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S-Z Forms

  • Sabbatical Leave Checklist

    Use this checklist to create and implement a sabbatical leave policy in your workplace.

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  • Safe Practices for Construction Workplaces - Sample Code

    The sample code in this form was developed by the California Department of Occupational Safety and Health. It is a suggested code, is general in nature and is intended as a basis for preparation of a code that fits the specific contractor's operations more exactly.

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  • Safety Inspection for General Work Areas and Offices Checklist

    Personalize

    Use this checklist to ensure that general work areas and offices are free of potential health or safety hazards.

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  • Safety Inspection for Work Spaces and Surfaces Checklist

    Use this checklist to ensure that work spaces and surfaces are free of potential health or safety hazards.

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  • Safety Program Self Audit Checklist

    Use this checklist to help ensure that your workplace safety program complies with state requirements and is well tailored to reducing risks and claims in your workplace.

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  • San Francisco Fair Chance Ordinance - Notice to Job Applicants and Employees

    Employers covered by San Francisco’s Fair Chance Ordinance (FCO) must post this notice and must also give it to applicants/employees prior to making any criminal history inquiry that is permissible under the FCO. In addition, the notice must be sent to any labor union representing San Francisco employees.  

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  • San Francisco Fair Chance Ordinance - Notice to Job Applicants and Employees - Chinese

    Employers covered by San Francisco’s Fair Chance Ordinance (FCO) must post this notice and must also give it to applicants/employees prior to making any criminal history inquiry that is permissible under the FCO. In addition, the notice must be sent to any labor union representing San Francisco employees.

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  • San Francisco Fair Chance Ordinance - Notice to Job Applicants and Employees - Spanish

    Employers covered by San Francisco’s Fair Chance Ordinance (FCO) must post this notice and must also give it to applicants/employees prior to making any criminal history inquiry that is permissible under the FCO. In addition, the notice must be sent to any labor union representing San Francisco employees.  

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  • San Francisco Fair Chance Ordinance - Notice to Job Applicants and Employees - Tagalog

    Employers covered by San Francisco’s Fair Chance Ordinance (FCO) must post this notice and must also give it to applicants/employees prior to making any criminal history inquiry that is permissible under the FCO. In addition, the notice must be sent to any labor union representing San Francisco employees.  

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  • San Francisco Flexible or Predictable Work Arrangement Request

    Free

    Employees covered by the San Francisco Family Friendly Workplace Ordinance may (but are not required to) use this sample form to request flexible or predictable working arrangements from their employers.

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  • School and Child Care Activities Leave Checklist

    Use this checklist to create and implement a school and child care activities leave policy for your company.​​

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  • Security and Violence Prevention

    Use this form to identify and take preventive measures to increase security and minimize violence in the workplace. Acts of physical violence may arise from outside sources, such as burglars or customers, or from within, such as a disgruntled present or past employee.

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  • Select International Trade-Related Internet Resources

    A list of organizations and their associated Web Sites available to provide guidance and understanding of the international trade process and cross-cultural business practices.                                        

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  • Serious Incident Report

    Fax this report to the nearest Cal/OSHA District Office within eight hours of a serious injury or death.

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  • Sexual Harassment Guidelines by EEOC and FEHA

    Use this form to learn how the Equal Employment Opportunity Commission (EEOC) and the Fair Employment and Housing Act (FEHA) address sexual harassment claims.​​​ Formerly Sexual Harassment Guidelines by EEOC.​​​​​

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  • Sexual Harassment Investigation Checklist

    Review this checklist when conducting a harassment investigation for your company.​

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  • Sexual Harassment Mandatory Supervisor Training - Summary Training Record

    Use this form to track ongoing company compliance with supervisor training required by California law.

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  • Sexual Harassment Supervisor Training Certificate

    Use this form to track sexual harassment training received every two years by individual supervisors and other employees with supervisory authority. Maintain in the file.

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  • Shippers Letter of Instruction

    A form utilized by an exporter to convey instructions to a freight forwarder in regard to an export shipment.

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  • Standard Industrial Classification Codes

    This chart lists Standard Industrial Classification (SIC) codes.

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  • State Disability Insurance and Paid Family Leave Benefit Amounts

    Free

    Use this table to determine what benefits an employee is eligible for under State Disability Insurance and Paid Family Leave. For more information, go to www.edd.ca.gov.​​​

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  • State Disability Insurance Checklist

    Use this checklist when your employee becomes disabled.

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  • Summary of Family Medical and Pregnancy Disability Leave Laws

    This form summarizes employer obligations as provided in Federal and State family medical leave laws and the California Pregnancy Disability Leave law. It also shows the relationship between these laws and benefits available to employees while taking these leaves. ​​

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  • Telecommuting Agreement

    Personalize

    Use this form once a telecommuting relationship has been approved to describe the expectations your company has of employees who telecommute.

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  • Telecommuting Request

    Provide this form to employees who request to telecommute. This form will help you understand why they wish to telecommute and whether such accommodation is appropriate.

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  • Telecommuting Request Checklist

    This checklist should be completed after receiving a request for telecommuting plan to evaluate whether telecommuting is appropriate for the individual and the job an employee performs.

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  • Telecommuting Safety Checklist

    Use this form in conjunction with your company's safety checklist for your workplace to ensure the telecommuter's workspace is safe.

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  • Temporary Modified Duty Agreement

    Use this form to document a temporary, modified duty assignment.

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  • Termination Checklist

    Use this checklist when terminating an employee to ensure that you have completed all legally required forms.​

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  • Termination Decision Checklist

    Use this checklist to help evaluate whether termination of an employee is likely to lead to litigation. This checklist helps to avoid potential legal problems by suggesting issues to review with counsel before terminating the employee. ​

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  • Texting While Driving - OSHA

    Free

    Distribute this pamphlet to your employees that are required to drive. It explains the importance of not texting while driving.

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  • Training Sign-In Sheet

    Personalize

    Use this sign-in sheet to document and verify which employees attend training. Keep the signed form in the employee's personnel file.

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  • Training Sign-In Sheet - Spanish

    Use this sign-in sheet to document and verify which employees attend training. Employers not fluent in Spanish should refer to the English version to complete this form properly. Keep the signed form in the employee's personnel file.

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  • Unemployment Insurance - Responding to a Claim Checklist

    Review this checklist for suggested actions on how to handle a claim for unemployment insurance.

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  • Unemployment Insurance Benefit Table

    Review this chart to determine the employee’s quarterly wage during the employment base period and the corresponding weekly benefit amount.

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  • Unemployment Insurance Benefit Table - Spanish

    Review this chart to determine the employee’s quarterly wage during the employment base period and the corresponding weekly benefit amount.

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  • Unemployment Insurance Claim - Appealing to an Administrative Law Judge Checklist

    Use this checklist if you disagree with the EDD’s final determination regarding an unemployment insurance claim.​

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  • Unemployment Insurance Claim - Appealing to the Appeals Board Checklist

    Use this checklist if you have appealed the EDD’s decision for a UI claim to an administrative law judge and still believe the decision is incorrect.​

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  • Unfair Labor Practice Charge Against Employer - NLRB Form 501

    Free

    This form is used to file an unfair labor practice charge against an employer.

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  • Unfair Labor Practice Charge Against Labor Organizations or its Agents - NLRB Form 508

    Free

    This form is used to file an unfair labor practice charge against an employee group or union.

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  • Unfair Labor Practice Charge Under Section 8(e) of the NLRA - NLRB Form 509

    Free

    This form is used to file an unfair labor practice charge against an employer, employee group or union.

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  • Unfair Labor Practices

    Use this form to learn about the unfair labor practices of employers and labor unions as contained in the National Labor Relations Act.

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  • Unpaid Personal Leaves of Absence Checklist

    Use this checklist to create and implement an unpaid personal leaves of absence policy for your company.​​

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  • Unprofessional Behavior and Sexual Harassment

    Use this form to learn more about certain behavior that may qualify as sexual harassment.​

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  • US Commercial Service Global Resources

    A pertinent area of the USDOC is the International Trade Administration (ITA), which includes the U.S. Commercial Service (USCS), the ITA’s trade promotion unit. The USCS has a network of offices in the United States and abroad.

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  • Usance Draft - Bankers Acceptance

    Usance Draft / Banker's Acceptance:  A time draft drawn upon and accepted by a bank in connection with a trade transaction.  Generally created for time periods not exceeding six months, often in connection with a time/usance letter of credit.

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  • VETS-4212

    Free

    Certain federal contractors must file a VETS-4212 form. Reports must be filed between August 1, and September 30. The report is required on an annual basis.​​​​​

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  • Victims of Crime Leave Checklist

    Use this checklist to create and implement a crime victims' leave policy for your company.

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  • Voluntary Self-Identification of Disability

    Free

    Federal regulations implementing Section 503 of the Rehabilitation Act of 1973 require certain federal contractors to ask applicants to voluntarily self-identify their disability status at both the pre-offer and post-offer phases of the application process and to invite  all employees to self-identify every five years. The rule applies to federal contractors and subcontractors that have 50 or more employees and a contract of $50,000. These contractors must develop an affirmative action program and solicit disability information. All invitations to self-identify must be made using this Voluntary Self-Identification of Disability form which is  provided by the Office of Federal Contract Compliance Programs.

    Any version of this form must be at least 11-pitch for font size (with the exception of the footnote and the burden statement which must be at least 10-pitch in size.) 

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  • Volunteer Civil Service Leave Checklist

    Use this form to create and implement a volunteer civil service leave policy for your company.

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  • W4 - Employees Withholding Allowance Certificate

    Free

    Use this required form to obtain information from an employee to determine the correct Federal income tax amount to withhold from his/her paychecks. ​​

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  • W4 - Employees Withholding Allowance Certificate - Spanish

    Free

    Use this required form to obtain information from an employee to determine the correct Federal income tax amount to withhold from his/her paychecks. ​​

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  • Wage and Employment Notice to Employees (Labor Code section 2810.5)

    Free

    Provide this form to all nonexempt employees at the time of hire. If any change is made to the information on this form, notify employees of the change in writing within seven calendar days after the time a change was made unless notice is provided in another writing required by law within seven days of the change.​​

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  • Wage and Employment Notice to Employees (Labor Code section 2810.5) - Spanish

    Free

    Provide this form to all nonexempt employees at the time of hire. If any change is made to the information on this form, notify employees of the change in writing within seven calendar days after the time a change was made. ​​

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  • Wage Order 01 - Manufacturing

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 1 regulates wages, hours, and working conditions in the Manufacturing Industry.

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  • Wage Order 01 - Manufacturing - Spanish

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 1 regulates wages, hours, and working conditions in the Manufacturing Industry.

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  • Wage Order 02 - Personal Services

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 2 regulates wages, hours, and working conditions in the Personal Services Industry.

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  • Wage Order 03 - Canning Freezing and Preserving

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 3 regulates wages, hours, and working conditions in the Canning, Freezing, and Preserving Industry.

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  • Wage Order 04 - Professional Technical Clerical Mechanical and Similar Occupations

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 4 regulates wages, hours, and working  conditions in the Professional, Technical, Clerical, Mechanical, and similar occupations.

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  • Wage Order 05 - Public Housekeeping

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 5 regulates wages, hours, and working conditions in the Public Housekeeping Industry.

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  • Wage Order 06 - Laundry Linen Supply Dry Cleaning and Dyeing

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 6 regulates wages, hours, and working conditions in the Laundry, Linen Supply, Dry Cleaning, and Dyeing Industry.

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  • Wage Order 07 - Mercantile

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 7 regulates wages, hours, and working conditions in the Mercantile Industry.

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  • Wage Order 08 - Industries Handling Products After Harvest

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 8 regulates wages, hours, and working conditions in industries handling products after harvest.

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  • Wage Order 08 - Industries Handling Products After Harvest - Spanish

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 8 regulates wages, hours and working conditions in industries handling products after harvest.

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  • Wage Order 09 - Transportation

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 9 regulates wages, hours, and working conditions in the Transportation Industry.

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  • Wage Order 10 - Amusement and Recreation

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 10 regulates wages, hours, and working conditions in the Amusement and Recreation Industry.

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  • Wage Order 11 - Broadcasting

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 11 regulates wages, hours, and working conditions in the Broadcasting Industry.

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  • Wage Order 12 - Motion Picture Industry

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 12 regulates wages, hours, and working conditions in the Motion Picture Industry.

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  • Wage Order 13 - Industries Preparing Agricultural Products for Market on the Farm

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 13 regulates wages, hours, and working conditions in industries preparing agricultural products for market, on the farm.

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  • Wage Order 13 - Industries Preparing Agricultural Products for Market on the Farm - Spanish

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 13 regulates wages, hours and working conditions in industries preparing agricultural products for market, on the farm.

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  • Wage Order 14 - Agricultural Occupations

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 14 regulates wages, hours, and working conditions in agricultural occupations.

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  • Wage Order 14 - Agricultural Occupations - Spanish

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 14 regulates wages, hours, and working conditions in agricultural occupations.

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  • Wage Order 15 - Household Occupations

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 15 regulates wages, hours, and working conditions in household occupations.

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  • Wage Order 16 - On-site Construction Drilling Logging and Mining

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 16 regulates wages, hours, and working conditions in the On-site Construction, Drilling, Logging, and Mining Industries.

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  • Wage Order 17 - Miscellaneous Employees

    Free

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 17 regulates wages, hours, and working conditions for miscellaneous employees.

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  • Wage Order Checklist

    Updated

    Use this checklist to help you with the Industrial Welfare Commission (IWC) Wage Orders. Wage Orders outline the mandatory guidelines for paying nonexempt employees.

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  • Wage Orders - Business Occupation Listing

    Free

    This chart lists businesses and occupations, and their corresponding Wage Orders.

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  • WARN Notice - Employees

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    Use this form to notify employees of plant closures or mass layoffs in accordance with the WARN Act.

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  • WARN Notice - State and Local Officials

    Use this form to notify state and local officials of plant closures or mass layoffs in accordance with the WARN Act.

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  • WARN Notice - Union Representatives

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    Use this form to notify union representatives of plant closures or mass layoffs in accordance with the WARN Act.

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  • Warning Letter Checklist and Sample

    New

    This letter is an example of a warning letter given for a particular situation with respect to performance and conduct. It is NOT meant for you to print out and deliver to an employee. Rather, you are to review this letter and use the examples as a guide for how to draft your own letter of warning. ​

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  • Work Surfaces and Work Space Safety

    Specific Cal/OSHA standards govern workplace conditions and structures. Use this form to help you identify and meet these standards.

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  • Worker Training and Instruction Record

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    Use this form to document and track all training provided to an employee.

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  • Workers' Compensation Benefits for Victims of Workplace Violence

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    Use this sample notice when an employee is a victim of a crime at your workplace. You must give the employee written notification of his or her eligibility for workers' compensation benefits for resulting injuries, including psychiatric injuries.

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  • Workers' Compensation Checklist

    Complete this checklist to fulfill your obligations regarding workers' compensation.​​

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  • Workers' Compensation Claim Form - DWC 1

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​

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  • Workers' Compensation Claim Form - DWC 1 - Chinese

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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  • Workers' Compensation Claim Form - DWC 1 - Korean

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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  • Workers' Compensation Claim Form - DWC 1 - Spanish

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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  • Workers' Compensation Claim Form - DWC 1 - Tagalog

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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  • Workers' Compensation Claim Form - DWC 1 - Vietnamese

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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  • Workers' Compensation Information and Assistance Offices

    Free

    Contact addresses and phone numbers for local DWC Information and Assistance Units. The I & A Unit provides information and assistance to employees, employers, insurance carriers and other interested parties concerning rights, benefits and obligations under California's workers' compensation laws.​

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  • Workers' Compensation Insurance Shoppers Checklist

    Use this form to ask potential brokers and carriers important questions as you shop for a workers' compensation policy.

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  • Workplace Safety Record Keeping Requirements - CalOSHA

    Use this form to help you identify the records you must make and keep under various Cal/OSHA standards.

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  • Workplace Security Profile

    Fill out this Cal/OSHA form in order to assess the risk of violence in a particular workplace.

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  • Workplace Violence Factors and Control Checklist- OSHA

    Free

    This checklist can help employers identify present or potential workplace violence problems. It contains various factors and controls that are commonly encountered in retail establishments. Not all of the questions listed here fit all types of retail businesses, and this checklist does not include all possible topics specific businesses need. Employers should expand, modify, and adapt this checklist to fit their own circumstances.

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  • Workplace Violence Incident Report Form

    Make this form available to all employees to use when they believe an incident of workplace violence has occurred. Any employee who experiences an incident s/he believes to be threatening or violent should complete this incident report form; and all supervisors should be trained regarding its use. Supervisors should be trained that upon completion of the incident report form, they are to immediately forward the form to the Crisis Management Team, or whatever person or group is responsible in your company for responding to workplace violence concerns. The completion of this form is what launches an investigation.

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  • Workplace Violence Incident Report Form 1- OSHA

    Free

    This form can be used to gather information from a workplace violence incident. Employers should expand, modify,and adapt this form to fit their own circumstances.

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  • Workplace Violence Incident Report Form 2- OSHA

    Free

    This form can be used to gather information from a workplace violence incident. Employers should expand, modify,and adapt this form to fit their own circumstances.

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  • Workplace Violence Inspection Checklist- OSHA

    Free

     This checklist can help employers identify present or potential workplace violence problems. It contains various factors and controls that are commonly encountered in retail establishments. Not all of the questions listed here fit all types of retail businesses, and this checklist does not include all possible topics specific businesses need. Employers should expand, modify, and adapt this checklist to fit their own circumstances.

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  • Work-Related Injuries and Illnesses Log - Form 300

    Free

    You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, medical treatment beyond first aid, that are diagnosed by a physician or licensed health care professional, or meet any criteria listed in CCR Title 8 sec. 14300.8 through 14300.12. You must complete an Injury and Illness Incident Report (Cal/OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you're not sure whether a case is recordable, call your local Cal/OSHA office for help.

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  • Work-Related Injuries and Illnesses Summary- Form 300A

    Free

    All establishments covered by 8 CCR sec. 14300 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember to review the log to verify that the entries are complete and accurate before completing this summary. Post this Summary page from February 1 to April 30 of the year following the year covered by the form.

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  • Worksite Ergonomics Evaluation Form

    Use this form to evaluate if employee workspaces meet ergonomic standards.

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