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Cal/OSHA Form 301 Injury and Illness Incident Report Attention This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes. Department of Industrial Relations See CCR Title 8 14300. 29 b 6 - 10 Division of Occupational Safety Health Information about the employee This Inj...

How to fill out osha form 301

How to fill out OSHA Form 301:

1. Begin by downloading a copy of OSHA Form 301 from the official OSHA website or obtain it from your workplace's OSHA representative.
2. Start by providing your personal and contact information in the designated sections of the form. This includes your full name, job title, employee ID number, and contact details.
3. Indicate the date and time of the incident that the form pertains to. Specify whether it occurred during regular working hours or outside of normal working hours if applicable.
4. Fill in the location or department where the incident took place. Include specific details such as the address, building, and floor number to accurately identify the incident site.
5. Describe the incident in detail, providing a concise explanation of what happened, what caused it, and any contributing factors. Use clear and specific language while avoiding any assumptions or opinions.
6. Specify the nature of the injury or illness resulting from the incident. Include details such as the type of injury, body part affected, and severity level.
7. Indicate the type of treatment administered, if any, including first aid, on-site medical attention, or hospitalization. Provide information on the medical professional involved and any medical facility used.
8. If applicable, briefly outline any restrictions placed on the affected employee's work activities as a result of the incident. Include details such as modified work duties or time off work.
9. Finally, sign and date the OSHA Form 301 to confirm the accuracy and completeness of the information. Ensure that any other required signatures, such as a supervisor or safety officer, are also provided.

Who needs OSHA Form 301?

1. Employers: It is crucial for employers to use OSHA Form 301 to record and report any work-related injuries or illnesses that result in medical treatment beyond first aid or days away from work. This form helps maintain accurate records of incidents and aids in identifying workplace hazards.
2. Employees: Workers who have suffered a work-related injury or illness that requires medical treatment beyond first aid or results in days away from work may also need to be aware of OSHA Form 301. They should cooperate with their employer in providing accurate information to complete the form.

It is important to note that specific requirements for OSHA Form 301 may vary depending on the jurisdiction and industry. Employers should always consult OSHA guidelines and regulations to ensure compliance with reporting procedures.

For pdfFiller’s FAQs

What is osha form 301?

OSHA Form 301 is a form used to record workplace injuries and illnesses.

Who is required to file osha form 301?

Employers with more than 10 employees are required to file OSHA Form 301.

How to fill out osha form 301?

To fill out OSHA Form 301, you need to document details of workplace injuries and illnesses, including the date of occurrence, nature of injury, and treatment provided.

What is the purpose of osha form 301?

The purpose of OSHA Form 301 is to track and record workplace injuries and illnesses for statistical and regulatory purposes.

What information must be reported on osha form 301?

Information such as the date of injury, nature of illness, treatment provided, and days away from work must be reported on OSHA Form 301.

When is the deadline to file osha form 301 in 2023?

The deadline to file OSHA Form 301 in 2023 is typically within 7 days of the injury or illness being recorded.

What is the penalty for the late filing of osha form 301?

The penalty for the late filing of OSHA Form 301 can vary, but may include fines up to $13,653 per violation.

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