Village Safety PolicyVillage of North Palm Beach, Florida
Administrative Policy
Title: Village Safety Policy
Adoption Date: January 23, 2007
Effective Date: January 23, 2007
Revision Date:
PURPOSE:
State and federal laws, as well as the Village of North Palm Beach's policy, make the safety and
health of our employees its top priority. Safety and health considerations must be a part of
every operation, and every employee's responsibility at all levels. It is the intent of Village of
North Palm Beach to comply with all laws concerning the operation of Village functions and the
health and safety of our employees and the public.
The safety program is organized in a committee system. The Village Manager shall appoint one
appropriate individual to serve as Safety Coordinator over all safety efforts. The Safety
Coordinator, however, is not responsible for line functions that are normally the responsibility of
Department Heads. It is expected that Department Heads will compliment the efforts of the
Safety Coordinator assuring realistic efforts will be taken to reduce accidents, injuries and
liability losses and to provide for the safety of the public. These efforts should be continuous
and equal in importance to all other operational considerations.
It is the objective of the Village of North Palm Beach to promote and operate a safety and health
program that will reduce the number of injuries and illnesses to an absolute minimum, not
merely in keeping with, but surpassing the best experience of similar operations by others. Our
goal is to always strive to have zero accidents and injuries reported.
II. POLICY STATEMENT: (MANAGEMENT COMMITMENT AND INVOLVEMENT)
The Village of North Palm Beach is committed to providing employees with a safe and healthful
workplace. It is the policy of this organization that employees report unsafe conditions and not
perform work tasks if the work is considered unsafe. Employees must report all accidents,
injuries, and unsafe conditions to their supervisors in writing. Failure to report an unsafe
condition shall result in disciplinary action.
Employee recommendations to improve safety and health conditions will be considered by the
Safety Committee. Recommendations for safety improvements from the Safety Committee will
be given top priority, as the correction of unsafe conditions is essential in maintaining a healthy
work environment.
Any employee who willfully or repeatedly violates workplace safety rules shall be subject to
disciplinary action. This action may include verbal or written reprimands and may ultimately
result in termination of employment.
The primary responsibility for the coordination, implementation, and maintenance of our
workplace safety program has been assigned to Village Safety Coordinator:
Name: Mary Kay McGann
Telephone: (561) 841-3358
Title: Human Resources Director Email: marykay@village-npb.org
Employees must notify their direct supervisor in writing of any unsafe conditions. Supervisors
will be actively involved with employees in establishing and maintaining an effective Safety
Program. Our Safety Committee, the Village Manager, or other members of our management
team will participate with employees in ongoing safety and health program activities, which
include:
• Providing safety and health education and training; and
• Reviewing and updating workplace safety policies and procedures.
This policy statement serves to express management's commitment to and involvement in
providing our employees a safe and healthful workplace. This workplace safety program will be
incorporated as the standard of practice for this organization. Compliance with the safety rules
will be required of all employees as a condition of employment.
III. POLICY INDEX /TABLE OF CONTENTS:
Section I -Purpose ........................................................................ Page....1
Section II -Policy Statement (Management Commitment and Involvement)..........1
Section III -Policy Index /Table of Contents ..................................................2
Section IV -Responsibilities .......................................................................3
Department Head ...........................................................................3
First Line Supervisor .......................................................................3
Employees ....................................................................................4
Section V -Safety Committee .....................................................................4
Safety Committee Organization .........................................................4
Responsibilities .............................................................................. 4
Communication .............................................................................. 5
Meetings .......................................................................................5
Response .....................................................................................5
Section VI -Safety and Health Training ........................................................5
Safety and Health Orientation ...........................................................5
Job-Specific Training ......................................................................5
Periodic Retraining of Employees ......................................................5
Section VII -First Aid Procedures ................................................................6
Emergency Phone Numbers .............................................................6
Minor First Aid Treatment .................................................................6
Non-Emergency Medical Treatment ...................................................6
Emergency Medical Treatment ..........................................................6
2
First Aid and CPR Training .......................................................... .....7
First Aid Instructions .................................................................. ......7
Section IIX -Accident Investigation Procedures ......................................... .....8
Section IX -Record-Keeping Procedures ................................................ ......8
Section X -Safety Policies and Procedures .............................................. .....8
Office Safety ............................................................................ .....9
Computers .............................................................................. ...... 9
Housekeeping .......................................................................... ......9
Fire Prevention ......................................................................... ....10
Material Handling ..................................................................... .....11
Personal Protective Equipment (PPE) ........................................... ....12
Hand Tools ............................................................................. .....13
Power Tools and Equipment ....................................................... .....14
Electrical Hazards ..................................................................... ....17
Public Utility Services: Line Locations ........................................... .....18
Ladders and Scaffolding ............................................................ .....19
Working in Confined Spaces ....................................................... ....19
Motor Vehicle and Mobile Equipment ........................................... .....20
Working in the Public Right-of-Ways ............................................ .....21
Chemical Hazards .................................................................... ....22
Vessel Operations .................................................................... .... 23
Employee Acknowledgement ............................................................... .....24
Forms Index ..................................................................................... .....25
Appendix A -Sample Safety Committee Agenda Outline ............................ .....26
Appendix B -Sample Safety Committee Minutes Outline ........................... .....27
Appendix C -Sample Safety Committee Recommendation Memorandum..... .....28
Appendix D -Accident Investigation Report ............................................ .....29
Appendix E -Instructions for Completing the Accident Investigation Report... .....31
Appendix F -Florida League of Cities' Property/Liability Loss Notice ............ .....32
Appendix G -Worker's Compensation Info Sheet .................................... ......33
Appendix H -Employee Injury Field Report ............................................. .....34
Appendix I - Bi-Weekly Log of Work-Related Injuries and Illnesses .............. .....35
Appendix J -Sample Safety Committee Employee Suggestion Form ........... .....36
IV. RESPONSIBILITIES:
A. Department Head
The department head shall be primarily responsible for the safe operation of his or her
department. The department head has regular contact with both first line supervisors and
employees in general. The department head must ensure the safety of each employee and the
efficient operation of the departmental functions.
B. First Line Supervisor
1. The first line supervisor has the primary responsibility for the implementation of definite
safety policies established by the Village's management.
2. See that the employee receives appropriate care as rapidly as possible.
3. Notify HR Department immediately that an injury occurred.
4. Complete Employee Injury Field Report (Appendix H) and Accident Investigation Report
(Appendix D) immediately or as soon as possible following completion of Steps 2 and 3..
5. Route the completed Employee Injury Field Report (Appendix H) and Accident
Investigation Report (Appendix D) forms to the Safety Coordinator (HR Department)
within twenty-four (24) hours of the accident (or at the start of the next business day if
the accident occurs over a weekend or holiday).
6. Ensure that corrective measures are taken to prevent a recurrence of the accident/injury.
C. Employees
Employees are expected to follow all safety procedures. This cooperation is needed to ensure
the protection of all employees, Village equipment, Village buildings, and the general public.
Employees are encouraged to detect and report to supervisors, any hazardous conditions,
practices, and behaviors, and to make suggestions for their correction in writing. Should an
injury occur the employee should:
1. Take immediate appropriate action to care for the injury, any injury.
2. Advise your supervisor immediately of any injury.
3. If medical attention by a physician is required, you must provide a signed release form
from the physician prior to reporting back to work.
4. The release to return to duty form should be forwarded to the HR Department.
5. It is your responsibility to keep your supervisor aware of pending follow-up doctor
visits/treatments and the progress of your recovery.
V. SAFETY COMMITTEE:
A. Safety Committee Organization
A safety committee has been established to recommend improvements to our Safety Program
and to identify corrective measures needed to eliminate or control recognized safety and health
hazards. The safety committee consists of the Safety Coordinator; at least one (1)
representative appointed by the Department Head from each of the following departments:
• Country Club,
• Parks and Recreation,
• Public Safety, and
• Public Works;
and up to two (2) alternates from the remaining departments:
• Community Development,
• Finance,
• Library, and
• Village Clerk
as recommended by the Safety Coordinator and approved by the Village Manager.
B. Responsibilities
The Safety Committee shall determine the schedule for evaluating the effectiveness of control
measures used to protect employees from safety and health hazards in the workplace.
The Safety Committee will be responsible for reviewing and updating workplace safety policies
and procedures based on accident investigation findings, any inspection findings, employee
reports of unsafe conditions or work practices, and accepting and addressing complaints and
suggestions from employees.
The Safety Committee will be responsible for assisting management in updating the workplace
safety program by evaluating employee injury and accident records, identifying trends and
patterns, and formulating corrective measures to prevent recurrence.
The Safety Committee will be responsible for assisting management in evaluating employee
accident and illness prevention programs, and promoting safety and health awareness and
coworker participation through continuous improvements to the Safety Program.
C. Communication
Within five (5) working days after each Safety Committee meeting, the Safety Coordinator shall
communicate to the Village Manager in writing those issues determined by the Safety
Committee to need further action. (A sample memo is attached as Appendix C.)
D. Meetinas
Safety Committee meetings shall be held at least quarterly. Meetings may be called as needed
at the discretion of the Safety Coordinator. The Safety Coordinator will distribute the minutes of
each meeting within one (1) week after the meeting.
E. Response
The Village Manager's response to any recommendation of the Safety Committee will be routed
to the appropriate Department Head(s) for response/action. The Department Head shall note
his/her actions taken and route the form to the Safety Coordinator for the appropriate record-
keeping.
VI. SAFETY AND HEALTH TRAINING:
A. Safety and Health Orientation
Workplace safety and health orientation begins on the first day of initial employment or job
transfer. Upon initial employment or job transfer, employees are required to acknowledge by
signature that they have received a copy of the Village Safety Policy and are bound by its
contents as a condition of employment. Each employee has access to a copy of this safety
manual, through his or her supervisor, for review and future reference. A personal copy of the
safety policies and procedures pertaining to his or her job will be provided if requested.
Supervisors will make themselves available to answer questions of employees and ensure
knowledge and understanding of safety policies and job specific procedures described in our
Workplace Safety Program Manual. Supervisors will inform all employees that compliance with
the safety policies and procedures described in the Workplace Safety Manual is required for
continued employment with the Village.
5
B. Job-Specific Training
Supervisors will carefully review with each employee the specific safety policies and procedures
that are applicable and that are described in this Village Safety Policy.
Supervisors will give employees verbal instructions and specific directions on how to perform
the work safely.
Supervisors will observe employees performing the work. If necessary, the supervisor will
provide a demonstration using safe work practices, or remedial instruction to correct training
deficiencies before an employee is permitted to do the work without supervision.
All employees will receive safe operating instructions on seldom-used or new equipment before
using the equipment.
Supervisors will review safe work practices with employees before permitting the performance
of new, non-routine, or specialized procedures.
C. Periodic Retraining of Employees
All employees will be retrained periodically on safety policies and procedures and when
changes are made to the workplace safety manual. Individual employees will be retrained after
the occurrence of awork-related injury caused by an unsafe act or work practice and when a
supervisor observes an employee displaying unsafe acts, practices, or behaviors.
VII. FIRST-AID PROCEDURES:
A. Emergency Phone Numbers
Police /Fire /Rescue 911
(561) 848-2525
Emergency
Non-emergency
Poison Control 1-800-222-1222
or (561) 650-6333
Safety Coordinator (561) 841-3358
HR Department (561) 882-1155
B. Minor First-Aid Treatment
(national toll-free #)
(local center)
(after hours calls will forward to cell phone)
First-aid kits are kept in every Village facility building (see your supervisor for specific locations)
and in every Village vehicle and vessel. If you sustain an injury or are involved in an accident
requiring minor first-aid treatment:
1. Inform your supervisor.
2. Administer first-aid treatment to the injury or wound.
3. Access to a first-aid kit is not intended to be a substitute for medical attention.
4. Provide details for the completion of the Employee Injury Field Report (Appendix H).
__. _ ._
C. Non-Emergency Medical Treatment
For non-emergency work-related injuries requiring professional medical assistance,
management must first authorize treatment. If you sustain an injury requiring treatment other
than first-aid:
1. Inform your supervisor immediately.
2. Proceed to the medical facility designated by the Village. Your supervisor will arrange
transportation if necessary.
3. Provide details for the completion of the Employee Injury Field Report (Appendix H) and
Accident Investigation Report (Appendix D).
D. Emergency Medical Treatment
If you sustain a severe injury requiring emergency treatment:
Call for help (911-Fire Rescue) and seek assistance from a co-worker.
Use the emergency telephone numbers and instructions posted in your work area to request
assistance and transportation to the local hospital emergency room.
Provide details for the completion of the Employee Injury Field Report (Appendix H) and
Accident Investigation Report (Appendix D).
E. First-Aid and CPR Training
Each employee will receive training and instructions on first-aid procedures. Re-certification is
required periodically.
F. First-Aid Instructions
In all cases requiring emergency medical treatment, immediately call, or have a co-worker call,
to request emergency medical assistance.
• W~unds~
o Minor: (cuts, lacerations, abrasions, or punctures)
Wash the wound using soap and water; rinse it well. Cover the wound using clean
dressing.
o Maior: (large, deep and bleeding)
Stop the bleeding by pressing directly on the wound, using a bandage or cloth. Keep
pressure on the wound until medical help arrives.
• Broken Bones:
Do not move the victim unless it is absolutely necessary. If the victim must be moved,
"splint" the injured area. Use a board, cardboard, or rolled newspaper as a splint.
7
Burns:
o Thermal: (Heat)
Rinse the burned area without scrubbing it, and immerse it in cold water for a maximum
of one (1) minute; do not use ice water. Blot the area dry and cover it using sterile
gauze or a clean cloth.
o Chemical:
If chemical is a dry substance, brush the chemical from skin surface prior to flushing;
flush the exposed area with cool water for 15 to 20 minutes.
Eye Iniury:
o Small particles:
Do not rub eyes. Use the corner of a soft clean cloth to draw particles out or hold
eyelids open and flush the eyes continuously with water using an eye wash station.
o Large or stuck particles:
If a particle is stuck in the eye, do not attempt to remove it. Cover both eyes with
bandage.
o Chemical:
Immediately irrigate the eyes and under the eyelids with water for 30 minutes.
Neck and Spine Iniury:
If the victim appears to have injured his or her neck or spine or is unable to move his or her
arm or leg, do not attempt to move the victim unless it is absolutely necessary.
Heat Exhaustion:
Loosen the victim's tight clothing. Give the victim sips of cool water. Make the victim lie
down in a cooler place with the feet raised.
VIII. ACCIDENT INVESTIGATION PROCEDURES:
The supervisor at the location where the accident occurred will perform an accident
investigation. The Department Head is responsible for seeing that the accident investigation
reports are being filled out completely, and that the form(s) is routed to the Safety Coordinator
(HR Department) within twenty-four (24) hours of the accident. Supervisors will investigate all
accidents, injuries and occupational diseases in their division using the following investigation
procedures:
1. Implement temporary control measures to prevent any further injuries to employees.
2. Review the equipment, operations and processes to gain an understanding of the
accident situation.
3. Identify and interview each witness and any other person who might provide clues to the
accident's cause.
4. Investigate causal conditions and unsafe acts; make conclusions based on existing
facts.
5. Complete the Accident Investigation Report (Appendix D).
6. Provide recommendations for corrective actions.
7. Indicate the need for additional or remedial safety training.
An accident investigation is not designed to find fault or place blame, but is an analysis of the
accident to determine causes that can be controlled or eliminated.
8
IX. RECORD-KEEPING PROCEDURES:
The Safety Coordinator will control and maintain all employee accident/injury records and Safety
Committee records. All safety-related records are to be maintained as appropriate under
Florida Statutes and include:
• Safety committee agendas, minutes, and correspondence,
• Supervisor's Accident Investigation Reports and supplements,
• Workers' Compensation Notice of Injury Reports DWC 1, and
• Bi-Weekly Log of Work-Related Injuries and Illnesses.
X. SAFETY POLICIES AND PROCEDURES:
The safety policies and procedures contained on these pages have been prepared to protect
you in your daily work. Employees are to follow these rules, review them often and use good
common sense in carrying out assigned duties.
OFFICE SAFETY
• Keep an eye open for loose or rough floor covering and report it to your supervisor.
• Exercise caution when approaching a door that can be pushed open towards you.
• Gently push doors open and slow down when coming to a blind corner.
• Walking hastily between desks will result in bruises and falls. Slow down and pay attention
to your movements.
• Electrical cords should not be placed near foot traffic; however, if this is necessary, an
approved cord cover must be utilized to minimize tripping hazards.
• All file, desk, and table drawers shall be kept closed when not in use. Close drawers
immediately after each use. Never open more than one file drawer at a time.
• Overloading the top drawer of unsecured file cabinets is dangerous. If unfamiliar with the
file cabinet, test the drawers and be careful not to pull them out too far if there is no locking
device on them.
• Furniture such as tables, desks, and chairs must be maintained in good condition and free
of sharp corners, projected edges, wobbly legs, etc. Notify your supervisor immediately of
any deficiencies.
• It is a hazard to tilt chairs or use them improperly. Avoid using chairs as a stepping stool as
they may fall over. Be sure the chair is behind you before you sit down.
• Never use chairs, desks, or other furniture as a makeshift ladder. Always use a step ladder
or safety step stool.
• Message spindles should not be used unless a suitable blunt cover protects the point and/or
the point is bent at a horizontal angle.
• Keep the blades of paper cutters closed when not in use. Keep fingers and hands clear of
blades when operating the paper cutter.
• Pencils are safest when carried point down in pockets.
• Scissors, paper cutters, glass, and razor blades can cause painful injuries. Report such
accidents at once to your supervisor and protect yourself from infection.
• Keep paper clips, thumbtacks, and pins in a secure place so as not to cause any
unnecessary wounds. Keep razor blades covered. Even a little scratch can get infected.
• Be sure equipment is grounded and that the cord is in good condition. If a machine gives
you a shock or starts smoking, UNPLUG IT, and immediately report it to your supervisor.
9
B. COMPUTERS
• In order to prevent repetitive eyestrain injuries make sure your monitor is directly in front of
you, with the top of the screen at eye level.
• Make sure your keyboard and mouse are low enough to allow you to relax your shoulders.
• Never rest your wrists on the desk, wrist pad or armrests while you are typing or using a
mouse to avoid strain on your wrist.
• To avoid eyestrain or computer vision syndrome, experts advise that you take a 1-minute
break every half-hour when working on a computer. During the break, you should look away
from the computer and focus on an object that is 15 feet or more away.
C. HOUSEKEEPING
• All work areas and storage facilities must be kept clean, neat and orderly. All aisles,
stairways, passageways, exits, and access ways to buildings shall be kept free from
obstructions at all times. All grease and water spills shall be removed from traffic areas at
once.
• Do not place supplies on top of lockers, hampers, boxes or other moveable containers at a
height where they are not visible from the floor. Store heavy items below shoulder level.
• When piling materials for storage, make sure the base is firm and level. Cross tie each
layer. Keep piles level and not stacked too high. Keep isles clean and with adequate space
to work in them.
• When storing materials suspended from racks or hooks, secure them from falling. Route any
walk ways a safe distance from beneath the suspended materials.
• When storing materials overhead on balconies, provide adequate toe boards to prevent
objects from rolling over the edge.
• Tools, equipment, machinery, and work areas are to be maintained in a clean and safe
manner. Defects and unsafe conditions shall be reported to your supervisor immediately.
• Return tools and equipment to their proper storage place when not in use.
• Lay out extension cords, air hoses, water hoses, ladders, pipes, tools, etc. in such a way as
to minimize tripping hazards or obstruction to traffic.
• Clean up spills immediately to avoid slipping hazards. In the event the removal cannot be
done immediately, the area must be appropriately guarded, signed, or roped off.
• Nail points and tie wires must not be left exposed when packing and unpacking boxes,
crates, and other storage packages. Nails are to be removed as soon as lumber is
disassembled.
• Sharp or pointed objects should be stored as to prevent persons from coming in contact with
the sharp edges or points. Place sharp objects into a sealed, labeled, sturdy container (i.e.
cardboard box) prior to disposal.
• All packing materials should be properly disposed of to prevent fires.
• Wastebaskets are to be emptied into approved containers.
• Oil and greasy rags shall be put into a designated metal container for that purpose.
• Adequate lighting in obscure areas shall be secured for the protection of both employees
and public. Notify your supervisor of areas with inadequate lighting.
D. FIRE PREVENTION
Fire equipment shall be prominently displayed, labeled for usage and kept clear for easy access
at all times.
10
All employees should know the location and type of fire extinguishers and how to use them.
After using an extinguisher, report its use immediately to your supervisor and or the facility
engineer, so a replacement may be obtained or the extinguisher recharged.
Different types of fires require different types of extinguishers. The following describes
extinguisher ratings and how they should be used:
"A" rating -fires involving wood, rubber, paper, cloth and plastics
"B" rating -fires involving flammable liquids, gases and greases such as motor oil, paint
thinner, gasoline, propane or natural gas.
"C" rating -fires involving live electrical equipment; prevents possible severe electrical
shock.
"D" rating -fires involving metals such as sodium and magnesium.
Oily rags and other flammable wastes shall be kept in covered, metal containers. Such debris
shall be removed as soon as possible and, in no case, shall be left unattended in a building
overnight.
Cleaning solvents that have flammable properties shall be kept in approved safety containers.
Each container shall be labeled as to its contents. Use of gasoline is prohibited for cleaning
floors or any parts of buildings.
Gasoline used in small quantities in shops for fueling engines under repairs, being tested or
adjusted, shall be handled and dispersed in the smaller (one gallon) approved metal safety
containers. Containers must be labeled as to their contents.
The fueling of any type of motorized equipment while the engine is running is prohibited. When
transferring flammable liquids, make sure the filler nozzle touches the equipment or can be filled
in order to guard against the build-up of static electrical charge.
Never fill a tank to its full capacity to allow room for expansion of the liquid.
No artificial light, except UL approved flashlights will be used near escaping gasoline or other
flammable vapors, or when entering an enclosure suspected of containing gas.
Exits shall not be locked (chained or otherwise) from the inside.
All City vehicles shall have a 2A513C, 2-1/2 Ib. fire extinguisher securely mounted in a
convenient location.
All fire extinguishers must be inspected and certified annually by an extinguisher company
licensed by the State of Florida. Each department shall have a designated person to inspect fire
extinguishers on a monthly basis. Discrepancies shall be reported to the supervisor who shall
be responsible for obtaining a replacement unit.
E. MATERIAL HANDLING
Accidents can be avoided by taking time to plan ahead, using mechanical equipment whenever
possible, and thinking about the proper way to do the task and the proper tools to use while
performing it.
11
4-STEP MANUAL LIFTING PROCESS
STEP I -Getting Ready
• Size up the load. If it is too heavy or bulky, play it safe -get help.
• Check the load over and remove any protruding materials such as nails, splinters, sharp
edges, or anything that could cause you to loose your grip such as oil or grease.
• Wear gloves if surface is rough.
• Be sure the path you take is clear from any obstacles.
STEP 2 -Picking it up
• Ensure firm footing and balance, and try to stand with
grip load firmly.
• If load is below waist, bend knees to get into position,
muscles tight and lift slowly with your legs.
• Lift object or load close to the body.
feet about shoulder width apart,
keep your back straight, stomach
STEP 3 -Carrying it carefully
• Be sure you can see where you are going; turn your body in the direction of your feet.
• Use extra care in tight places as not to smash hands and fingers.
STEP 4 -Putting it down
• If receiving surface is about waist high, use the surface edge to take part of the load, and
then push it forward.
• If you must lower the load to the floor or ground, bend your knees, keep back straight,
stomach muscles tight, and again use your legs.
Employees who are issued a back belt should be sure to use it properly. Your supervisor will
provide initial training at time of issuance and periodic retraining when necessary.
F. PERSONAL PROTECTIVE EQUIPMENT (PPE)
The variety of work operations performed by municipal employees involves potential industrial
hazards. The tasks performed range from custodial services to heavy construction activities.
Care should be taken by each employee to protect themselves and others from injury by
following these general rules:
1. Clothing:
a. The wearing of loose, flowing, or ragged clothing on or near moving machinery or
equipment is prohibited (i.e. long sleeves, shirt tails, etc.)
b. To avoid injuries, footwear should be in good condition. Wear appropriate footwear
required for the work being done. If you have any doubts about the appropriate type
of footwear necessary ask your supervisor.
c. Hair should be pulled back and secured on the head, so as not to get in the way,
especially around moving equipment.
d. Gas and oil soaked clothes are a serious hazard. Keep clothes oil free.
e. Safety vests shall be worn at all times when working on the right-of-way, roadways,
and areas of reduced visibility.
12
2. Head Protection:
Hard hats shall be worn in the following situations:
a. All personnel working on a site involving construction.
b. All personnel working with high voltage electrical equipment.
c. All personnel engaged in tree trimming or cutting operations.
d. All personnel engaged in inspections or supervision of the above activities.
e. Supervisors may designate additional areas where hardhat usage is required, as the
need arises.
3. Face and Eve Protection:
Hazards involving the possibility of injuries to the face and eyes exist with both indoor
and outdoor tasks. They range from dust, particles of steel, concrete, sand, and
splashes from corrosives and liquid chemicals. Safety glasses, goggles, or face shields
made of plastic or glass offer a vital protection when used properly. Dirty or scratched
lenses may provide another hazard from reduced visibility and should be cleaned or
replaced immediately.
All Village employees are expected to follow the below safety procedures
regarding face and eye protection.
a. Safety goggles or safety glasses should be worn when:
1) Grinding, cutting, milling, or drilling with power tools.
2) Using impact wrenches, compressed air tools and pressure washers.
3) Chipping, scraping, or scaling paint, rust, carbon, or other materials.
4) Using punches, chisels, or other impact tools.
5) Cutting or breaking glass.
6) Chipping or breaking concrete.
7) Soldering.
8) Cleaning dirt from vehicles, machinery, etc.
9) Sand blasting or air cleaning operations.
10) Using power woodworking machinery, both fixed and portable.
11) Tree trimming, brush cutting or stump removal.
12) Using any lawn mowing equipment (mowers, blowers, edgers, etc). A full
plastic face shield shall be worn when handling acids, caustics, and other
harmful dusts, liquids, or gases.
b. A proper face shield with lens or welders' lens shall be worn at all times during metal
cutting and welding operations. Warning signs shall be posted to warn others prior
to any welding operations. Additionally, welding screens shall be used if available.
c. A face shield should always be used with other eye protection such as goggles or
glasses.
4. Finger, Palm and Hand Protection
a. Do not wear rings, metal, bracelets, and other jewelry when working around
machinery. Jewelry increases the danger of electrical shock and can cause fingers
or hands to be badly injured.
13
b. Gloves should be worn when handling hot, cold, abrasive, caustic, infectious, or any
other hard to handle materials. Several types of gloves are available to employees;
be sure to choose gloves appropriate for the task at hand.
c. Any allergic reactions or rashes thought to have been caused by gloves shall be
reported at once.
G. HAND TOOLS
All employees are required to follow the safety procedures detailed below:
• Employees that are inexperienced in the use of a hand or power tool shall not use the tool
unless properly trained and supervised.
• Select the right tool for the job.
• Sharpen and carry all cutting tools with the sharp edge down.
• Check the handles of all tools for tightness and splinters prior to use.
• Check the head of each tool, such as hammers, chisels, punches, etc. If the tool needs to
be dressed, repair it prior to use or do not use it.
• Wear shatterproof glasses or goggles when using chisels, punches, and wedges.
• Use only properly insulated tools when working around electrical circuits or equipment.
• Avoid using metal measuring tapes, fabric containing woven metal strands, rope with wire
cord, or other tools and equipment that have conductive properties while around energized
electrical circuits or equipment.
• Return all tools to their proper place.
H. POWER TOOLS AND EQUIPMENT
Potential serious injuries can occur from the operation of both portable and stationary power
tools. All employees who use power tools or equipment must first be trained and display
adequate knowledge of safety operating procedures.
• General Safety Rules
o All power tools should be visibly inspected for damage, prior to each use (i.e. cords,
housings, blades, etc,).
o Make sure all machine guards are in proper place prior to operation.
o Install or repair equipment only if you are qualified. Unplug equipment prior to repairing
or making adjustments.
o Be sure equipment is properly grounded. Check all ground connections regularly for
tightness.
o Wear all proper protective equipment required for the job.
o Unplug power cords by pulling on the plug, not the cord.
o Work area should be clean, well lit, and dry.
o Do not carry tools by the cord.
Always be aware of your surroundings. Stay alert and safe!
1. Portable Power Tools
a. SAWS
1) Do not use dull or loose blades.
14
2) Do not overload the motor by pushing too hard or cutting material that is too
heavy.
3) Before cutting, inspect the material to be cut for nails or foreign objects.
4) Be sure you have firm footing and balance.
b. DRILLS
1) Select the correct drill bit for job and be sure that it is sharp.
2) Make sure the material being drilled is secured or clamped firmly.
3) Hold the drill firmly and at the correct angle. Don't force with all your
strength.
4) Always remove the bit from the drill when work is complete.
c. ROUTERS
1) Never start the router when the cutting edge of the bit is in contact with the
work.
2) Hold the router firmly, especially when starting.
3) When the cut is complete, turn off the motor. Do not lift the machine from the
work until the motor has come to a complete stop.
4) Always keep router base flat on work surface.
d. GRINDING WHEELS
1) Before use, make sure that wheels are firmly held on spindles and work rests
are tight.
2) Stand to one side while starting motor, until operating speed is reached. This
prevents injury if a defective wheel breaks apart.
3) Use light pressure when you start grinding, too much on a cold wheel may
cause failure.
e. PORTABLE SANDERS
1) Arrange cord so that it will not be damaged by the abrasive belt.
2) Keep both hands on the tool to ensure good control.
3) Hold onto sander when you plug it in.
4) Clean dust and debris from motor and lubricate regularly.
2. Stationary Power Tools
a. TABLE SAW
1) Never reach over the saw to push stock that has been sawed.
2) Stand slightly to one side, never in line with the saw.
3) To avoid 'kickback' (the greatest hazard of running a table saw):
- Never use a dull blade.
- Do not cut 'freehand" or attempt to rip badly warped wood.
- Use splinter guard.
- Do not drop wood on an unguarded saw.
15
b. RADIAL-ARM SAW
1) The saw and motor should always be returned to the rear of the table against
the column after a cut is made.
2) If the motor slows while cutting, it means it is overloaded. It can also mean
low voltage, bad blades or the material is being fed too fast.
3) Keep machine in good alignment and adjustment to prevent excessive
vibration.
c. JIG SAW
1) Be sure blade is secured tightly.
2) Handle material being cut with both hands and keep fingers away from blade.
3) When making curved cuts, do not push stock into blade. Turn stock on the
table until curve has been cut.
d. COMPRESSED AIR
1) The use of compressed air for cleaning purposes is prohibited.
2) Eye protection is required.
3) Be sure that the discharge end of air hose is securely fastened prior to
turning compressed air into the hose.
4) Always maintain a secure hold on any air-powered tool to prevent injury to
the operator or anyone nearby.
3. Grounds Maintenance Equipment
a. MOWERS
1) Wear employer prescribed Personal Protective Equipment (PPE), such as
eye/face protection, gloves, and hearing protection during mowing
operations.
2) Make sure all equipment is in good operating condition prior to use.
3) No mowing equipment will be left unattended with the motor running.
4) Visually inspect the area to be mowed. Remove or allow around hazards.
5) If a cutting unit strikes a solid object or vibrates abnormally, stop immediately,
turn off the engine, wait for all motion to stop and inspect for damage. Raise
the cutting decks when driving from one area to another.
6) Do not run the engine in a confined area without adequate ventilation.
7) Bystanders should be warned by the operator of the danger of flying objects.
Do not direct discharge towards bystanders.
8) Become familiar with the controls and know how to stop the engine quickly.
9) Keep all safety devices and decals in place, replace as needed.
10) Operator must keep feet and hands away from the undercarriage of the
mower.
11) Check safety switches daily.
12) No mowing equipment shall be operated without the manufactured safety
guards in place.
13) Do not touch engine, muffler, or exhaust pipe while engine is running.
14) Never refuel with engine running.
15) Use only approved gasoline containers.
16
16) Do not smoke while handling gasoline.
17) Do not use mowers in rainy weather.
b. CHAIN SAWS
1) When transporting a chain saw in a vehicle, keep the chain and the bar
covered with a guard. Secure the chain saw to prevent fuel spillage and
damage.
2) When transporting a chain saw by hand, stop the engine, grip the saw
handle, place the muffler at the side away from your body and position the
guide bar to the rear.
3) Always start a chain saw with a 10-inch or larger bar on the ground.
4) Do not place a chain saw on your knee when starting it.
5) Always use both hands to maintain control of the chain saw using only those
grip locations specified by the manufacturer.
6) When moving from tree to tree or cut to cut, activate the chain brake, remove
your finger from the trigger and keep the bar away from your body.
7) Do not operate a chain saw above your shoulder height.
8) Do not set a saw down while the blade is engaged.
9) Stop the engine and turn the switch to 'OFF' when the chain saw is to be left
unattended or refueled. Do not overfill the fuel tank.
10) Place cones and barricades in the area where you are performing chain saw
operations.
11) Choose an area for cut branches to fall before beginning work. Alert
coworkers by yelling 'timber' to notify them of falling branches
12) Disengage spark plug wire before attempting to remove jammed material
from blade.
c. EDGERS
1) Do not start an edger if the blade is touching the ground.
2) Operate the edger at full blade speed.
3) When edging along roads, stay as close to the curb as possible.
4) Wear your employer prescribed Personal Protective Equipment (PPE), such
as eye/face protection, gloves, breathing filters, and hearing protection.
5) Do not use the edger in rainy weather.
6) Do not use the edger if it has loose or worn blades, belts, or other parts. If
these conditions exist, tag the edger out of service and do not use it.
7) Visually inspect the area to be edged for possible hazards.
8) When working in close proximity to roadways, always wear a safety vest.
d. LINE TRIMMING /WEED EATER /BRUSH CUTTER
1) Before refueling the trimmer, remove it from your harness, place it on the
ground, and allow the engine to cool.
2) Wear employer prescribed Personal Protection Equipment (PPE), such as
eye/face protection, gloves, breathing filters, long pants and hearing
protection.
3) Only use grip locations as specified by the manufacturer as a handhold when
operating the unit; keep both hands on the unit during operations.
4) Visually inspect for and trim around hazards.
17
5) Do not perform trimming operations above 10 feet in height alone; a co-
worker must assist you.
6) When working in close proximity to roadways, always wear a safety vest.
e. BACKPACK BLOWERS
1) Do not use the blower to clean yourself.
2) Do not direct the blower toward bystanders.
I. ELECTRICAL HAZARDS
Where electrical equipment must be used in damp or wet locations, use low voltage equipment
and wear rubber boots and gloves.
Proper lockout/tagout procedures shall be followed when performing installation, repair,
maintenance, modification, or any other adjustments to power equipment where unexpected
energy surges or start-up of the equipment could harm employees.
Never attempt work in or near overhead lines, underground power lines or gas lines. Contact
the appropriate personnel prior to any work being performed.
In the event of a downed power line, stay away from the danger area, keep others away and
contact emergency services or the appropriate personnel equipped to do the repair work.
In case of contact with live wires, do not touch the victim. Call 911 immediately.
Control or fuse boxes should be kept closed at all times and should be labeled to indicate the
areas or machinery they operate.
Extension cords should not be run across aisles or through oil or water. Extension cords should
not be bound tightly as they become damaged and dangerous. Cords should be inspected for
kinks, worn insulation and exposed strands or wire before use. Dispose of and replace any
cords exhibiting wear.
When fuses blow continually, it is an indication of an overload or short. This condition should be
reported to your supervisor immediately.
Keep electrical equipment properly oiled and free of grease and dirt.
J. PUBLIC UTILITY SERVICES: LINE LOCATIONS
Public utilities are often installed in or near work sites. Because of this, good coordination
between the utility companies and the Village is imperative. Contact with or damage to other
utilities may affect the safety of the workers on the job, the safety of the general public, or may
cause interruption of essential utility services. To avoid these problems, line locations are
required prior to any digging, trenching, overhead or underground operations. Whenever
possible, the utility companies should be notified in time to schedule a walk through of the work
site to locate any utility at least 24-48 hours in advance.
18
Employees should be knowledgeable of the Uniform Color Code, as published by the Utility
Location and Coordination Council. Do not proceed until clarification is received if any doubt
exists as to the location of a utility.
A supervisor must follow the safety procedures detailed below BEFORE WORK IS
STARTED:
1. Check plans to see if any utility services are located in or adjacent to the work.
2. Contact other utility agencies and coordinate line locations.
3. Make a personal inspection of the job site to identify what signs, post markers, overhead
electrical lines, etc., may be seen and make this information known to all affected
employees.
4. Have all utility agencies' emergency phone numbers at the job site area, so that an
immediate report can be made if accidental contact is made.
IF ACCIDENTAL CONTACT IS MADE:
1. Call 911 for emergency medical/fire/rescue services.
2. Report incident to the affected utility service and to your supervisor.
3. Secure the area and re-route traffic, if necessary, until situation is cleared or until
relieved by the proper authorities.
K. LADDERS AND SCAFFOLDING
The following procedures will prevent accidents and possible injury relating to ladders and
scaffolding:
1. Ladders
a. Metal ladders shall not be used in the vicinity of electrical circuits.
b. Inspect for defects before using. Keep rungs clean and free of grease and oil.
c. Ladders should not be placed against a window sash.
d. Straight ladders form a triangle when placed against a wall or object for climbing.
When properly placed, the bottom side of the triangle should be about one fourth as
long as the vertical, (i.e. if the ladder is leaned against the wall eight feet high, the
feet should be set two feet from the wall.)
e. When using a straight ladder, it should be long enough to extend at least three rungs
above the level to which the user is climbing. Step-ladders are not designed to be
used as straight ladders.
f. If the bottom of a ladder is placed on an insecure surface, secure the ladder in a
position by the use of hooks, ropes, spikes, cleats or other anti-slip devices, or by
stationing an employee at the ladder base to hold it in position during use.
g. Never stand on the top step of a ladder to work.
h. Only one person should be on a ladder at a time.
i. If it is necessary to place a ladder near a door or where there is potential traffic, set
up warning signals, or take other precautions to prevent accidental contacts which
might upset the ladder.
19
2. Scaffolding
a. Planks and other materials used in building scaffolding must be sound and free from
knots. Keep planks in good condition with a spar varnish (never use paint on
planks).
b. Planking should be adequately cleated; the scaffolding over ten feet high should
have toe boards, mid-rails and handrails.
c. Be sure staging is on a sound base.
d. Loose tools on top of scaffolding are liable to fall and injure someone. Keep tools in
a bucket or box secured on the scaffolding.
L. WORKING IN CONFINED SPACES
The Occupational Safety and Health Administration (OSHA) confined space standard defines a
confined space as a space that is large enough for an employee to enter, has restricted means
of entry or exit, and is not designed for continuous employee occupancy. Examples of confined
spaces are storage tanks and bins, ducts, tunnels, sewers, manholes and wet wells. The most
common confined space areas for Village employees will be sewers, manholes and wet wells.
Specific confined space hazards include physical hazards (mechanical equipment, temperature,
sound, collapse, entrapment, etc.), oxygen deficiency (identified as the primary hazard),
combustibility (fire and explosion), and toxic air contaminants. The presence of any one or
combination of these hazards constitutes a Permit Required Confined Space (PRCS). Before
entry into a PRCS, a written permit must be obtained according to the Confined Space
Operating and Rescue Procedures Plan.
• General Safety Procedures
o Before entering confined spaces, test for oxygen and explosive/toxic vapors and gases.
o Venting of hazardous atmospheres shall be accomplished before entering, whenever
possible.
o Maintain adequate ventilation while working.
o When using portable blowers to ventilate, make sure the air intake will not pick up
carbon monoxide fumes from the engine.
o Adequate respiratory equipment shall be available for use, if necessary, and all potential
users shall be instructed in the proper use of such equipment.
o No employees shall enter a manhole sewer, tank, or other underground confined space
without a safety belt or harness and an attached lifeline, tended by another employee at
the point of entry.
o Use barricades and warning signs to protect pedestrian traffic and to alert vehicle traffic
to the hazard when opening manholes in streets.
o Never allow exits to be blocked.
o Ladders shall be used when entering manholes, when there is any doubt about the
safety of manhole steps.
o Only lights approved and provided by the Village shall be used in manholes on areas
where explosive vapors or gases may exist.
M. MOTOR VEHICLE & MOBILE EQUIPMENT
Village vehicles are easily identified and, therefore, constitute a traveling advertisement seen by
many citizens. We exercise an important influence upon good or bad public relations through
20
our relationship with other motorists. By utilizing courteous, considerate, and safe driving
habits, we shall build good public relations as well as avoid needless accidents.
• General Safety Procedures (Motor Vehicles):
o Employees will not ride in the back of a truck; they shall sit in seats constructed for that
purpose.
o All employees shall be responsible for a safety check EACH DAY of any vehicle or
mobile equipment he/she is assigned to drive. Safety checks shall be documented on
the appropriate form provided by the department.
o Supervisors shall be notified immediately of any necessary repairs needed.
o Position all adjustments for safe driving before starting vehicle (i.e., seat, mirrors, etc.).
o Drivers of Village vehicles must possess a valid Florida driver's license and they must be
thoroughly familiar with state and local regulations governing motor vehicle operation.
o All slow moving equipment operated in public right-of-ways shall be equipped with a
triangular shaped reflecting sign and flashing lights in accordance with Florida Motor
Vehicle Code.
o Be sure all loads are secured prior to movement of vehicle.
o Never take drugs or strong medication before operating ~ vehicle. Remember that
drugs, illnesses or extreme fatigue may affect your ability to judge distances, speed, and
driving conditions.
o Supervisors are responsible for ensuring that employees are utilizing seat belts. Failure
to utilize the seat belts may result in disciplinary action.
o No more than three (3) persons shall be permitted to ride in the front seat of any vehicle
at one time.
o Never leave the vehicle unattended with the motor running.
o Stay within posted speed limits. Slow down when conditions warrant.
o Be particularly cautious and alert while driving around children.
o Do not assume the right-of-way.
o Avoid tailgating. Keep a safe distance behind other vehicles and slow down or stop to
let tailgaters pass.
o Turn on low beam headlights during rainstorms and fog.
o When refueling, shut off motor and do not smoke.
• Motor Vehicle Accident Procedures:
o Obtain first aid or medical treatment, if required.
o Notify the Police Department of the jurisdiction where accident occurred immediately,
and request an investigation at the scene. Notify Supervisor as soon as practical.
o Exchange names, driver's license numbers and vehicle numbers with the other persons
involved. Offer no information regarding the responsibility for the accident or what
should have been done to avoid the accident.
1. Aerial Platforms and Baskets:
a. Exercise extreme care when operating this type of equipment near overhead power
lines.
b. Only those employees who are trained and well versed in this type of equipment
operation shall be allowed to perform these operations.
c. Vehicle must remain parked while platform or basket is raised.
d. When outriggers are part of the vehicle's equipment, use them.
21
e. Strategically place appropriate warning devices to warn on-coming traffic while
working in or near roadways.
N. WORKING IN THE PUBLIC RIGHT-OF-WAYS
Municipal employees are often required to work in or along public roads and right-of-ways,
normally used for vehicle or pedestrian traffic to repair utility services, or perform tree trimming,
or landscaping tasks, and other maintenance activities. It is desirable that, whenever possible,
some continued flow of traffic be maintained with the least possible interference with normal
traffic patterns.
The following are general guidelines to be followed when working in these situations:
Notify all appropriate agencies prior to partial or full closure of a road as necessary,
Wear employer prescribed Personal Protective Equipment (PPE) such as a safety vest, hard
hat, safety shoes, gloves, etc.,
Individuals working in roadways and right-of-ways must be properly trained in current traffic
control practices, and
The Traffic Control and Work Zone Safety Plan shall serve as the standard for all related
activities and should be referred to often.
O. CHEMICAL HAZARDS
• General Safety Policies:
o Never eat, drink, or smoke around chemicals in the work area.
o Keep flammable and explosive material away from any heat sources.
o Make sure there is enough ventilation in the work area. If you feel the slightest amount
of dizziness or nausea, report the incident immediately to your supervisor.
o Use the proper personal protective equipment. This may include gloves, safety glasses,
masks, respirators, and work clothes depending on the type of chemicals you are using.
o Know how to properly dispose of all contaminated materials.
o Always use established procedures for handling, storing or transporting hazardous
chemicals.
Special care should be taken when mixing chemicals or loading chemical application devices as
most injuries occur at that time.
P. VESSEL OPERATIONS
Village vessels provide visible security for the residents and visitors to the island. Their function
is vital for this protection. Like our motor vehicles, vessel operations have an important
influence upon both good and bad relations through our contacts with other boaters. By utilizing
courteous, considerate and safe boating habits, we will maintain good public relationships and
reduce and avoid potential boating accidents.
• General Safety Procedures (vessels)
o All employees, prior to exiting the Village docks, will conduct a general safety inspection
of the vessel.
22
o Supervisors will be notified immediately of any necessary safety issues or necessary
repairs.
o Make sure all loose items are secured. Especially the overhead storage compartments.
o Never operate the vessel if you are on any strong prescribed medications. Operating
under some medicines can affect judgment.
o Do not overload the vessel with occupants. Always have an equal number of life vests
(PFD's) for the number of occupants.
o Never leave the vessel unattended while engines are running.
o During general/routine patrol, follow all boating laws.
o When refueling, shut engines off and do not allow anyone nearby to smoke.
o When practical while docking, utilize bumpers. Secure towlines to permanent fixed
objects (cleats, pylons, etc.)
o Know the direction of the wind, current and your proximity to objects that can cause
damage to the vessel. Example: taking a vessel stop near seawalls, bridges, pylons,
jetties and sandbars.
o When traveling outside the Intra-coastal waterway (ICW), operators should don their
personal floatation devices (PFD) and attach the suicide lanyard around their wrist.
o When the operator is utilizing excessive speed, the suicide lanyard should be wom.
o Only approved footwear should be worn by vessel operators. If civilians are being
escorted, it is recommended when practical to have them remove their shoes if the
shoes are not slip or skid resistant, i.e. spiked heals or sandals.
o While operating vessels at night, navigational lights should be in operation. Note, for
covert reasons it may be necessary to run blacked out. Extreme caution should be
utilized.
Approv~i by:
/~3~c~~
~y't~night U ~ Date
m Village Manager
23
Village of North Palm Beach
Village Safety Policy
Employee Acknowledgement
I acknowledge that I,
received a copy of the Village of
(Print employee name)
North Palm Beach Safety Policy which specifically outlines established guidelines and proper
procedures for all employees related to the Village's safety and health program.
I also acknowledge and understand the Village's philosophy regarding workplace safety and
health considerations, and that it is every employee's responsibility at all levels.
I understand that it is my responsibility to follow the procedures outlined in the manual on
workplace safety and to report any instances I may observe where a potential safety issue or
risk occurs or is observed, to higher management in my department, to the Department of
Human Resources, or to the Village Manager. I further understand the Village of North Palm
Beach has provided the Safety Policy to enhance my knowledge and perception of "workplace
safety" in order to promote a safe working environment and health conditions.
I further state that I have read the foregoing acknowledgement and know the contents thereof
and agree to abide by same as a condition of my employment with and during the daily
execution of my duties at the Village of North Palm Beach.
Employee Signature
Position Title
Date
Department or Division
24
FORMS INDEX
Form Descri tion of Use Pa a No.
Safety Committee Agenda Sample of agenda format for Safety Committee meetings. 26
Outline
Safety Committee Minutes Sample of minutes format for Safety Committee meetings. 27
Outline
Safety Committee The Safety Committee is responsible for providing
Recommendation recommendations to the Village Manager regarding safety- 28
related issues.
Accident Investigation Report An investigation procedure that supervisors will use to
(with instructions for investigate all accident, injuries and occupational diseases, and 29-31
completing the Accident submit to the Safety Coordinator within 24 hours of the incident
Investi ation Re ort in uestion.
A property loss /liability report for insurance, to be completed
Florida League of Cities by the employee and/or supervisor in the event of damage,
Property /Liability Loss loss, or other liability to Village-owned property that occurs with 32
Notice an injury or illness, and submitted to the Finance Department as
soon as ossible after.
Worker's Compensation Outlines procedures to follow for employees injured on the job,
Information Sheet telephone number to call, information to provide and medical 33
facilities and roviders for emer enc treatment.
An accident/injury record for workers' compensation, to be
Employee Injury Field Report completed by the employee and/or supervisor in the event of an 34
injury or illness, and submitted to the Human Resources
Department as soon as ossible after.
Logs and records detailed information about every work-related
death, injury or illness that involves loss of consciousness,
Bi-Weekly Log of Work- restricted work activity or job transfer, hours or days away from 35
Related Injuries and Illnesses work, medical treatment beyond first aid and significant work-
related injuries and illness that are diagnosed by a physician or
licensed health care rofessional
Safety Committee Employee Used by employees to share safety ideas for the Village by 36
Suggestion Form submittn the form outlinin the idea to the Safet Committee.
25
Appendix A
(SAMPLE SAFETY COMMITTEE AGENDA OUTLINE)
Village of North Palm Beach
Safety Committee Meeting Agenda
Committee Meeting DATE
Committee Meeting TIME
1. Call to Order
2. ROLL CALL
3. APPROVAL OF MINUTES
a. Dates of previous meetings for which minutes are to be reviewed /approved
4. SAFETY COORDINATOR'S REPORT
5. OLD BUSINESS (Previous action items)
6. NEW BUSINESS (Review of accidents since previous meeting)
a. Briefly list all "CASES" /INCIDENTS
b. Then list all RECOMMENDATIONS for: (in same format as above)
- ACCIDENT PREVENTION
- SAFETY PROGRAM UPDATES
- SAFETY TRAINING IMPROVEMENTS /ADDITIONS
- SUGGESTIONS FROM EMPLOYEES
7. Q & A /COMMENTS
8. ADJOURNMENT
26
Appendix B
(SAMPLE SAFETY COMMITTEE MINUTES OUTLINE)
Village of North Palm Beach
Safety Committee Meeting Minutes
Committee Meeting DATE
Committee Meeting TIME
ROLLCALL (Committee Members in Attendance)
APPROVAL OF MINUTES from previous Safety Committee meeting(s)
SAFETY COORDINATOR'S REPORT
OLD BUSINESS (Previous Action Items)
NEW BUSINESS
REVIEW OF "CASES" /ACCIDENTS since Previous Meeting
RECOMMENDATIONS for:
o ACCIDENT PREVENTION
o SAFETY PROGRAM UPDATES
o SAFETY TRAINING IMPROVEMENTS /ADDITIONS
SUGGESTIONS FROM EMPLOYEES
Q & A /COMMENTS
ADJOURNMENT
MINUTES PREPARED BY
27
Village of North Palm Beach Appendix C
MEMORANDUM
TO: Mark Bates, Village Manager
FROM: Safety Committee
BY: Mary Kay McGann, Human Resources Director /Safety Coordinator
DATE:
RE: Safety Committee Recommendation(s)
The Safety Committee is recommending the following action(s) and forwarding to you for your review /
approval.
SAFETY CONCERN(S):
SUGGESTED IMPROVEMENT(S) /ACTION(S):
ESTIMATED COST: $
SAFETY COORDINATOR'S COMMENTS AND RECOMMENDATIONS:
VILLAGE MANAGER USE ONLY
^ APPROVAL ^ DISAPPROVAL
ADDITIONAL COMMENTS (AS NEEDED):
VILLAGE MANAGER SIGNATURE
DATE
ROUTE DOCUMENT TO:
RESPONSE /ACTION TAKEN BY DEPARTMENT:
DEPTARTMENT HEAD SIGNATURE DATE
ROUTE DOCUMENT BACK TO SAFETY COORD/NA TOR (HR DEPT.) FOR RECORD-KEEPING.
28
Appendix D
Village of North Palm Beach
ACCIDENT INVESTIGATION REPORT
To be completed by Supervisor on-scene or HR
(NOTE: ATTACH COPY OF POLICE REPORT FOR VEHICULAR ACCIDENT)
Report #
1. Name of injured employee:
2. Sex: [ ] M [ ] F Age:
3. Time of accident:
4. Employee's job title:
(HR use only]
S.S. #
Date of Accident:
a.m. p.m. Day of accident:
5. Length of experience on job:
6. Address of location where accident occurred:
(years)
(months)
7. Nature of injury, Injury type, and part of the body affected:
8. Describe the accident and how it occurred:
9. Cause of accident (briefly):
10. Was personal protective equipment required? [ ]yes [ ] no Was it provided? [ ]yes [ ] no Was it being
used? [ ]yes [ ] no if "no", explain:
11. Witness(es) -name and contact information:
12. Safety training provided to the injured? [ ]yes [ ] no if "no", explain:
29
Appendix D
13. Interim corrective actions taken to prevent recurrence:
14. Recommended permanent corrective action to prevent recurrence:
15. Date of report
17. Name of person completing form:
16. Employee Signature:
18. Signature of person completing form:
19. Status and follow-up action taken by safety coordinator:
20. Safety Coordinator (signature):
21. Date:
See instructions for guidance in completing this form. Return completed forms within 24-hours to:
Village of North Palm Beach
c/o Human Resources Department
501 US Highway 1
North Palm Beach, FL 33408
Ph. 882-1155 /Fax 848-3344
30
Appendix E
Village of North Palm Beach
INSTRUCTIONS FOR COMPLETING THE ACCIDENT INVESTIGATION REPORT
An accident investigation is not designed to find fault or place blame but is an analysis of the accident to
determine causes that can be controlled or eliminated.
(Items 1-6) Identification This section is self-explanatory
(Item 7) Nature of Injury Describe the injury, e.g. strain, sprain, cut, burn fracture
Injury Type First Aid -injury resulting in minor injury/treated on premises
Medical -injury treated off premises by physicians
No injury - no injury, near miss type of accident
Part of Body Be specific and be sure to indicate right or left side, if necessary
(Item 8) Describe the accident Describe the accident, including exactly what happened, and where
and how it happened. Describe the equipment or materials involved.
(Item 9) Cause of accident Describe all conditions or acts which contributed to the accident, i.e.
(a) unsafe conditions -spills, grease on the floor, poor housekeeping
or other physical conditions
(b) unsafe acts -unsafe work practices such as failure to warn,
failure to use required personal protective equipment
(Item 10) Personal Protective Equipment (PPE) Self -explanatory
(Item 11) Witness(es) List name(s), address(es), and phone number(s)
(Item 12) Safety training provided Was any safety training provided to the injured related to the
work activity being performed?
(Item 13) Interim corrective action Measures taken by supervisor to prevent recurrence of
incident, i.e., barricading area, posting warning signs, shutting down operations
(Item 14) Permanent corrective action Self -explanatory
(Items 15 - 18) Signatures and Dates This section is self-explanatory
(Item 19) Follow up Once the investigation is complete, the safety coordinator shall review
and follow-up the investigation to ensure that corrective actions recommended by the safety committee and
approved by the Village are taken, and control measures have been implemented.
(Item 20) Safety Coordinator Signature Self -explanatory
31
Appendix F
Florida League of Cities Public Risk Services
PROPERTY/LIABILITY LOSS NOTICE DATE:
MEMBER: Village of North Palm Beach DATE OF LOSS: (MM/DD/YY)
FMIT #: 0955 TIME OF LOSS: AM ^ PM ^
PERSON TO CONTACT:
PHONE: EXT: PREVIOUSLY REPORTED: YES
REPORTED BY: ^ NO ^
Rllll I~INC~_ G(~NTFNTS (7R INI ~4N1~ M~4RINF I (ASS
LOCATION OF LOSS:
LOCATION NUMBER ON POLICY:
KIND OF LOSS (Fire, Theft, etc.): POLICE OR FIRE DEPT. REPORTED TO:
CASE NUMBER:
PROBABLE AMOUNT ENTIRE LOSS: $
DESCRIPTION OF LOSS & DAMAGE, 1F SCHEDULED EQUIPMENT, PLEASE LIST ITEM NUMBER:
AUTO AND GENERAL LIABILITY LOSS
PR(1PG'RTV iIA MAGF-('1 AiMANT
DESCRIBE PROPERTY (if auto, year, make, model, plate no.): POLICE OR FIRE DEPT. REPORTED TO:
CASE NUMBER:
OWNER'S NAME AND ADDRESS: BUSINESS PHONE (A/C, no., ext.): RESIDENCE PHONE (A/C, no.):
OTHER DRIVER'S NAME & ADDRESS (Check if same as owner) BUSINESS PHONE (A/C, no., ext.): RESIDENCE PHONE (A/C, no.):
DESCRIBE DAMAGE: ESTIMATE AMOUNT:
$ WHERE CAN VEHICLE BE SEEN?
IN_IIiR F.II PA RTIF.C (Total t! 1 Aleace nce cenaraTe lictino if mnrP than two
NAME & ADDRESS
PHONE (A/C, No.)
PEDESTRIAN INSURED
VEHICLE OTHER
VEHICLE
AGE EXTENT
OF INJURY
WITNESS OR PASSENGERS (Ibtal # )Please use separate listing if more than two.
INSURED OTHER
NAME & ADDRESS PHONE (A/C, No.) VEHICLE VEHICLE OTHER (Specify)
PROPERTY DAMAGE -MEMBER VEHICLE
VEHICLE NUMBER, YEAR, MAKE, MODEL: V.LN. (Vehicle Identification Number): LICENSE NUMBER:
DRIVER'S NAME AND ADDRESS: BUSINESS PHONE (A/C, no., ext.):
RELATION TO MEMBER DRIVER'S LICENSE
(Employee, Spouse, Etc.): DATE O F BIRTH:
NUMBER: PURPOSE OF USE:
USED WITH PERMISSION?
YES ^ NO ^
DESCRIBE DAMAGE: ESTIMATED AMOUNT: WHERE CAN VEHICLE BE SEEN?
$ WHEN?
r~LC Claims Center-Property ~ Liability
125 East Colonial Drive / P.O. Box 538135 /Orlando, FL 32853-8135
407-425-9142 - 800-756-3042 -Fax 407-425-9378
32
Appendix G
Village of North Palm Beach
WORKER'S COMPENSATION INFO SHEET
Effective 10/1 /2006 9/30/2007
Policy Holder: Florida Municipal Insurance Trust (FMIT)
Policy # 0955
Policy Administrator: Florida League of Cities (FLC)
Normal business hours: 9 a.m. - 5 p.m.
Phone Number: 1-800-445-6248
Director of W/C Claims: Crosby Coleman x 1752
Managed Care Supervisor: Linda Smith x 1781
Claims Supervisor: Wilma Mosley x 1820
W/C Case Managers/Adju sters: Phone Number: 1-800-756-3042
Fax Number: 1-800-707-7656
Michael Coefield x 1791 medical only
Maria Valenzuela x 1783 medical only
Doris Candelaria x 1757 lost time adjuster
Beverly Boesch x 1739 nurse case manager
Billing Information:
FLORIDA LEAGUE OF CITIES
P.O. BOX 538135
ORLANDO, FL 32853-8135
When an on-the job injury occurs:
• If it is alife-threatening emergency, dia1911
• If it is NOT alife-threatening emergency, report the injury to the Supervisor then HR Dept.
• In either situation, CALL TOLL-FREE 24-hours a day, 365 days a year:
1-877-676-3890
o To report the injury
o To receive first aid information
o To receive authorization for treatment
The law requires that all on-the job deaths or accidents causing three (3) or more employees to be
lzospitalizect MUST be reported within 24 hours to the Florida Department of Financial Services
Division of Worker's Compensation at 1-800-219-8953 or (850) 992-8953.
FLC will assign each employee (case) a claim number. The employee must have a claim number to
obtain non-emergency medical services. Except in the case of life-threatening emergencies, all
medical services must be from an approved worker's compensation provider. Supervisors/Employees
should contact the HR Dept. to assist the employee with finding an approved treatment center and
obtain the necessary authorizations.
HR Dept use only:
Instead of calling, may fax completed DWC-1 First Report of Injury (FROI) to:
Fax: (800) 707-7656 Attention: Intake Coordinator
33
Village of North Palm Beach
EMPLOYEE INJURY FIELD REPORT
Appendix H
The following information is required for reporting an employee injury to the worker's compensation carrier. PLEASE
COMPLETE AS MUCH OF THE FORM AS POSSIBLE AND ROUTE THE COMPLETED FORM TO THE HR DEPT. WITHIN
TWENTY-FOUR (24) HOURS. In the event of a fatality, or if three (3) or more people are hospitalized as a result of one
(1) accident or incident, the form must be submitted to HR within eight (8) hours.
INJURED WORKER INFORMATION
Name of Injured Worker:
Sex: [ ] M [ ] F Address:
City:
Date of Birth:
$ / hr: hrs / wk:
State:
SS #:
Apt:
Zip:
Did the Injured Worker return to work at full or light duty?
What day did the Injured Worker return to work?
(Please provide an answer to this question, even if the Employee returned to work on the date of accident.)
Was the Injured Worker Paid for the Day of the Accident? [ ]Yes [ ] No
Has the Injured Worker Lost Time from work due to this accident? ( ]Yes [ ] No
Will you continue to pay wages/salary in lieu of Workers' Compensation? [ ]Yes [ ] No
ACCIDENT /INJURY INFORMATION
Date of Injury:
Place of Injury -Street Address:
City
Type of Injury and Part of Body Affected: (be specific)
State:
Zip:
Employee's Description of Accident (attach additional sheet if necessary):
Were there any witnesses to the accident /Injury? [ ]Yes [ ] No
If "yes", please provide name and contact info:
Name of Person Completing Form:
Do you, the Employer, agree with the accident description? [ ]Yes [ ] No
If "no", please explain (attach additional sheet if necessary):
Ph. #:
MEDICAL INFORMATION
Is this being reported as an injury (open claim) OR for information purposes only (first-aid)?
Has the injured worker sought medical treatment? [ ]Yes [ ] No
If so, where? Please provide name, address and telephone number of medical provider, if possible.
Position Title
Date of Hire:
Time of Injury:
34
G
d
Q
Q
m m
~~
~ '~
~ N
E °~- ~;
~ C to
~ ~ O
Q
~ ~
N ~-
~ ~ L_
L O (6
T N ~
O ~ ~
~- _O ~
~ Q ..~'
N
O N (6
."' ~ N
~ ~ ~
~ ~+ C
~ ~= O
~ ~~-°, is
c a
C N ~
~ ~ U
(~ C ~
~ ~U ~O
o ~
~~a_°i
N
~ N ~
c U ~
f6 ~ C
~ O '~
o Q~
.. ~
E ~ c
to C ~
L ~
~. ~ O
c
C ~ '~
0 ~ ~
~ -p N
Q 7
N
N
N
C
'a
C
lC
N
~L
._
A~
W
_~
t4NN
I.f~
M~
W Y
L
0
ao
t
O O
Z J
~ >+
O Y
d ~
of d
~ m
-a ~
a~ y
N N
c ~ C
(0 U O
Q N
0 0 -a
co W
O .~ ` (n
'y Q
>_ L ~ U
N
C T
Y ~ 2
O 4 ~
3 -O
7
to
UOC LL
C ~ !f~
~ ~ V/
~ W f0
~ O Q
vino J
Nf4~ U
N
C
to w O
7
O N ~
~U to N
C C ~
° _ >_
U ~ ~
O ~ N
O
O N ~
N ~ o
~ 'c a~i
> ~- ~
o -o
C ~ C
_ (0 N
~ N
L.., c
i
O
~ 3 ~
~ C
-_ C .
~ C
o ''~ `° W
3 ~ N
C N d Q
~° ~ U
O O U
m aoi .J W
N N
y to
Oo~ W
3 ;~ } m
7
>j° U
~ } ~ (n
o c W
~ ~ ~
t6mo
~ w ~
c ~ w
m ~ 'o
~~~
(6 C ~
N O U
-6 ~ (0
~ ~ O
N
(0 C (A
~ N N
C
~ ~ O
3 ~' 3
U_ N
> "O ~
N ~ O
O ~ ~ Z
~ w O
O O LL
3 ~
W
~ o c d
ow o
c T'y W
a3~'
~ m o H
a~N°- ~
m ~ lL
-° o H
E °L Z
~~mE uJ
0 o m Q
r ~ ~ ~
o oY
a~ ° >, 3
~ ro m 3
X03 Q
C '~ ~
L O Y
3
a`>
w O
0
m
~ ~ c o
~
W '0 c
0 ~ N
.-. N
J L
Z ~
~ ~
V ~
~
U U
N
U N -O
~ ~ ~ Y
~
.~
O
~~ ~ 3
a ~ ~ ~ ~
U N
L ~
7 O
O '- T
~
N N
~ ~ Y
m o
N
°' N 3
y o
m ~
~
a O
~ _
cu
d
f6 'O
L
+ N
N ~
-
+
.C ~ C O =
m
~ ~ in N ~
~ ~ ~ ~ N
7 .
7 >+ N C N
O
C O t
_
o T
.
N ~ U -
~ O Q
N O
C
C ~
.
~
°~
~ 'O U
~ o
~
. 7 U
L
.
.
U X
~
~ o m
s m
~ ~
rn
_ T
O O O N "p
O Z'N N~
~ ~ to C C
0 - O
N
F
O
E
m
z
m
T
0
n
E
W
N
N o
~ Z
U
m
w
F-
w
J
a
O
U
w
Q
z
w
a'
Q
a
w
D
m
Appendix J
Village of North Palm Beach
Safety Committee Employee Suggestion Form
PLEASE SHARE YOUR IDEAS WITH US!
My Idea to improve safety in the workplace is:
(Please be as specific as you can in describing your plan or idea. Also, please write as though the
reader has no knowledge of your situation)
This form should be used for overall improvements in the workplace only. /F YOU NOTICE OR
ARE AWARE OF A HAZARDOUS OR DANGEROUS SITUATION AT ANY VILLAGE
WORKSITE, YOU MUST IMMEDIATELY REPORT IT TO YOUR SUPERVISOR. Do not use this
form instead. Properly submitted forms will be discussed at the next regularly scheduled Safety
Committee meeting.
Employee name (please print)**
Employee signature
Department
Date
*"You may remain anonymous if you prefer, but providing your information will allow the committee to contact you if there
are any questions about your idea or how to implement it.
Please submit completed forms to:
Village of North Palm Beach
c/o Human Resources
501 US Highway 1
North Palm Beach, FL 33408
Ph (561) 882-1155 /Fax (561) 848-3344
36