the IIPP policy, which includes specifics about responsibilities, implementation, and program elements.

Goals

  • Protect the health and safety of employees.
  • Reduce workers' compensation claims.
  • Reduce the time spent to replace or reassign injured workers.
  • Minimize the potential for code-violation penalties from regulatory agencies.

To assist UCLA Health non-hospital based departments in establishing and implementing an injury illness prevention program, this Injury and Illness Prevention Plan (IIPP) template has been prepared by the Office of Environmental Health & Safety in accordance with UCLA Health Policy 8000/1100: Safety Management and Injury and Illness Prevention Plan.
The template includes 8 essential components as mandated by CCR Title 8, Section 3203:

  1. Introduction and Scope:
  2. Roles and Responsibilities
  3. Identification and Evaluation of Workplace Hazards:
  4. Correcting Workplace Hazards
  5. Communicating Workplace Hazards
  6. Incident, Injury and Illness Reporting and Investigations
  7. Training and Documentation
  8. Compliance

Compliance

Your local written plan should be maintained by your Clinic Manager or Safety Administrator. Per Cal-OSHA, each employee must be made aware of their employer's IIPP and their responsibilities under their plan.

Print the document, obtain the necessary signatures, review with departmental employees, and document the training in writing. Please return the Acknowledgement of Receipt and Statement of Accuracy to our office upon completion. Annual IIPP review/revision and training with employees is required.

The Office of Environmental Health & Safety is available to help you with your departmental safety program. To learn more about the development and implementation of your IIPP, contact EH&S or visit your departmental management team for more information.

Forms

  • Accident Investigation Form
  • Office Inspection Checklist
  • Hazard Notification/Safety Recommendation Form
  • Hazard Identification/Correction Form
  • Training Documentation Form
  • Acknowledgment of Receipt and Implementation of IIPP
  • Entering IIPP through INSPECT- Supervior and Employee walkthrough
  • Entering Work Site Safety Plan(WSSP) through INSPECT

More Information

  • UCLA Health Ambulatory and Community Practices IIPP template
  • Cal/OSHA Injury and Illness Prevention Program
  • Federal OSHA
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