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Safety DR BC Security
Disaster Business Continuity
Security Policies Procedures
Job Descriptions

Safety Program TemplateSafety Program Template

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Effective management of worker safety and health protection is a decisive factor in reducing the extent and the severity of work-related injuries and illnesses. Effective management addresses all work-related hazards, including the potential hazards that could result from a change in work site conditions or practices. Additionally, it addresses hazards whether or not they are regulated by government standards.

The template has been updated to include electronic forms that can be Emailed, completed on a PC, iPad, tablet, or laptop, and filed electronically. A completely green process. The electronic forms include:

  • Area Safety Inspection Report
  • Employee Job Hazard Analysis Acknowledgement
  • First Report of Injury
  • Inspection Checklist Office Areas
  • Inspection Checklist Alternative Locations
  • New Employee Safety Checklist
  • Safety Program Responsibility Contact List
  • Training Record
You can either cut and paste the forms you need directly out of the MS WORD template or use the MS WORD files that contain the individual forms so they can be customized for your particular requirements. A sample of one of these forms is provided when you download the table of contents from the link above.

Revision History

The Safety Program Template addresses all of the issues associated with mandated safety requirements. This Safety Program can be used as a template for any size enterprise. 

The Safety Program template is 60 pages and includes everything needed to customize the Safety Program to fit your specific requirement.  The Safety was updated in January of 2010 and reflects the latest issues associated with the most recent legislation -- Sarbanes Oxley and OSHA.

The electronic document includes proven written text and examples for the following major sections of a disaster recovery plan:

  • Policy Statement
  • Safety Rules - including a check list of standard proven rules
  • Accident Investigation Process
  • Hazard Recognition and Control
  • Safety Committee including membership and procedures
  • Training including guidelines for orientation, job instruction, Supervisor training as well as specialized training
  • Communication including for management and employees
  • Record Keeping including inspection; accident investigation; training and coordination with Safety Committee.
  • Job Description for Safety Director (ADA compliant)
  • Technical Appendix including definition of necessary phone numbers and contact points; and sample forms:
    • First Report of Injury
    • Safety Audit Checklist
    • Alternate Work site Safety Checklist (i.e. work at home)

There is an extensive description that shows how a full test of the Safety Program can be conducted. 

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