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Home | Sample Policies

Sample Policies and Forms

The forms and policies collected below are intended as samples. Review them with your employment law counsel to confirm that they are appropriate for your specific needs and situation. Used as a starting point, these can greatly reduce the cost of having an attorney draft documents from scratch for use in your organization.

Online Exclusive: Sample drug and alcohol policy
December 2015
New research published by Australia's Flinders University National Centre for Education and Training on Addiction (NCETA) has found that when employers have policies in place to address alcohol and other drug use, employees are significantly less likely to engage in risky drinking and drug-related behavior. . . . more »
Featured resource: ATV operator safety policy
August 2015
All-terrain vehicles (ATVs) are increasingly common in various industries. ATVs have different handling characteristics than other vehicles, though, and can be extremely dangerous if mishandled. In June, for example, a Madera farm worker was killed when he took a corner too quickly, struck a pole, and broke his neck. . . . more »
Online Exclusive: Sample protective footwear policy
COCA Online Exclusive July 2015
When your workers require specialty safety shoes, you must pay for them. When workers aren't required to wear specific safety footwear, you may still choose to defray some of the costs of their protective footwear. It's best to have a policy to inform your workers exactly what your safety footwear requirements are and how much of their footwear expense you'll cover. . . . more »
Featured resource: Electronic device safe use policy
April 2015
Our cell phones, tablets, and laptops have become essential parts of our jobs. We use them to store safety data sheets and safe work procedures, measure sound levels, keep in contact with remote workers, and perform many other business-related functions. But if we're not careful how and when we use them, these devices might create a hazard by distracting us from work at critical moments. . . . more »
Online Exclusive: Sample ergonomic injury prevention policy
COCA Online Exclusive January 2014
Ergonomic injuries are the most common nonfatal lost workday injury by an overwhelming margin. Of about 1.2 million nonfatal injuries recorded by the U.S. Bureau of Labor Statistics in 2012, 443,560 fell into this category. Most of these were repetitive stress injuries (a smaller number were slip-and-fall injuries). . . . more »
Online Exclusive: Sample policy for seasonal and communicable diseases
COCA Online Exclusive January 2012
Each year in the United States, as many as one in five people fall victim to seasonal influenza. Twenty million will suffer some form of gastroenteritis (stomach illness).And more than a billion cases of "the common cold" strike each year--that's more than two colds apiece. Peak season for all of these illnesses typically hits in January and February. . . . more »
Online Exclusive: Sample Policy for Employee Participation in Incident Investigations
COCA Online Exclusive June 2012
The U.S. Chemical Safety Board (CSB)--which investigates the root causes of catastrophic chemical incidents--recently released a new policy on employee participation in those investigations. Like many employers, the CSB already included employees in its incident investigations; the new policy is intended to assure uniformity and increase employee participation. . . . more »
Online Exclusive: Sample Voluntary Respirator Use Policy
COCA Online Exclusive May 2012
In many workplaces, hazards from air contaminants are not generally present at levels that require respiratory protection, so respirators are not part of the personal protective equipment regularly used. . . . more »
Online Exclusive: Sample Healthcare Worker Injury Prevention Policy
COCA Online Exclusive February 2012
California has adopted the Hospital Patient and Health Care Worker Injury Protection Act in Section 6403.5 of the Labor Code. The act covers the lifting, repositioning, and transfer of patients by healthcare workers in acute care hospitals. . . . more »
Online Exclusive: Sample Slip, Trip, and Fall Prevention Policy
COCA Online Exclusive February 2012
Slips, trips, and falls are the leading cause of lost-worktime injuries in California, so it makes sense for employers to have a policy in place to prevent these accidents. A formal policy that involves everyone in the organization in identifying and controlling slip, trip, and fall hazards can help you prevent these accidents. . . . more »
Featured Resource: Portable Fire Extinguisher Use Policy
August 2011
Many workplaces are equipped with portable fire extinguishers that can control small fires, preventing property damage and loss of life. However, General Industry Safety Orders Section 6151(g) prohibits workers from using fire extinguishers unless they have received training in their proper use. . . . more »
Sample Return-to-Work Policy
COCA Online Exclusive May 2011
When an employee has been away from work because of an injury or illness or is returning to work with new medical issues (for example, a veteran who has been injured on duty), you may need to provide accommodations to help the worker smoothly re-enter the workplace. The sample return-to-work policy below will help you provide the necessary assistance while complying with workers' compensation and disability rights laws. . . . more »
Online Exclusive: Sample Policy for Preventing Lead Exposures During Pregnancy and Breastfeeding
COCA Online Exclusive April 2011
Workers in more than 100 industries may be exposed to lead on the job. These exposures can be dangerous to adults—but they can be especially dangerous to pregnant or breastfeeding women an . . . more »
Sample Forklift Attachment and Modification Policy
COCA Online Exclusive July 2010
Adding attachments to or modifying the lifting apparatus on a forklift can create hazards if not done with care. Under this company's policy, the following must be done if any attachment is added to a forklift or modification made to the lifting apparatus: . . . more »
Cell Phone Policy
Updated May 2010
Cell Phone Policy This sample policy has been newly updated to reflect the latest technology changes, including texting

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more »
Sample Incident and Near Miss Reporting Policy
Updated May 2010
Sample Incident and Near Miss Reporting Policy In order to ensure a safe, healthful, and efficient work environment for our employees, the Company has established the following incident and near miss reporting policy as a condition of employment and continued employment

. . .
more »
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