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Plan Of Action BWC-8006 - Ohio

Plan Of Action Form. This is a Ohio form and can be used in Employers Workers Comp .
 Fillable pdf Last Modified 1/20/2014
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10-Step Business Plan Plan of Action (POA) Policy number Employer DBA Street address City Employer printed name Employer signature Program period Telephone number ( ) E-mail address State Title Date ZIP code Briefly describe the product or service your business provides. How many full and part-time employees do you have in Ohio? (If seasonal, please indicate vs. non-seasonal) Full-time Seasonal Non-seasonal Part-time Seasonal Non-seasonal Temporary Seasonal Non-seasonal Leased employees Seasonal Non-seasonal BWC-8006 (Rev. 12/03/2009) UA-6 American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person a) Doing now b) Improvements to be made responsible Completion date Step 1 ­ Visible active senior management leadership a) Authorizing necessary resources for accident prevention POA Describe: b) Discussing safety processes and improvements regularly during staff or employee meetings c) Ensuring management is held accountable for accident-prevention activities and for managing accident prevention processes d) Annually assessing the success of the safety process by using surveys, personal interviews and/or behavior sampling e) Encouraging employees to take an active part in maintaining a safe workplace BWC assessment Step 1 Date Meets Below American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 2 ­ Employee involvement and recognition a) Safety and health involvement teams, focus groups, or safety and health committees Accident investigations analysis and assessment POA Describe: a) Doing now b) Improvements to be made b) c) Safety and health audits d) Acting as instructors for safety and health training programs Recognition opportunities can include: a) Recognizing employees for excellence in accident prevention; Recognizing employees for consistently high contribution to safety and health; Recognizing employees for their contributions to continuous improvement through participation in problem-solving, decision-making or perception surveys; b) c) d) Recognizing employees who suggest safety and health improvements or complete safety and health projects. BWC assessment Step 2 Date Meets Below American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 3 ­ Medical treatment and return to work practices a) Informing employees of procedures for obtaining medical treatment, including informing employees of the selected MCO POA Describe: a) Doing now b) Improvements to be made b) Immediate reporting of injuries and illnesses to a supervisor c) Regular communication with injured or ill employees who are off work d) Investigation of all injuries or illnesses within 24 hours to identify process and corrective measures e) When not prohibited by a labor agreement, a modified-duty or transitional work program that allows employees to return to work in a productive capacity during the recuperative period Date Meets Below BWC assessment Step 3 American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 4 ­ Communication a) Quarterly written and/or verbal feedback to all employees on their accident-prevention performance POA Describe: a) Doing now b) Improvements to be made b) A process for upward communication and downward communication throughout the organization, including obtaining and responding to employee suggestions c) Memos, bulletin boards, staff and general meetings d) Feedback should include the organization's overall safety and health performance BWC assessment Step 4 Date Meets Below American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 5 ­ Timely notification of claims a) Reports claims immediately to MCO POA Describe: a) Doing now b) Improvements to be made b) Verified MCO reports claim to BWC within 24 hours. BWC assessment Step 5 Date Meets Below American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 6 ­ Safety and health process coordination a) Helping management and employees identify accident prevention and safety and health training needs through perception surveys, interviews, behavior sampling or other similar methods Helping supervisors make changes or develop strategies that improve the organization's safety systems and processes Identifying and communicating new safety and health requirements POA Describe: a) Doing now b) Improvements to be made b) c) d) Compiling injury and illness-related records e) Tracking progress on safety and healthrelated projects f) Working with employees to optimize safe work practices BWC assessment Step 6 Date Meets Below American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 7 ­ Written orientation and training plan a) Company safety and health policy statement; POA Describe: a) Doing now b) Improvements to be made Safety and health written orientation and training plan will include: b) Employee responsibilities; c) Medical procedures, such as how and when to report injuries or illnesses; d) Actions to take in case of emergency; e) How to report unsafe practices and conditions; f) Return to work procedures. American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Safety and health training will include: a) Hazard communication; b) Bloodborne pathogens, if applicable; c) Specific job/task safe work practices and hazard recognition; d) Recordkeeping of employee training and sign-off of training. At a minimum, training must cover: a) Procedures for safe and efficient use of machinery and tools; b) Ergonomic risk factors, including the prevention of cumulative trauma disorders; c) Chemical hazards and how to prevent contact or exposure; d) If appropriate, procedures for lockout/ tagout, hot work permits and confinedspace entry. Date Meets Below BWC assessment Step 7 American LegalNet, Inc. www.FormsWorkFlow.com 10-Step Business Plan Plan of Action (POA) Employer Policy number Person responsible Completion date Step 8 ­ Written and communicated safe work practices a) General safe work pr
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