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Drug-Free Safety Program - Safety Action Plan

Company name

Policy number

The purpose of an action plan is to help employers improve their safety and health processes. Review the results from the Safety Management Self-Assessment and identify and prioritize manageable action items that will generate the desired improvements. If you would like assistance completing this action plan or with developing or implementing any of the action plan activities, please call 1-800-644-6292 and request personal assistance from your assigned BWC representative.

For each section determine:

1.What actions (if any) you will take and how they will be accomplished?

2.Who will be responsible for ensuring the completion of each action item?

3.When will each planned action item be completed?

4.What is the expected improvement to your safety and health process once the action item is completed?

1.Management commitment –The level of commitment that management demonstrates to the safety and health process

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

2.Accountability –The process used to assign safety and health management responsibilities and to evaluate, recognize and reward performance

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

3.Employee participation –The extent the employees participate in and are encouraged to be involved in the safety and health of the workplace

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

BWC-1588 (Rev. Oct. 2, 2014)

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DFSP-5

4.Safety culture –The organizational values, management style, environment and social norms related to safety and health

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

5.Hazard prevention and control –The process to identify and correct unsafe acts and conditions

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

6.Safety and health training and education – The process of ensuring safety education and training is provided to people at all levels, and that skills are assessed to ensure understanding

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

7.Accident analysis – The method of gathering and analyzing accident information; determining root causes and identifying safety improvements to prevent future accidents

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

BWC-1588 (Rev. Oct. 2, 2014)

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DFSP-5

8.Workers’ compensation claims management –The management process for ensuring timely filing of claims, care for injured workers, and minimizing the financial impact of claims on the organization

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

9.Return-to-work practices –The management process for ensuring a safe, efficient return to work by injured workers to help reduce financial burdens on the employee and employer

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

10.Employee health promotion (wellness) – The organization’s efforts to encourage personal health improvement and health maintenance among its employees

Planned activity (attach separate sheet if needed)

Person responsible

Target date

Describe how this completed activity will improve your safety and health process

X

Signature of company official responsible for this action plan

Date submitted

BWC-1588 (Rev. Oct. 2, 2014)

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DFSP-5

Document Properties

Fact Name Description
Form Purpose The DFSP 5 form is designed to help employers create a Safety Action Plan aimed at improving workplace safety and health processes.
Management Commitment This section emphasizes the importance of management's involvement in the safety and health initiatives of the organization.
Accountability Process The form outlines how responsibilities for safety management are assigned and evaluated, promoting a culture of accountability.
Employee Participation Encouraging employee involvement is crucial for enhancing workplace safety. The form provides a framework for fostering this participation.
Governing Laws The DFSP 5 form is governed by Ohio Revised Code Section 4123.54, which relates to workplace safety programs.
Contact for Assistance Employers can call 1-800-644-6292 for help in completing the action plan or implementing its activities with their BWC representative.

Documents used along the form

The Ohio DFSP 5 form is an essential document for employers participating in the Drug-Free Safety Program. It outlines a safety action plan aimed at improving workplace safety and health processes. Several other forms and documents complement the DFSP 5 form, each serving a unique purpose in the safety management framework. Below is a list of these documents, along with a brief description of each.

  • Safety Management Self-Assessment: This document allows employers to evaluate their current safety practices and identify areas needing improvement. It serves as a foundation for creating the action plan.
  • Motorcycle Bill of Sale: This form is essential for transferring ownership of a motorcycle. For more information, visit https://documentonline.org/blank-california-motorcycle-bill-of-sale.
  • Accident Investigation Report: This report details the circumstances surrounding workplace accidents. It helps identify root causes and suggests preventive measures to avoid future incidents.
  • Employee Safety Training Records: This record tracks the safety training provided to employees. It ensures that all staff members are adequately trained and knowledgeable about safety protocols.
  • Workers’ Compensation Claim Form: Employers use this form to report workplace injuries and illnesses. Timely filing is crucial for ensuring that employees receive appropriate care and benefits.
  • Return-to-Work Program Document: This outlines the procedures for reintegrating injured employees back into the workplace. It focuses on creating a safe and supportive environment for recovery.
  • Safety Policy Manual: This comprehensive document outlines the organization’s safety policies, procedures, and responsibilities. It serves as a reference for employees and management alike.
  • Health Promotion Program Outline: This document details initiatives aimed at promoting employee health and wellness. It encourages healthy behaviors and preventive care among staff.
  • Emergency Action Plan: This plan outlines procedures to follow in case of emergencies, such as fires or natural disasters. It ensures that employees know how to respond effectively in critical situations.
  • Hazard Assessment Checklist: Employers use this checklist to identify potential hazards in the workplace. It helps prioritize safety improvements and implement necessary controls.
  • Safety Meeting Minutes: These records document discussions from safety meetings. They provide insights into ongoing safety concerns and the steps taken to address them.

Understanding these forms and documents can enhance the effectiveness of the safety action plan. Each one plays a vital role in fostering a culture of safety and ensuring that workplace health and safety standards are upheld.

Guidelines on Filling in Ohio Dfsp 5

Completing the Ohio Dfsp 5 form is an essential step in enhancing workplace safety and health. This form requires careful consideration and planning to ensure that the action plan is effective and meets the needs of the organization. Once the form is filled out, it will serve as a guiding document for implementing safety measures and improving overall workplace conditions.

  1. Obtain the Form: Download the Ohio Dfsp 5 form from the appropriate state website or request a copy from your local Bureau of Workers' Compensation office.
  2. Company Information: Fill in your company name and policy number at the top of the form.
  3. Management Commitment: Identify planned activities that demonstrate management's commitment to safety. Assign a responsible person and set a target date for completion. Describe how these activities will improve safety.
  4. Accountability: Outline the processes for assigning safety responsibilities. Specify planned activities, responsible individuals, target dates, and expected improvements.
  5. Employee Participation: Detail how employees will be involved in safety initiatives. Include planned activities, responsible persons, target dates, and the anticipated impact on safety.
  6. Safety Culture: Describe the organizational values and norms regarding safety. List planned activities, assign responsibility, set target dates, and explain how these will enhance safety culture.
  7. Hazard Prevention and Control: Identify processes for recognizing and correcting unsafe conditions. Document planned activities, responsible persons, target dates, and expected improvements.
  8. Safety and Health Training: Outline the training programs for employees at all levels. Include planned activities, responsible persons, target dates, and the expected impact on safety knowledge.
  9. Accident Analysis: Describe how accident information will be gathered and analyzed. List planned activities, responsible persons, target dates, and anticipated improvements.
  10. Workers’ Compensation Claims Management: Detail the management process for handling claims. Document planned activities, assign responsibility, set target dates, and describe expected improvements.
  11. Return-to-Work Practices: Explain the processes for facilitating a safe return to work for injured employees. Include planned activities, responsible persons, target dates, and expected outcomes.
  12. Employee Health Promotion: Describe initiatives to promote employee wellness. Document planned activities, assign responsibility, set target dates, and explain the expected benefits.
  13. Signature: Have the company official responsible for the action plan sign and date the form at the bottom.

Common mistakes

Completing the Ohio DFSP 5 form can be a straightforward process, but many people make common mistakes that can hinder the effectiveness of their safety action plans. One frequent error is failing to provide specific details about the planned activities. The form requires not just a general idea of what actions will be taken, but a clear outline of how these actions will be accomplished. Without this information, it becomes difficult to implement the plan effectively.

Another mistake often made is neglecting to identify who will be responsible for each action item. Assigning responsibility is crucial for accountability. When no one is designated to oversee the tasks, the likelihood of completion decreases significantly. This oversight can lead to confusion and delays in improving safety and health processes.

Additionally, many individuals overlook the importance of setting target dates for each action item. Without deadlines, it is easy for tasks to fall by the wayside. Target dates help ensure that actions are completed in a timely manner and provide a framework for evaluating progress. This lack of urgency can ultimately stall the entire safety improvement initiative.

Lastly, failing to articulate the expected improvements from each completed action can undermine the purpose of the action plan. It is essential to describe how each activity will enhance safety and health processes. This reflection not only motivates those involved but also provides a clear rationale for the actions taken. Without this insight, the plan may seem disconnected from the overall goals of the organization.

FAQ

  1. What is the purpose of the Ohio DFSP 5 form?

    The Ohio DFSP 5 form is designed to help employers create a Safety Action Plan. This plan aims to improve safety and health processes within the workplace. By reviewing the results from the Safety Management Self-Assessment, employers can identify and prioritize action items that will lead to meaningful improvements in safety.

  2. Who should complete the DFSP 5 form?

    The DFSP 5 form should be completed by employers or designated safety personnel within a company. It is essential that those responsible for workplace safety take the lead in developing the action plan to ensure it aligns with the company’s specific needs and goals.

  3. What are the key components of the action plan?

    The action plan includes several key components, such as:

    • Management commitment
    • Accountability
    • Employee participation
    • Safety culture
    • Hazard prevention and control
    • Safety and health training and education
    • Accident analysis
    • Workers’ compensation claims management
    • Return-to-work practices
    • Employee health promotion
  4. How do I determine the actions to take in the plan?

    To determine the actions, review the results from the Safety Management Self-Assessment. Identify areas that need improvement and prioritize manageable action items. For each action, specify how it will be accomplished, who is responsible, and when it will be completed.

  5. Can I get help with the DFSP 5 form?

    Yes, assistance is available. If you need help completing the action plan or implementing the activities, you can call 1-800-644-6292. Request personal assistance from your assigned BWC representative, who can guide you through the process.

  6. What should I include for each planned activity?

    For each planned activity, include the following:

    • A description of the activity
    • The person responsible for its completion
    • A target date for completion
    • An explanation of how this activity will improve safety and health processes
  7. What happens after I submit the DFSP 5 form?

    After submission, the action plan will be reviewed. Companies should begin implementing the planned activities as outlined in the form. Regular evaluations of the plan's effectiveness should also be conducted to ensure continuous improvement in safety and health processes.

  8. Is there a deadline for submitting the DFSP 5 form?

    While specific deadlines may vary, it is important to submit the DFSP 5 form as soon as possible after completing the Safety Management Self-Assessment. Timely submission helps ensure that safety improvements can be implemented without delay.

  9. How does the DFSP 5 form impact workers' compensation claims?

    By implementing the action plan outlined in the DFSP 5 form, employers can improve their safety processes. This, in turn, can lead to a reduction in workplace accidents and injuries, ultimately minimizing the financial impact of workers' compensation claims on the organization.

  10. What is the significance of management commitment in the action plan?

    Management commitment is crucial for the success of the action plan. It sets the tone for the entire organization, demonstrating that safety is a priority. When management is actively involved, employees are more likely to engage in safety practices and contribute to a positive safety culture.