SAFETY PROGRAM

	SKILLED NURSING CARE FACILITIES

	SIC CODE 8051

	For further information on safety programs developed by the Division of Safety of Florida's Department of Labor and Employment Security, call 904/488-3044 or 
	800/367-4378 (within Florida).

	Material contained in this publication is in the public domain and may be reproduced, fully or partially, without permission of the State of Florida.

	May, 1994

	PREFACE

	How to Use This Manual

To The Employer:

The purpose of this safety manual is to establish standards for an industry-specific safety program for establishments covered under the following Standard Industry Classification (SIC code): 8051, Skilled Nursing Care Facilities.  This safety program has been developed by the Florida Division of Safety with voluntary input from Florida employers, workers' compensation insurance carriers, labor organizations, trade associations, and other industry leaders. 

This manual is intended to serve as the basis for an employer integrated safety and health management program.  Implementation of this safety program satisfies the requirements of the Division of Safety.  The essential elements of this program include:  top management's commitment and involvement; the establishment and operation of safety committees; provisions for safety and health training; first aid procedures; accident investigations; recordkeeping of injuries; and workplace safety rules, policies, and procedures.

If this manual meets the needs of your establishment, it may be used exactly as written.  If you have previously established and are maintaining a safety program, you can continue to use your program provided that the essential elements covered in this safety program are also addressed in your program.  Use of all or part of this manual does not relieve employers of their responsibility to comply with other applicable local, state or federal laws.  In addition, if an employer maintains the OSHA 200 Log to meet federal requirements, then that will meet the log and summary requirements of the LES SAF 200 form in Section VI of this program.

It is intended that this manual be enhanced and continuously improved by the employer.  Any section of this manual may be modified by the employer to accommodate actual operations and work practices, provided that the original intent of that section is not lost.  For example, if a safety committee meets weekly or quarterly instead of monthly, then Section II of the manual should be amended to accommodate this practice.  If there is a safety rule, policy, or procedure appropriate for the work or work environment which has not been included, or if a rule included in Section VII is inappropriately written, then a new safety rule, policy, or procedure should be added to improve the manual.  Likewise, if a specific rule in the Safety Rules, Policies, and Procedures section does not apply because the equipment or work operation described is not used, then that specific rule should be crossed out or deleted from the manual.  If accidents occur, new safety rules should be developed and incorporated in Section VII of this manual to prevent their recurrence.  

	TABLE OF CONTENTS

Section I. Management Commitment and Involvement	1
Policy Statement	1
Section II.  Safety Committee	2
Safety Committee Organization	2
Responsibilities	2
Meetings	2
Safety Committee Minutes	3
Section III.  Safety and Health Training	4
Safety and Health Orientation	4
Job-Specific Training	4
Periodic Retraining of Employees	4
Section IV.  First Aid Procedures	5
Minor First Aid Treatment	5
Non-Emergency Medical Treatment	5
Emergency Medical Treatment	5
First Aid Training	5
First Aid Instructions	6
Section V.  Accident Investigation	7
Accident Investigation Procedures	7
Accident Investigation Report	8
Instructions for Completing the Accident Investigation Report	9
Section VI.  Recordkeeping Procedures	10
Section VII.  	Safety Rules, Policies, and Procedures	11

	Section I. Management Commitment and Involvement
	
Policy Statement

The management of this organization is committed to providing employees with a safe and healthful workplace.  It is the policy of this organization that employees report unsafe conditions and do not perform work tasks if the work is considered unsafe.  Employees must report all accidents, injuries, and unsafe conditions to their supervisors.  No such report will result in retaliation, penalty, or other disincentive.

Employee recommendations to improve safety and health conditions will be given thorough consideration by our management team.  Management will give top priority to and provide the financial resources for the correction of unsafe conditions.  Similarly, management will take disciplinary action against an employee who willfully or repeatedly violates workplace safety rules.  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:
	
Name:		
Title:		Telephone:		

Senior management will be actively involved with employees in establishing and maintaining an effective safety program.  Our safety program coordinator, myself, or other members of our management team will participate with you or your department's employee representative in ongoing safety and health program activities, which include:

	•	Promoting safety committee participation;
	•	Providing safety and health education and training; and
	•	Reviewing and updating workplace safety rules.

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.

Signature of CEO/President	Date	

	Section II.  Safety Committee

Safety Committee Organization
A safety committee has been established as a management tool to recommend improvements to our workplace safety program and to identify corrective measures needed to eliminate or control recognized safety and health hazards.  The safety committee employer representatives will not exceed the amount of employee representatives.
Responsibilities
The safety committee will be responsible for assisting management in communicating procedures 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 assisting management in reviewing and updating workplace safety rules based on accident investigation findings, any inspection findings, and employee reports of unsafe conditions or work practices; and accepting and addressing anonymous 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 co-worker participation through continuous improvements to the workplace safety program.

Safety committee members will participate in safety training and be responsible for assisting management in monitoring workplace safety education and training to ensure that it is in place, that it is effective, and that it is documented.

Management will provide written responses to safety committee written recommendations.
Meetings
Safety committee meetings are held quarterly and more often if needed and each committee member will be compensated at his or her hourly wage when engaged in safety committee activities.

Management will post the minutes of each meeting (see page 3) in a conspicuous place and the minutes will be available to all employees.

All safety committee records will be maintained for not less than three calendar years.  

Safety Committee Minutes
Date of Committee Meeting:			Time:		
Minutes Prepared By:			Location:		

Members in Attendance
Name	Name	Name	

			

Review of Accidents Since Previous Meeting:		

Recommendations for Prevention:		

Recommendations from Anonymous Employees:		

Suggestions From Employees:		

Recommended Updates To Safety Program:		

Recommendations from Accident Investigation Reports:		

Safety Training Recommendations:		

Comments:		

		

	Section III.  Safety and Health Training
Safety and Health Orientation 
Workplace safety and health orientation begins on the first day of initial employment or job transfer.  Each employee has access to a copy of this safety manual, through his or her supervisor, for review and future reference, and will be given a personal copy of the safety rules, policies, and procedures pertaining to his or her job.  Supervisors will ask questions of employees and answer employees' questions to ensure knowledge and understanding of safety rules, policies, and job-specific procedures described in our workplace safety program manual. 
All employees will be instructed by their supervisors that compliance with the safety rules described in the workplace safety manual is required.

Job-Specific Training
  •	Supervisors will initially train employees on how to perform assigned job tasks safely.  
  •	Supervisors will carefully review with each employee the specific safety rules, policies, and procedures that are applicable and that are described in the workplace safety manual.

  •	Supervisors will give employees verbal instructions and specific directions on how to do 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.

Periodic Retraining of Employees
All employees will be retrained periodically on safety rules, policies and procedures, and when changes are made to the workplace safety manual.

Individual employees will be retrained after the occurrence of a work-related injury caused by an unsafe act or work practice, and when a supervisor observes employees displaying unsafe acts, practices, or behaviors.  

Section IV.  First Aid Procedures

	EMERGENCY PHONE NUMBERS

Safety Coordinator		Poison Control		
First Aid		Fire Department		
Ambulance		Police			
Medical Clinic				
Clinic Address				
Minor First Aid Treatment
First aid kits are stored at the landing trailer and in the transport vehicles.  If you sustain an injury or are involved in an accident requiring minor first aid treatment:

  •	Inform your supervisor.
  •	Administer first aid treatment to the injury or wound.
  •	If a first aid kit is used, indicate usage on the accident investigation report.  
  •	Access to a first aid kit is not intended to be a substitute for medical attention.
  •	Provide details for the completion of the accident investigation report.
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:

  •	Inform your supervisor.
  •	Proceed to the authorized medical facility.  Your supervisor will assist with transportation, if necessary.
  •	Provide details for the completion of the accident investigation report.
Emergency Medical Treatment
If you sustain a severe injury requiring emergency treatment:

  •	Call for help and seek assistance from a co-worker. 
  •	Use the emergency telephone numbers and instructions posted on the first aid kit to request assistance and transportation to the local hospital emergency room.
  •	Provide details for the completion of the accident investigation report.
First Aid Training
Each employee will receive training and instructions from his or her supervisor on our first aid procedures.

First Aid Instructions
	In all cases requiring emergency medical treatment, immediately call, or have a co-worker call, to request emergency medical assistance.

WOUNDS:

	Minor:  Cuts, lacerations, abrasions, or punctures
		  •	Wash the wound using soap and water; rinse it well.
		  •	Cover the wound using clean dressing.
	Major:  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.
BURNS:

	Thermal (Heat)
		  •	Rinse the burned area, without scrubbing it, and immerse it in cold water; do not use ice water.
		  •	Blot dry the area and cover it using sterile gauze or a clean cloth.
	Chemical
		  •	Flush the exposed area with cool water immediately for 15 to 20 minutes.

EYE INJURY:

	Small particles
		  •	Do not rub your eyes.
		  •	Use the corner of a soft clean cloth to draw particles out, or hold the eyelids open and flush the eyes continuously with water.
	Large or stuck particles
		  •	If a particle is stuck in the eye, do not attempt to remove it.
		  •	Cover both eyes with bandage.
	Chemical
		  •	Immediately irrigate the eyes and under the eyelids, with water, for 30 minutes.
	
NECK AND SPINE INJURY:

		  •	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.

Section V.  Accident Investigation
Accident Investigation Procedures
An accident investigation will be performed by the supervisor at the location where the accident occurred.  The safety coordinator is responsible for seeing that the accident investigation reports (see page 2) are being filled out completely, and that the recommendations are being addressed. Supervisors will investigate all accidents, injuries, and occupational diseases using the following investigation procedures:

  •	Implement temporary control measures to prevent any further injuries to employees.

  •	Review the equipment, operations, and processes to gain an understanding of the accident situation. 

  •	Identify and interview each witness and any other person who might provide clues to the accident's causes.

  •	Investigate causal conditions and unsafe acts; make conclusions based on existing facts.

  •	Complete the accident investigation report.

  •	Provide recommendations for corrective actions.  

  •	Indicate the need for additional or remedial safety training.

Accident investigation reports must be submitted to the safety coordinator within 24 hours of the accident.

Accident Investigation Report
							       		
	REPORT #		
COMPANY:		ADDRESS:		
		
Name of injured:		S.S. #		
Sex :	[    ] M	[    ] F	Age:				Date of accident		
Time of accident:	a.m. :		p.m.:		                             Day of accident		
Employee's job title:		
Length of experience on job:	(years)		(months)				
Address of location where the accident occurred:		
	
Nature of injury, Injury type, and Part of the body affected:		
		
Describe the accident and how it occurred:		
	
Cause of the accident		
	
Was personal protective equipment required? 	[   ] yes	[   ] no	Was it provided?	[   ] yes	[   ] no	
Was it being used? 	[   ] yes	[   ] no	If "no", explain		
	
Was it being used as trained by supervisor or designated trainer? 	[   ] yes	[   ] no	If "no", explain.	

Witness(es):		

	
Safety training provided to the injured? 	[   ] yes	[   ] no	If "no", explain.		
	
Interim corrective actions taken to prevent recurrence:		

Permanent corrective action recommended to prevent recurrence:		

Date of report:		
Prepared by:		
Supervisor (Signature):		Date:		
	
Status and follow-up action taken by safety coordinator:		

Safety Coordinator (Signature):		Date:		

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 resulted in minor injury/treated on premises; Medical - injury treated off premises by physician; Lost time -injured missed more than one day of work; No Injury - no injury, near-miss type of incident.  Part of the Body:  Part of the body directly affected, e.g., foot, arm, hand, head.

(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 the 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:  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 accident area, posting warning signs, shutting down operations.

(Item 14):  Self-explanatory

(Item 15):  Self-explanatory

(Item 16) 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 employer are taken, and control measures have been implemented.  

Section VI.  Recordkeeping Procedures

Recordkeeping Procedures

The safety coordinator will control and maintain all employee accident and injury records.  Records are maintained for a minimum of three (3) years and include:

  •	Accident Investigation Reports, 

  •	Workers' Compensation Notice of Injury Reports, and

  •	Log & Summary of Occupational Injuries and Illnesses. (Copies of the OSHA 200 form and current recordkeeping requirements can be obtained from the OSHA web site, http://www.osha.gov

	Section VII.  	Safety Rules, Policies, and Procedures

The safety rules 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.

ALL EMPLOYEES
Hazardous Materials	VII.3
Personal Protective Equipment	VII.4
Lifting Procedures	VII.4
Housekeeping	VII.4
Office Safety	VII.5
Ladders and Step Ladders	VII.6
Hand Truck Operations	VII.7
Carts		VII.7
Pallet Jack Use 	VII.7
Compressed Gas Cylinders
	Storage and Handling	VII.8
	Use of Cylinders	VII.8
Storeroom/Stockroom	VII.9

PROFESSIONAL STAFF
Moving Residents	VII.10

NURSES
Infection Control	VII.12

MAINTENANCE
Machine Guarding	VII.13
Hand Tool Safety	VII.12
	Files/Rasps	VII.13
	Chisels	VII.13
	Hammers	VII.14
	Saws	VII.14
	Screwdrivers	VII.14
	Wrenches	VII.14
	Pliers		VII.15		
	Vises		VII.15
	Snips		VII.15
Tool Boxes/Chests/Cabinets	VII.15
Electrical Powered Tools	VII.16
Grinders	VII.17

	SAFETY RULES, POLICIES, AND PROCEDURES

KITCHEN PERSONNEL
General Rules	VII.17
Knives/Sharp Instruments	VII.18

ADMINISTRATION / SOCIAL SERVICES PERSONNEL
Driving Safety
Fueling Vehicles	VII.18
Driving Rules	VII.18

ALL EMPLOYEES

Hazardous Materials
   1.	Follow the instructions on the label and in the corresponding Material Safety Data Sheet 	(MSDS) for each chemical product used in your workplace.
   2.	Use personal protective clothing or equipment such as neoprene gloves, rubber boots, shoe covers, rubber aprons, and protective eyewear, when using chemicals labeled "Flammable", "Corrosive", "Caustic" or "Poisonous".
   3.	Each time you use your gloves, wash your gloves before removing them using cold tap water and normal hand washing motion. Always wash your hands after removing the gloves.
   4.	Only dispense a liquid labeled "Flammable" from its bulk container located in areas posted "Flammable Liquid Storage".
   5.	Before pouring, dispensing or transferring any liquid from a bulk container labeled "Flammable", observe the following safety procedure:
	 Only use red color-coded, metal containers for transferring the liquid.
	 Electrically ground and bond the containers as follows:

	(1) Attach the clip at one end of the grounding wire to the rim of the dispensing         container and then attach the clip at the other end of the grounding wire to a ground    source, such as a ground driven steel stake.

	(2) Attach the clip at one end of the bonding wire to the rim of the dispensing          container and then attach the clip at the other end of the bonding wire to the rim of the receiving container.

	(3) You are now ready to dispense the liquid from the bulk container into the        opened receiving container. Upon completion, replace the lid on the receiving      container and remove the bonding wire.

   6.	Before using the chemical exhaust hood, manually flip the fan motor switch to the "on" position.
   7.	Do not use chemicals from unlabeled containers and unmarked cylinders.
   8.	Do not drag containers labeled "Flammable".
   9.	Use a rubber cradle when transporting unpackaged, glass bottles of chemicals.
  10.	Do not store chemical containers labeled "Oxidizer" with containers labeled "Corrosive" or "Caustic".
  11.	Wear chemical goggles and a face shield when using, applying or handling chemical liquids or powders from containers labeled "Caustic" or "Corrosive".

ALL EMPLOYEES

Personal Protective Equipment
   1.	Do not continue to work if your safety glasses become fogged.  Stop work and clean the glasses until the lenses are clear and defogged.
   2.	Wear ear plugs or ear muffs in areas posted "Hearing Protection Required".
   3.	Do not use protective clothing or equipment that has split seams, pin holes, cuts, tears or other visible signs of damage.

Lifting Procedures
  1.	Plan the move before lifting; remove obstructions from your chosen pathway.
  2.	Test the weight of the load before lifting by pushing the load along its resting surface.
  3.	If the load is too heavy or bulky, use lifting and carrying aids such as hand trucks, dollies, pallet jacks and carts, or get assistance from a co-worker.
  4.	If assistance is required to perform a lift, coordinate and communicate your movements with those of your co-worker.
  5.	Position your feet 6 to 12 inches apart with one foot slightly in front of the other.
  6.	Face the load.
  7.	Bend at the knees, not at the back.
  8.	Keep your back straight.
  9.	Get a firm grip on the object with your hands and fingers.  Use handles when present. 
 10.	Never lift anything if your hands are greasy or wet.
 11.	Wear protective gloves when lifting objects with sharp corners or jagged edges.
 12.	Hold objects as close to your body as possible.
 13.	Perform lifting movements smoothly and gradually; do not jerk the load.
 14.	If you must change direction while lifting or carrying the load, pivot your feet and turn your entire body.  Do not twist at the waist.
 15.	Set down objects in the same manner as you picked them up, except in reverse.
 16.	Do not lift an object from the floor to a level above your waist in one motion.  Set the load down on a table or bench and then adjust your grip before lifting it higher.
 17.	Slide materials to the end of the tailgate before attempting to lift them off of a pick-up truck.  Do not lift over the walls or tailgate of the truck bed.

Housekeeping
  1.	Do not place material such as boxes or trash in walkways and passageways.
  2.	Mop up water around drinking fountains, drink dispensing machines and ice machines.
  3.	Do not store or leave items on stairways.
  4.	Do not block or obstruct stairwells, exits or accesses to safety and emergency equipment such as fire extinguishers or fire alarms.
  5.	Straighten or remove rugs and mats that do not lie flat on the floor.
  6.	Return tools to their storage places after use.
  7.	Do not use gasoline for cleaning purposes.
  8.	Use caution signs or cones to barricade slippery areas such as freshly mopped floors.

ALL EMPLOYEES

Office Safety
  1.	Close drawers and doors immediately after use.
  2.	Open one file cabinet drawer at a time.
  3.	Put heavy files in the bottom drawers of file cabinets.
  4.	Use the handle when closing doors, drawers and files.
  5.	Do not stand on furniture to reach high places.
  6.	Use a ladder or step stool to retrieve or store items that are located above your head.
  7.	Do not kick objects out of your pathway; pick them up or push them out of the way.
  8.	Do not block your view by carrying large or bulky items; use a dolly or hand truck or get assistance from a fellow employee.
  9.	Store sharp objects, such as pens, pencils, letter openers or scissors in drawers or with the points down in a container.
 10.	Carry pencils, scissors and other sharp objects with the points down.
 11.	Do not tilt the chair you are sitting in on its back two legs.
 12.	Position hands and fingers on the handle of the paper cutter before pressing down on the blade.
 13.	Keep the paper cutter handle in the closed/locked position when it is not in use.
 14.	Do not use paper cutting devices if the finger guard is missing.
 15.	Keep floors clear of items such as paper clips, pencils, tacks or staples.
 16.	Keep fingers away from the ejector slot when loading or testing stapling devices.
 17.	Point the ejector slot away from yourself and bystanders when refilling staplers.
 18.	Use a staple remover, not your fingers, for removing staples.
 19.	Do not use extension or power cords that have the ground prong removed or broken off.
 20.	Use a cord cover or tape the cord down when running electrical or other cords across aisles, between desks or across entrances/exits.
 21.	Do not connect multiple electrical devices into a single outlet.
 22.	Turn off and unplug office machines before adjusting, lubricating or cleaning them.
 23.	Do not use fans that have excessive vibration, frayed cords or missing guards.
 24.	Do not use frayed, cut or cracked electrical cords.
 25.	Do not place floor type fans in walkways, aisles or doorways.
 26.	Do not place your fingers in or near the feed of a paper shredder.
 27.	Do not throw matches, cigarettes or other smoking materials into trash baskets.
 28.	Keep doors in hallways fully open or fully closed.
 29.	Use handrails when ascending or descending stairs or ramps.  
 30.	Obey all posted safety and danger signs.
 31.	Do not run on stairs or take more than one step at a time.
 32.	Clean up spills or leaks immediately by using a paper towel, rag or a mop and bucket.

ALL EMPLOYEES

Ladders and Step Ladders
  1.	Read and follow the manufacturer's instructions label affixed to the ladder if you are unsure how to use the ladder.
  2.	Do not use ladders that have loose rungs, cracked or split side rails, missing rubber foot pads, or other visible damage. 
  3.	Keep ladder rungs clean and free of grease.  Remove buildup of material such as dirt or mud.
  4.	Do not use a metal ladder on roof tops or within 50 feet of electrical power lines.
  5.	Do not place a ladder in a passageway or doorway without posting warning signs or cones that detour pedestrian traffic away from the ladder.  Lock the doorway that you are blocking with the ladder and post signs that will detour traffic away from your work.
  6.	Allow only one person on the ladder at a time.
  7.	Face the ladder when climbing up or down.
  8.	Maintain a three-point contact by keeping both hands and one foot or both feet and one hand on the ladder at all times when climbing up or down.
  9.	When performing work from a ladder, face the ladder and do not lean backward or sideways from the ladder.
 10.	Do not stand on the top two rungs of any ladder.
 11.	Do not stand on a ladder that wobbles, or that leans to the left or right.
 12.	When using a ladder, extend the top of the ladder at least 3 feet above the edge of the landing.
 13.	Secure the ladder in place by having another employee hold it.
 14.	Do not move a rolling ladder while someone is on it.
 15.	Do not place ladders on barrels, boxes, loose bricks, pails, concrete blocks or other unstable bases.
 16.	Do not carry items in your hands while climbing up or down a ladder.
 17.	Do not try to "walk" a ladder by rocking it.  Climb down the ladder, and then move it.
 18.	Do not use a ladder as a horizontal platform.

ALL EMPLOYEES

Hand Truck Operations
  1.	Tip the load slightly forward so that the tongue of the hand truck goes under the load.
  2.	Push the tongue of the hand truck all the way under the load to be moved.
  3.	Keep the center of gravity of the load as low as possible by placing heavier objects below the lighter objects.
  4.	When loading hand trucks, keep your feet clear of the wheels.
  5.	Push the load so that the weight will be carried by the axle and not the handles.  The operator should only balance and push.
  6.	Place the load so that it will not slip, shift or fall.  Use straps, if provided, to secure the load.
  7.	If your view is obstructed, use a spotter to assist in guiding the load.
  8.	For extremely bulky or pressurized items such as gas cylinders, strap or chain the items to the hand truck.
  9.	Do not walk backward with the hand truck, unless going up stairs or ramps.
 10.	When going down an incline, keep the hand truck in front of you so that it can be controlled at all times.
 11.	Move hand trucks at a walking pace.  
 12.	Store hand trucks with the tongue under a pallet, shelf, or table.
 13.	Do not exceed the manufacturer's load rated capacity.  Read the capacity plate on the hand truck if you are unsure.

Carts
  1.	Do not exceed the manufacturer's load rated capacity noted on the manufacturer's label on the cart.
  2.	Use a spotter to help guide carts around corners and through narrow aisles. 
  3.	Do not stand on a cart or float, or use it as a work platform.

Pallet Jack Use
  1.	Only pallet jack operators may operate pallet jacks.
  2.	Do not exceed the manufacturer's load rated capacity.  Read the lift capacity plate on the pallet jack if you are unsure.
  3.	Do not ride on pallet jacks.
  4.	Start and stop gradually to prevent the load from slipping.
  5.	Pull manual pallet jacks; push when going down an incline or passing close to walls or obstacles. 
  6.	If your view is obstructed, use a spotter to assist in guiding the load.
  7.	Stop the pallet jack if anyone gets in your way.
  8.	Do not place your feet under the pallet jack when it is moving.
  9.	Keep your feet and other body parts clear of pallet before releasing the load.
 10.	Do not leave pallet jack unattended with the load suspended.

ALL EMPLOYEES

Compressed Gas Cylinders
  Storage and Handling
  1.	Do not handle oxygen cylinders if your gloves are greasy or oily.
  2.	Store all cylinders in the upright position.
  3.	Place valve protection caps on gas cylinders that are in storage or not in use.
  4.	Do not lift cylinders by the valve protection cap.
  5.	Do not store compressed gas cylinders in areas where they can come in contact with chemicals labeled "Corrosive".
  6.	Place cylinders on a cradle, slingboard, pallet or cylinder basket to hoist them.
  7.	Do not place cylinders against electrical panels or live electrical cords where the cylinder can become part of the circuit.

  Use of Cylinders
  1.	Do not use dented or visibly damaged cylinders.
  2.	Use only an open ended or adjustable wrench when connecting or disconnecting regulators and fittings.
  3.	Do not transport cylinders without first removing regulators and replacing the valve protection caps.
  4.	Close the cylinder valve when work is finished, when the cylinder is empty or at any time the cylinder is moved.
  5.	Do not store oxygen cylinders near fuel gas cylinders such as propane or acetylene, or near combustible material such as oil or grease.
  6.	Stand to the side of the regulator when opening the valve.
  7.	If a cylinder is leaking around a valve or a fuse plug, move it to an outside area away from where work is performed and tag it to indicate the defect.
  8.	Do not use compressed gas to clean the work area, equipment or yourself.
  9.	Open compressed gas cylinder valves slowly.  Open fully when in use to eliminate possible leakage around the cylinder valve stem.

ALL EMPLOYEES

Storeroom/Stockroom
   1.	Use long handled snips when cutting strapping bands away from a shipping container.
   2.	Wear safety glasses when cutting strapping bands, uncrating materials and driving nails.
   3.	Stand to the side of the strapping band when cutting it.
   4.	Do not run on stairs or take more than one step of a staircase at a time.
   5.	Do not jump from elevated places such as truck beds, platforms or ladders.
   6.	Do not smoke while handling chemicals labeled "Flammable".
   7.	Do not store chemicals labeled "Flammable" near sources of ignition such as space heaters and sparking tools.
   8.	Do not handle or load any containers of chemicals if their containers are cracked or leaking.  
   9.	Obey all safety and danger signs posted in the workplace.
  10.	Store case cutters, exacto knives or other tools with cutting edges in sheaths when they are not in use.
  11.	Visually inspect for sharp objects or other hazards before reaching into containers such as garbage cans, boxes, bags or sinks.
  12.	Remove or bend nails and staples from crates before unpacking.
  13.	Stack heavy or bulky storage containers on middle and lower shelves of the storage rack.
  14.	When manually stocking shelves, position the materials to be shelved slightly in front of you, so you do not have to twist when lifting and stacking materials.
  15.	Do not let items overhang from shelves into walkways.
  16.	Remove one object at a time from shelves.
  17.	Place items on shelves so that they lie flat and do not lean against each other.
  18.	Move slowly when approaching blind corners.

PROFESSIONAL STAFF

Moving Residents
   1.	Always use the two person lifting rule.
   2.	Use mechanical lifts.
   3.	Use either the:
	  a. Lumbar Belt* or
	  b. Gaite Belt    
	          *  The Lumbar Belt is an enhancement to proper lifting techniques and not to be  	             relied on for physical support.    

   Bed to Gurney Transfer	
   1.	Adjust bed to the level of gurney.
   2.	Lock bed and lock gurney in place by bed.
   3.	Place a plastic sheet beneath draw-sheet to facilitate sliding the resident.  
   4.	Keep your knee on gurney when moving resident to edge.
   5.	Transfer resident in two stages, first onto edge, then to middle of gurney.

   Transfer From Bed To Wheelchair
   1.	Adjust the bed height to that of the wheelchair and lock bed in place. 
   2.	Move the wheelchair into position and lock wheelchair into place.
   3.	Reduce the lifting, by supporting patient's knee between your legs.
   4.	Talk to resident and together move resident to a standing position.  Keep your knees     slightly bent and back balanced.
   5.	Pivot and lower the resident into wheelchair by bending your knees.
   6.	Allow the resident to hold on to you at your waist or shoulders, not the neck.

   Moving Resident Up In Bed
   1.	Lock bed into place to prevent movement. 
   2.	Adjust the bed height so it is below your waist.
   3.	Work from the side of the bed, point your feet in the direction you are moving the resident. 
   4.	Use a draw sheet and adjust bed to flat position to move the resident.
   5.	Do not try to lift resident; reach under the resident's back and shoulders and slide       resident toward head of bed.
   6.	Request resident to assist you in this movement by pushing with feet and elbows.
   7.	When performing this task, keep your feet wide apart, and knees bent.

PROFESSIONAL STAFF

   Turning Resident Over In Bed
   1.	Lock the bed in place to prevent movement. 
   2.	Adjust the bed height to mid or upper thigh. 
   3.	Lower bed rails.
   4.	Cross residents legs and cross arms on his or her chest.
   5.	Place your knees against the bed for support. 
   6.	Keep your knees bent, your back balanced and use your body weight to help turn the   resident.
   7.	Do not lift, but turn the resident toward you.

   A Falling Resident
   1.	Do not try to prevent the fall once in progress.  Bend your knees and help guide the    resident safely to the floor.
   2.	Do not try to lift the resident; get help to remove resident from floor. 

   Transfer Resident From Wheelchair To Toilet
   1.	Lock the wheelchair into place.
   2.	Have the resident grasp the grab bar by the toilet and the arm of the wheelchair for support.  Do not lift the resident.
   3.	Have the resident pivot, helping to position his or her body.  Do not lift the resident. 
   4.	Bend your knees and assist resident but do not position resident by trying to lift him/her.
 
   Mechanical Apparatus
   1.	Do not lift; use transfer belts for safely moving residents from beds, chairs, cars, and  toilets.
   2.	Do not lift; use a roller board to move resident between gurney and bed.
   3.	Do not lift; have the resident use the trapeze to assist you during movement from or    in bed.

NURSES

Infection Control 
   1.	Do not bend, recap, remove, shear or purposely break any contaminated needle. 
   2.	Discard disposable needles or medical sharps into the containers labeled "Biohazard Sharps".
   3.	Do not reach into containers when discarding the sharp items.
   4.	Wash or flush areas with water if your skin surface, eye or mouth is splashed or spattered with blood or other bodily fluids.
   5.	Wear non-permeable gloves when contact with blood, non-intact skin, mucous membranes or other infectious materials is possible.
   6.	Do not use gloves which are torn, cut or punctured.
   7.	When required to wear protective gloves do not use hand to face movements when handling materials that are visibly contaminated with human blood. 
   8.	Wash hands and other exposed skin surfaces on the arms and forearms with soap and water or the waterless cleaner immediately upon removal of protective gloves.
   9.	Wear latex or vinyl gloves and full face and body protection whenever large amounts of blood or body fluids are present or anticipated.
  10.	Place protective equipment contaminated with human blood in the red containers labeled "Biohazard"; these containers prevent leakage during collection, handling, storage and transport. 
  11.	When performing emergency medical care, wear latex or vinyl gloves. When finished using the gloves, discard them immediately into the "Biohazard" marked bag/container for disposal.
  12.	Wear full face protection whenever administering care to patients who are vomiting, coughing, choking, sneezing or being intubated.
  13.	Clean up any broken glass using a dust pan and broom.  Do not pick up broken glass with your hands.
  14.	Use bag-valve masks or pocket "mask to mouth" devices when performing CPR.

MAINTENANCE

Machine Guarding
  1.	Replace the guards before starting machines, after making adjustments or repairs.
  2.	Do not remove, alter or bypass any safety guards or devices when operating any piece of equipment or machinery.

Hand Tool Safety
  1.	Tag worn, damaged or defective tools "Out of Service" and do not use them.
  2.	Do not use a tool if its handle has splinters, burrs, cracks or splits, or if the head of the tool is loose.
  3.	Do not use impact tools such as hammers, chisels, punches or steel stakes that have mushroomed heads.
  4.	When handing a tool to another person, direct sharp points and cutting edges away from yourself and the other person.
  5.	When using knives, shears or other cutting tools, cut in a direction away from your body. 
  6.	Do not carry sharp or pointed hand tools such as screwdrivers, scribes, aviation snips, scrapers, chisels or files in your pocket unless the tool or pocket is sheathed.
  7.	Do not perform "make-shift" repairs to tools.
  8.	Do not carry tools in your hand when climbing.  Carry tools in tool belts or hoist the tools to the work area with a hand line.
  9.	Do not throw tools from one location to another, from one employee to another, from scaffolds or other elevated platforms.
 10.	Transport hand tools only in tool boxes or tool belts.  Do not carry tools in your clothing.

  Files/Rasps
  1.	Do not use a file as a pry bar, hammer, screwdriver or chisel.
  2.	When using a file or a rasp, grasp the handle in one hand and the toe of the file in the other.
  3.	Do not hammer on a file.

  Chisels
  1.	Keep the cutting edge of the chisel sharp.
  2.	Do not use chisels with damaged striking ferrules.
  3.	Hold a chisel with a tool holder if possible. 
  4.	Clamp a small workpiece in a vise and chip towards the stationary jaw when working with a chisel.

MAINTENANCE

  Hammers
  1.	Use a claw hammer for pulling nails.
  2.	Do not strike nails or other objects with the cheek of the hammer.
  3.	Do not strike a hardened steel surface, such as a cold chisel, with a claw hammer.
  4.	Do not strike one hammer against another hammer.
  5.	Do not use a hammer if your hands are oily, greasy or wet.
  6.	Do not use a hammer as a wedge or a pry bar or for pulling large spikes.
  7.	Use only a sledge type hammer on a striking face wrench.

  Saws
  1.	Keep control of saws by releasing downward pressure at the end of the stroke.
  2.	Do not use an adjustable blade saw such as a hacksaw, coping saw, keyhole saw or bow saw, if the blade is not taut.
  3.	Do not use a saw that has dull saw blades.
  4.	Oil saw blades after each use.
  5.	Keep hands and fingers away from the saw blade while using the saw.
  6.	Do not carry a saw by the blade.
  7.	When using a hand saw, hold the workpiece firmly against the work table.

  Screwdrivers
  1.	Always match the size and type of screwdriver blade to fit the head of the screw.
  2.	Do not hold the workpiece against your body while using a screwdriver.
  3.	Do not put your fingers near the blade of the screwdriver when tightening a screw.
  4.	Use an awl, drill or nail to make a starting hole for screws.
  5.	Do not force a screwdriver by using a hammer or pliers on it.
  6.	Do not use a screwdriver as a punch, chisel, pry bar or nail puller.
  7.	Use a screwdriver that has an insulated handle for electrical work.
  8.	Do not carry a screwdriver in your pocket.
  9.	Do not use a screwdriver if your hands are wet, oily or greasy.
 10.	Do not use a screwdriver to test the charge of a battery.
 11.	When using a spiral ratchet screwdriver, push down firmly and slowly.

  Wrenches
  1.	Do not use wrenches that are bent, cracked or badly chipped, or that have loose or broken handles.
  2.	Do not slip a pipe over a single head wrench handle for increased leverage.
  3.	Do not use a shim to make a wrench fit.
  4.	Size the adjustable wrench to fit the nut before turning.
  5.	Use a split box wrench on flare nuts.
  6.	Do not use a wrench with broken or battered points.
  7.	Use a hammer on striking face wrenches.
  8.	Discard any wrench with spread, nicked or battered jaws, or if the handle is bent.

MAINTENANCE

  Wrenches (Continued)
  9.	Use box or socket wrenches on hexagon nuts and bolts as a first choice, and open end wrenches as a second choice.

  Pliers
  1.	Do not use pliers as a wrench or a hammer.
  2.	Do not attempt to force pliers by using a hammer on them.
  3.	Do not slip a pipe over the handles of pliers to increase leverage. 
  4.	Use pliers with an insulated handle for electrical work.
  5.	Do not use pliers that are cracked, broken or sprung.
  6.	When using diagonal cutting pliers, shield the loose pieces of cut material from flying into the air by using a cloth or your gloved hand.  

  Vises
  1.	When clamping a long workpiece in a vise, support the far end of the workpiece by using an adjustable pipe stand, saw horse or box.
  2.	Position the workpiece in the vise so that the entire face of the jaw supports the workpiece.
  3.	Do not use a vise that has worn or broken jaw inserts, or has cracks or fractures in the body of the vise.
  4.	Do not slip a pipe over the handle of a vise to gain extra leverage.

  Snips
  1.	Wear safety glasses or safety goggles when using snips to cut materials.
  2.	Wear work gloves when cutting materials with snips.
  3.	Do not use straight cut snips to cut curves.
  4.	Keep the blade aligned by tightening the nut and bolt on the snips.
  5.	Do not use snips as a hammer, screwdriver or pry bar.
  6.	Use the locking clip on the snips after use.

Tool Boxes/Chests/Cabinets
  1.	Use the handle when opening and closing a drawer or door.
  2.	Tape over or file off sharp edges on tool boxes, chests or cabinets.
  3.	Do not stand on tool boxes, chests or cabinets to gain extra height.
  4.	Lock the wheels on large tool boxes, chests or cabinets to prevent them from rolling.
  5.	Push large chests, cabinets and tool boxes; do not pull.
  6.	Do not open more than one drawer of a tool box at a time.
  7.	Close and lock all drawers and doors before moving the tool chest to a new location.
  8.	Do not use a tool box or chest as a workbench.
  9.	Do not move a tool box, chest or cabinet if it has loose tools or parts on the top. 

MAINTENANCE

Electrical Powered Tools
  1.	Do not use power equipment or tools on which you have not been trained.
  2.	Keep power cords away from the path of drills, saws, vacuum cleaners, floor polishers, mowers, slicers, knives, grinders, irons and presses.
  3.	Do not use cords that have splices, exposed wires, or cracked or frayed ends. 
  4.	Do not carry plugged in equipment or tools with your finger on the switch.
  5.	Do not carry equipment or tools by the cord. 
  6.	Disconnect the tool from the outlet by pulling on the plug, not the cord.
  7.	Turn the tool off before plugging or unplugging it.
  8.	Do not leave tools that are "On" unattended.
  9.	Do not handle or operate electrical tools when your hands are wet or when you are standing on wet floors.
 10.	Do not operate spark inducing tools such as grinders, drills or saws near containers labeled "Flammable" or in an explosive atmosphere such as a paint spraybooth.
 11.	Turn off electrical tools and disconnect the power source from the outlet before attempting repairs or service work.  Tag the tool "Out of Service".
 12.	Do not use extension cords or other grounded three-pronged power cords that have the ground prong removed or broken off.
 13.	Do not use an adapter such as a cheater plug that eliminates the ground.
 14.	Do not connect multiple electrical tools into a single outlet.
 15.	Do not run extension cords through doorways, or through holes in ceilings, walls or floors.
 16.	Do not drive over, drag, step on or place objects on a cord.
 17.	Do not use a power hand tool to cut wet or water soaked building materials or to repair pipe leaks.
 18.	Do not use a power hand tool while wearing wet cotton gloves or wet leather gloves.
 19.	Never operate electrical equipment barefooted.  Wear rubber-soled or insulated work boots.
 20.	Do not operate a power hand tool or portable appliance if the ground pin from the three pronged power plug is missing or has been removed.
 21.	Do not operate a power hand tool or portable appliance with a two-pronged adapter or a two conductor extension cord.
 22.	Do not operate a power hand tool or portable appliance while holding a part of the metal casing or holding the extension cord in your hand.  Hold all portable power tools by the plastic hand grips or other nonconductive areas designed for gripping purposes.

MAINTENANCE

Grinders
  1.	Do not use grinding wheels that have chips, cracks or grooves.
  2.	Do not use the grinding wheel if it wobbles.  Tag it "Out of Service".
  3.	Do not try to stop the wheel with your hand, even if you are wearing gloves.
  4.	Do not use grinder if it is not firmly anchored to the work bench.
  5.	Prior to installing a new grinding wheel, inspect the wheel for cracks or other visible damage; tap the wheel gently with a plastic screwdriver handle to detect cracks that are not visible. If the wheel has a dead sound rather than a ringing sound, do not use the wheel.
  6.	Do not install a grinding wheel whose labeled RPM speed is lower than the rated speed of the grinder.
  7.	Do not clamp a portable grinder in a vise to use it as a bench grinder.
  8.	Do not use grinding wheels if the tool rest is not adjusted to one-eighth of an inch from the wheel.
  9.	Do not use grinding wheels if the tongue guard is not adjusted to one-fourth of an inch from the wheel.

KITCHEN PERSONNEL

General Rules
 1. 	Do not remove safety guards provided on the equipment.  When a safety guard is removed for the purpose of making repairs or cleaning, replace the guard before the equipment is put into operation.
 2.	Do not position heated pots or pans with the handles protruding over the edge of range, table or counter.
 3.	Do not fill pots, pans, buckets or cookers more than 2/3 full.
 4.	When adding ingredients to hot liquids, add small portions to prevent splashing.
 5.	Use the release valve to release pressure before opening pressurized steam kettles or pressure cookers.
 6.	Transport hot liquids in closed containers.
 7.	Use carts for moving large hot items such as coffee urns, containers of hot water or containers of hot food.
 8.	Use the cart wheel locking lever to prevent movement while removing items from the cart.
 9.	Turn off gas supply and electrical current for appliances when they are not in use.
10.	Turn off circuit breakers to kitchen cooking equipment when cleaning the equipment.

KITCHEN PERSONNEL

Knives/Sharp Instruments
  1.	When handling knives and other cutting tools, direct sharp points and edges away from you.
  2.	Cut in the direction away from your body when using knives.
  3.	Store knives in knife blocks or in sheaths after use.
  4.	Do not use knives with dull blades.
  5.	Do not use honing steels that do not have disc guards.
  6.	Do not attempt to catch a falling knife.
  7.	Use knives for the operations for which they are named.
  8.	When opening cartons, use safety box cutters.   Do not cut with the blade extended beyond the guard.
  9.	Do not use knives with broken or loose handles.
 10.	Do not use knives as screwdrivers, pry bars, can openers or ice picks.
 11.	Do not leave knives in sinks full of water.  
 12.	Do not pick up knives by their blades.
 13.	Carry knives with their tips pointed towards the floor.
 14.	Do not carry knives, scissors or other sharp tools in pockets or aprons unless they are first placed in their sheaths or holders.
 15.	Follow this procedure when picking up any bags that have sharp objects protruding from them:  Grab the top of the bag above the tie-off with two hands and hold the bag away from your body.
 16.	Do not submerge hot glass in cold water or submerge a cold glass in hot water.

ADMINISTRATION / SOCIAL SERVICES PERSONNEL

Driving Safety
Fueling Vehicles
  1.	Turn the vehicle off before fueling.
  2.	Do not smoke while fueling a vehicle.
  3.	Wash hands with soap and water if you spill gasoline on your hands.

Driving Rules
   1.	Shut all doors and fasten your seat belt before moving the vehicle.
   2.	Obey all traffic patterns and signs at all times.
   3.	Maintain a three point contact using both hands and one foot or both feet and one hand when climbing into and out of vehicles.
   4.	Keep windows and windshield clean.
   5.	Do not operate vehicle if you are ill or fatigued.
   6.	Do not operate a vehicle if you are taking any medication whose container label indicates that the medication may cause drowsiness or other side effects. 
   7.	Only employer authorized personnel may operate any company vehicle.