Health And Safety Self Insured Group Funds Audit Worksheet {LIBC-225}

LIBC-225 - HEALTH & SAFETY SELF-INSURED GROUP FUND’S AUDIT WORKSHEET. This form issued by the Pennsylvania Department of Labor & Industry, Bureau of Workers’ Compensation is used to evaluate and document a self-insured group fund’s compliance with the state’s accident and illness prevention requirements. This form plays a critical role in ensuring that self-insured group funds are actively implementing, maintaining, and improving effective safety and health programs as mandated by Pennsylvania workers' compensation laws. The audit collects comprehensive information about the group fund, including general contact details, a description of the member businesses, and the number of members with certified workplace safety committees. It also requests the names and qualifications of individuals or organizations providing accident and illness prevention services. In addition to verifying the credentials of safety professionals, the worksheet assesses the structure and effectiveness of the fund’s accident and illness prevention services. This includes reviewing the fund’s policies, goals, employee involvement methods, reporting procedures, safety training, and standard operating procedures across various safety areas such as electrical safety, hazardous materials handling, machine safeguarding, and personal protective equipment. The audit also looks at services such as on-site surveys, analysis of injury trends, industrial hygiene evaluations, and consultations on hazard abatement. Another important part of the audit involves recordkeeping. The form asks for detailed records documenting when services were requested and delivered, the nature of the services, member responses to recommendations, and the overall effectiveness of the safety efforts. Additional supporting evidence, such as inspection reports, training documentation, and data on fund expenditures for safety services, is also required. www.FormsWorkflow.com