Santa Barbara SIPE Joint Powers Self Insurance

(805) 922-8003

IIPP/ Safety
Forms


Injury and Illness Prevention Program: this program applies to all schools enrolled under SIPE.

Employee Safety and Health Record for Santa Barbara County school employees. File this form with employee's safety record maintained by supervisor.

Safety Hazard/Suggestion Report Form (SIPE Form 2-588)

Hepatitis B Immunization Consent/Waiver Form (SIPE Form 93-1003)

Safety Incentive Funding Request Form

These forms are in PDF format. In order to fill out and save the "filled out" version, you must have Adobe Acrobat Professional 7.0.

You will be able to fill out the form online and print the completed form if you have the latest version of Adobe Reader which is available for free. Otherwise, you can print the form and fill it out by hand.

Injury and Illness Prevention Program 

Injury and Illness Prevention Program: The Santa Barbara County Schools Joint Powers Self-Insurance Program for Employees (SIPE) has developed an injury and illness prevention program to enhance our employee's health and safety in the workplace. This program applies to all schools enrolled under SIPE.

Download the Entire Document or by sections linked below.

Contents

Section A: Injury and Illness Prevention Program
• Policy
• General Responsibilities
• Disciplinary Procedures
• OSHA Inspectors Protocol
Section B: Safety Training
• General Safety Training
• Specific Instruction
• Training Records
• Master Training Guide

Section C: Employee Injury Reporting
Section D: Injury/Illness Reporting System
Section E: Return to Work Program
Section F: Lockout and Tagout Procedures
Section F1Electrical Safety
Section G: Eye and Face Protection
Section H: Exposure Control Plan for Bloodborne Pathogens
Section H1Aerosol Transmissible Disease Program
Section I: Hazardous Substance Program/Global Harmonized System (GHS)
Section J: Safety Awards Program
Section K: Back Support Belt Program
Section L: Asbestos
Section M: Safe Driving Procedures
Section N: Food Service
Section O: Ergonomics
Section P: Preventing Violence in the Workplace
Section Q: Responsibilities of the SIPE Safety Officer
Section R: Respiratory Protection
Section S: Program Procurement and Distribution of Safety Merchandise and Services
Section T: Heat Illness Prevention
Section U: Code of Safe Practices
Section V: Automated External Defibrillation Program