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This document serves as a Special Order issued by the California Department of Industrial Relations regarding unsafe conditions found during an inspection or investigation.
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How to fill out CAL/OSHA 3

01
Obtain the CAL/OSHA 3 form from the official CAL/OSHA website or your local CAL/OSHA office.
02
Fill in your business information, including the name, address, and contact details.
03
Provide details about the employee injured, including their name, job title, and department.
04
Describe the injury, including the nature of the injury and where it occurred.
05
Record the date and time of the incident.
06
Indicate the type of incident and any factors that may have contributed to the injury.
07
Sign and date the form to certify that the information is accurate.
08
Submit the completed form to CAL/OSHA within the required timeframe.

Who needs CAL/OSHA 3?

01
Employers in California who have employees that were injured on the job.
02
Businesses that are subject to CAL/OSHA regulations.
03
Employers who are required to report serious injuries, illnesses, or fatalities.
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People Also Ask about

Occupational Safety and Health Administration.
The Division of Occupational Safety and Health (DOSH, but more commonly known as Cal/OSHA) of the California Department of Industrial Relations is an agency of the Government of California established by the California Occupational Safety & Health Act of 1973.
Cal/OSHA's model plan is a template intended to provide the “essential framework” for employers to use as they navigate the many requirements of the law. For example, Cal/OSHA's model plan provides examples of workplace violence hazards and correction methods that employers should be on the lookout for.
Cal/OSHA. The Cal/OSHA Program is responsible for enforcing California laws and regulations pertaining to workplace safety and health and for providing assistance to employers and workers about workplace safety and health issues.
The Occupational Safety and Health Administration (OSHA) assures safe and healthful working conditions by setting and enforcing standards, and by providing training, outreach, education and assistance.

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CAL/OSHA 3 is a form used to report work-related injuries and illnesses that occur in California workplaces.
Employers in California who have had a work-related injury or illness resulting in a fatality, loss of consciousness, or significant injury requiring medical treatment are required to file CAL/OSHA 3.
To fill out CAL/OSHA 3, employers should provide details about the employee involved, the nature of the injury or illness, the circumstances surrounding the incident, and any first-aid or medical treatments administered.
The purpose of CAL/OSHA 3 is to help ensure that workplace safety and health regulations are followed, identify hazards, and prevent future incidents by collecting data on work-related injuries and illnesses.
On CAL/OSHA 3, employers must report the employee's name, job title, date of the incident, a description of the injury or illness, and details about how the incident occurred, including any contributing factors.
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