Injury and Illness Prevention Program · Non-Office Employee Orientation Form .....17-18 . This manual contains proprietary material of Insperityand is protected by copyright and

Beneficial State Bank

Injury & Illness Prevention Program

This manual contains proprietary material of Insperity and is protected by copyright and other laws respecting proprietary rights. It may not be reproduced, copied or transmitted in any form without the express written consent of Insperity. Insperity has loaned it to its client Bank who may not otherwise distribute it to anyone outside of the client Bank. It shall be returned to Insperity upon request. Nothing in this manual is intended to alter any procedures with respect to any collective bargaining agreement that may be in place. NON-HAZARDOUS IIP PROGRAM Page 1 of 18 Copyright 2012

One PacificCoast Bank

Injury and Illness Prevention Program

Date: September 1, 2013

Date Last Reviewed: September 1, 2013

By: Madison Le


INJURY AND ILLNESS PREVENTION PROGRAM

TABLE OF CONTENTS

A. Purpose ......................................................................................................................... Page(s) 3

B. Responsibility ............................................................................................................................ 3

C. Compliance ............................................................................................................................. 3-4

D. Communication ......................................................................................................................... 4

E. Hazard Assessment .................................................................................................................... 4

F. Accident/Exposure Investigations .......................................................................................... 4-5

G. Hazard Correction ..................................................................................................................... 5

H. Training and Instruction ......................................................................................................... 5-6

I. Recordkeeping ........................................................................................................................ 6-7

J. Employee Acknowledgment 8

APPENDICES Cover Page ............................................................................................................................................. 9

Code of Safe Work Practices ............................................................................................................... 10

Steps to Success Ergonomic Guidelines .............................................................................................. 11

Hazard Assessment and Correction Record ......................................................................................... 12

Accident/Exposure Investigation Program .......................................................................................... 13

Worker Training and Instruction Record ............................................................................................. 14

Minutes of Safety Meeting (Optional) ................................................................................................. 15

Office Employee Orientation Form ..................................................................................................... 16

Non-Office Employee Orientation Form ........................................................................................ 17-18


A. PURPOSE It is the policy of One PacificCoast Bank (“the Bank”) to provide a safe and healthful workplace. Every employee is responsible for the safety of himself/herself as well as others in the workplace. To achieve our goal of maintaining a safe workplace, everyone must be safety conscious at all times. The Bank maintains an Injury and Illness Prevention Program (IIPP). The Injury and Illness Prevention Program is available for review by employees and/or employee representatives in the Human Capital office. Signature of Human Capital Manager Date Printed Name Title Person responsible for implementing this Injury and Illness Prevention Program: Name Title Other persons may assist the above-named person as designated by management or the responsible person. B. RESPONSIBILITY The Injury and Illness Prevention (IIP) Program administrator has the authority and the responsibility for implementing and maintaining this IIP Program for One PacificCoast Bank. Managers and supervisors are responsible for implementing and maintaining the IIP Program in their work areas and for answering worker questions about the IIP Program. A copy of this IIP Program is available from each manager and supervisor. C. COMPLIANCE All workers, including managers and supervisors, are responsible for complying with safe and healthful work practices. Our system of ensuring that all workers comply with these practices include one or more of the following checked practices:

Informing workers of the provisions of our IIP Program Evaluating the safety performance of all workers Recognizing employees who perform safe and healthful work practices


Providing training to workers whose safety performance is deficient Disciplining workers for failure to comply with safe and healthful work practices

D. COMMUNICATION All managers and supervisors are responsible for communicating with all workers about occupational safety and health in a form readily understandable by all workers. Our communication system encourages all workers to inform their managers and supervisors about workplace hazards without fear of reprisal. Our communication system includes one or more of the following checked items:

New worker orientation, including a discussion of safety and health policies and procedures Review of our IIP Program Training programs Regularly scheduled safety meetings Posted or distributed safety information A system for workers to anonymously inform management about workplace hazards Our establishment has less than ten employees and communicates with and instructs

employees orally about general safe work practices and hazards unique to each employee's job assignment.

E. HAZARD ASSESSMENT Periodic inspections (Refer to Hazard Assessment Checklist) to identify and evaluate workplace hazards shall be performed by a competent observer in the office area. Periodic inspections are performed according to the following schedule: 1. When we initially established our IIP Program; 2. When new substances, processes, procedures or equipment which present potential new

hazards are introduced into our workplace; 3. When new, previously unidentified hazards are recognized; 4. When occupational injuries and illnesses occur; and 5. Whenever workplace conditions warrant an inspection. F. ACCIDENT/EXPOSURE INVESTIGATIONS All accidents, even near misses, must be reported to a supervisor or a member of Human Capital immediately, or as soon as possible following occurrence. In addition to any reporting requirements, each supervisor and/or Human Capital must investigate all accidents using the attached Accident/Exposure Investigation Report. Procedures for investigating workplace accidents and hazardous substance exposures include:


1. Interviewing injured workers and witnesses; 2. Examining the workplace for factors associated with the accident/exposure; 3. Determining the cause of the accident/exposure; 4. Taking corrective action to prevent the accident/exposure from recurring; and 5. Recording the findings and actions taken. G. HAZARD CORRECTION Unsafe or unhealthy work conditions, practices, or procedures shall be corrected in a timely manner based on the severity of the hazards. Hazards shall be corrected according to the following procedures: 1. When observed or discovered; and 2. When an imminent hazard exists which cannot be immediately abated without endangering

employee(s) and/or property, we will remove all exposed workers from the area except those necessary to correct the existing condition. Workers who are required to correct the hazardous condition shall be provided with the necessary protection.

H. TRAINING AND INSTRUCTION All workers, including managers and supervisors, shall have training and instruction on general and job-specific safety and health practices. Training and instruction is provided: 1. When the IIP Program is first established; 2. To all new workers; 3. To all workers given new job assignments for which training has not previously been

provided; 4. Whenever new substances, processes, procedures, or equipment are introduced to the

workplace and represent a new hazard; 5. Whenever the employer is made aware of a new or previously unrecognized hazard; 6. To supervisors to familiarize them with the safety and health hazards to which workers

under their immediate direction and control may be exposed; and 7. To all workers with respect to hazards specific to each employee's job assignment. General workplace safety and health practices include, but are not limited to, the following: 1. Implementation and maintenance of the IIP Program 2. Emergency Action and Fire Prevention Plan 3. Provisions for medical services and first aid including emergency procedures 4. Prevention of musculoskeletal disorders, including proper computer workstation ergonomics

and lifting techniques 5. Proper housekeeping, such as keeping stairways and aisles clear, work areas neat and

orderly, and promptly cleaning up spills


6. Prohibiting horseplay, scuffling, or other acts that tend to adversely influence safety 7. Proper storage to prevent stacking goods in an unstable manner and storing goods against

doors, exits, fire extinguishing equipment, and electrical panels 8. Proper reporting of hazards and accidents to supervisors 9. Hazard communication, including worker awareness of potential chemical hazards, and

proper labeling of containers 10. Proper storage and handling of toxic and hazardous substances including prohibiting eating

or storing food and beverages in areas where they can become contaminated I. RECORDKEEPING We have checked one of the following categories as our recordkeeping policy.

Category 1. Our establishment has 20 or more workers or has a workers' compensation experience modification rate of greater than 1.1 and is not on a designated low hazard industry list. We have taken the following steps to implement and maintain our IIP Program:

1. Records of hazard assessment inspections, including the person(s) conducting the

inspection, the unsafe conditions and work practices that have been identified and the action taken to correct the identified unsafe conditions and work practices, are recorded on a hazard assessment and correction form; and

2. Documentation of safety and health training for each worker, including the worker's name or other identifier, training dates, type(s) of training, and training providers are recorded on a worker training and instruction form.

Inspection records and training documentation will be maintained according to the following

checked schedule:

For one year, except for training records of employees who have worked for less than one year which are provided to the employee upon termination of employment; or

Since we have less than ten workers, including managers and supervisors, we only maintain inspection records until the hazard is corrected and only maintain a log of instructions to workers with respect to worker job assignments when they are first hired or assigned new duties.

Category 2. Our establishment has more than 20 workers and is on a designated high hazard

industry list and have a workers' compensation experience modification rate of 1.1 or less, and have taken the following steps to implement and maintain our IIP Program:

1. Records of hazard assessment inspections; and 2. Documentation of safety and health training for each worker.


Inspection records and training documentation will be maintained according to the following checked schedule:

For one year, except for training records of employees who have worked for less than

one year which are provided to the employee upon termination of employment; or We maintain inspection records only until the hazard is corrected and only maintain a

log of instructions to workers with respect to worker job assignments when they are first hired or assigned new duties.

Category 3. We are a local governmental entity (county, city, district, or and any public or quasi-public corporation or public agency) and we are not required to keep written records of the steps taken to implement and maintain our IIP Program.


NOTICE TO ALL EMPLOYEES As Chief of People of One PacificCoast Bank, I am concerned about workplace injuries and vehicle accidents. Accidents cause suffering and financial loss to employees and their families. Accidents also use up Bank dollars that could be better spent in upgrading operations, as well as employee benefits. I believe there is a safe way to do every job and to reach this goal, a comprehensive Injury and Illness Prevention Program has been established to develop, implement, and educate all employees about safety and health policies and procedures. All employees are expected to follow safe practices and obey safety rules. It will take the combined efforts of all of us to help reduce accidents.

EMPLOYEE ACKNOWLEDGMENT FORM

I have received, read, and understand the Injury and Illness Prevention Program of One PacificCoast Bank. Employee Signature Date


Appendices

Code of Safe Work Practices ............................................................................................................... 10

Steps to Success Ergonomic Guidelines .............................................................................................. 11

Hazard Assessment and Correction Record ......................................................................................... 12

Accident/Exposure Investigation Program .......................................................................................... 13

Worker Training and Instruction Record ............................................................................................. 14

Minutes of Safety Meeting (Optional) ................................................................................................. 15

Office Employee Orientation Form ..................................................................................................... 16

Non-Office Employee Orientation Form ........................................................................................ 17-18


CODE OF SAFE WORK PRACTICES 1. Falls are the most common office injury – pay attention to slip, trip, and fall hazards. 2. Pick up or clean up anything dropped on the floor. 3. Keep cords and wires out of the walkways. 4. When using stairs, hold on to the handrails. 5. When it is necessary to access high shelves, use a ladder or step stool. Do not use chairs or

boxes to stand on. 6. Be sure to follow ergonomic guidelines depicted on the following page. 7. Do not overload electrical circuits with double or triple plugs. If there is a need for more

electrical service, an electrician should add a circuit and outlets. 8. Ensure that everyone is familiar with emergency procedures and rules for evacuation. Fire

reporting procedures are included in the front cover of the office telephone book. 9. Do not attempt to operate or make repairs to office equipment unless you have been trained

to do so. 10. Report any frayed or damaged electrical cords. 11. Be sure file cabinets are bolted together or anchored to a wall or column to avoid having

them fall when drawers are opened. 12. When lifting anything heavy or awkward, ask for help or use appropriate carts or hand

trucks. 13. Alcohol and drugs are not allowed. Do not come to work under the influence or use them at

work. Failure to comply with this rule can result in immediate discharge. 14. Report every accident. If you become ill or injure yourself at work, report it to your

supervisor immediately. 15. Drivers of Bank-owned or personal vehicles during business hours must abide by all local,

state, and federal traffic laws. Devices sold to detect police speed checking devices are not allowed.

16. Drivers must not operate a vehicle if ability is impaired by any prescribed or non-prescribed medications, alcohol, illicit drugs, fatigue, illness, or injury. Employees who are taking any drug that recommends that the employee not operate machinery or may cause drowsiness may not operate a vehicle for business use. Employees are encouraged to consult their supervisor on this issue.

17. Drivers and passengers (if any) must properly use belt restraint systems in all cases. 18. All telephone calls while driving must be hands free. 19. No texting while driving. 20. Employee drivers may not pick up hitchhikers or any other unauthorized passengers or

riders.


STEPS TO SUCCESS 1. Align your equipment at your workstation so everything is vertically in front of you (chair,

keyboard, monitor, document holder, and footrest). This will prevent a twisted posture. 2. Position your body correctly at your workstation, as follows: Feet flat Back upright, supported by backrest Neck straight, chin slightly tucked Shoulders relaxed Elbows comfortably bent at a right angle Wrists straight

3. Adjust your equipment to promote the proper body position. Remember elbows bent at a 90-

degree angle so your hands are in line with your forearms. Knees bent at a 90-degree angle so your knees are level with your hips. Back straight in your chair so your lower back is supported.

4. Give yourself time to adjust to the changes you make at your workstation. Re-adjust to create

a comfortable posture, as needed. 5. If you are not able to adjust your existing equipment, you may need additional workstation

attachments. Please contact your supervisor. 6. Remember to take regular breaks and take time to stretch and exercise.


HAZARD ASSESSMENT CHECKLIST

Bank: Location:

Inspected By: Date Inspected:

= Satisfactory = Needs improvement Work Environment Safety

Description Corrective Action Needed Date Employee work areas adequately illuminated Employees not engaged in ergonomic hazards, e.g. awkward posture,

prolonged repetitive motion, contact stress, etc.

Employee work areas clean, orderly, and don’t present a hazard Employees not engaged in unsafe acts, e.g. using chairs as stepstools,

using multiple extension cords, etc.

Walking Surfaces

Aisles correctly established and clear No tripping hazards in evidence Floors dry - not slippery Cords not stretched across aisles or under carpets Entrance mats available and used in wet weather Carpet secure and free of tears, lumps, or loose pieces

Stairways, Aisles, Storage Rooms, Halls, Emergency Exits, Fire Extinguishers

Adequate lighting in stairways, aisles, and storage rooms Stairways clear - not cluttered Stair treads in good condition Handrails installed and in good condition Halls kept clear of equipment and supplies Emergency exit doors clearly marked and accessible All items stored at least 18 inches below sprinkler head Fire extinguishers accessible and fully charged

Bookcases, Shelves, Cabinets

Bookcases and shelves not overloaded Heavy storage shelves/bookcases secured to wall File drawers closed when not in use Heavier boxes stored at waist level and below

Electrical Safety, Chairs, Chemical Products, Step Stools, Ladders, Air Movement

Electrical outlets not overloaded Equipment properly grounded (3-pronged plugs) Electrical cords and plugs in good condition Extension cords not substituted for permanent wiring Chemical products properly used, stored, and labeled Paper cutter equipped with guard/blade spring

Functioning

Safe step stools and ladders properly used when needed Paper shredder guarded


ACCIDENT/EXPOSURE INVESTIGATION REPORT Date & Time of Accident: Location: Accident Description: Workers Involved: Preventive Action Recommendations: Corrective Actions Taken: Manager Responsible: Date Completed:


WORKER TRAINING AND INSTRUCTION RECORD

Worker’s Name Training Dates Type of Training Trainers


MINUTES OF SAFETY MEETING (Optional) Bank: Location: Date: Date previous meeting: Attendance: (Also list absentees who should have attended meeting) Minutes by: Date of next meeting: Minutes should serve as a record of important discussions relative to the control of losses and action taken or recommended to correct accident producing conditions. List under the following headings: 1. PREVIOUS RECOMMENDATIONS NOT ACTED UPON (list and indicate the reason

why, what to do now) 2. LOSSES SINCE LAST REPORT (list and indicate corrective action necessary) 3. OTHER ITEMS DISCUSSED (based on inspections, recommendations, etc.) 4. SUMMARY OF NEW RECOMMENDATIONS (indicate what is to be done, who is

responsible) 5. FUTURE PLANS (list items to be studied, reports to be made at next meeting, date,

etc.)


OFFICE EMPLOYEE SAFETY ORIENTATION NAME: DATE EMPLOYED:

DEPARTMENT ASSIGNED:

JOB ASSIGNMENT:

The following items should be discussed during orientation:

Bank safety policies and programs - employee to be given a copy of the Injury and Illness Prevention Program and be required to read it. Safety rules, both general and specific to job assignment. Safety rule enforcement policy (disciplinary procedures). Where, when, and how to report injuries. Where, when, and how to report unsafe conditions. Review of fire and emergency evacuation plan. Location and use of fire extinguishers. Requirements for safe work clothing and footwear, if applicable. Importance of housekeeping (spills, etc.). Special job hazards (chemicals, special precautions, etc.), if applicable. Assignment and use of personal protective equipment, if applicable. Proper lifting procedures (include demonstration).

Proper office ergonomics.

Employee is certified in the following: (i.e. CPR, First Aid, etc. If applicable)

SIGNED:

DATE:

Supervisor SIGNED:

DATE:

Employee


NON-OFFICE EMPLOYEE SAFETY ORIENTATION Employee Name Employee/Clock No.

Job Title New Hire Transfer/Change

Department Name Dept ID Shift

Date Orientation Started Supervisor

SECTION I - FACILITY DISCUSSION 1. Safety Bulletin Boards/Posters… 6. Storage of Hazardous Materials…

2. Exits, Stairs, and Signs… 7. Storage of Supplies/Materials…

3. Fire Extinguishing Eqmt/Alarm… 8. Disposal of Hazardous Materials…

4. First Aid Supplies/Room… 9. Disposal of Trash/Waste

5. Emergency Evacuation Procedures… 10. High Risk. Hazardous. Dangerous Areas…

Date Completed Supervisor’s Signature SECTION II - PERSONAL SAFETY DISCUSSION 1. Eye Glasses, Goggles, Face

Shields…

6. Protective Leggings, Aprons, Clothing…

2. Shoes/Boots 7. Respirators/Masks

3. Gloves 8. Decontamination Procedures

4. Ear Plugs/Muffs 9. Job Safety Analysis

5. Hard Hats, Hoods

Date Completed Supervisor’s Signature


SECTION III - TOOLS, MACHINES, AND EQUIPMENT INDOCTRINATION In addition to a thorough discussion of safety rules, regulations and practices, supervisors are required to conduct “hands on” demonstration(s) on the safe use of ALL power tools, machines and equipment to be used by the employee. The employee will give special instruction and emphasis on guards and safety devices and MANDATORY use of them. TOOL, MACHINE, OR

EQUIPMENT NAME NUMBER/

I.D. DATE SUPERVISOR’S

INTITIALS

1.

2.

3. Date Completed Supervisor’s Signature I have received demonstration(s) on the safe use of the tools, machines, and equipment listed above and I am aware that use of guards and safety devices is MANDATORY. I understand that I will be subject to discharge if I operate any tool, machine, or equipment with guard(s) or safety device(s) removed, disconnected, or otherwise made inoperable. Also, I understand that I will be subject to discharge if I attempt to operate any tool, machine, or equipment that is locked-out, tagged-out, being repaired, or is otherwise designated as “out-of-service.” Employee’s Signature Date

Documents

Injury and Illness Prevention Program · Non-Office Employee Orientation Form .....17-18 . This manual contains proprietary material of Insperityand is protected by copyright and