Injury and Illness Prevention

The Town of Corte Madera is committed to having a safe and healthful work environment. To achieve this goal, the Town has developed an Injury and Illness Prevention Program (IIPP) in accordance with Title 8, California Code of Regulations, Section 3203, of the General Industry Safety Orders to prevent workplace accidents, injuries, and illnesses. The responsibility for safety in the work environment belongs to everyone, and this program has been developed with this in mind.

Read the Town's Complete IIPP here. This IIPP Complete Packet contains relevant forms and instructions. To go to the forms needed for reporting or instruction, please use the IIPP Forms section below.

Accidents/Incidents

Incidents have been broken down into three categories. Please use the forms that are listed based on the appropriate category. If you are unsure of which category the accident/incident falls into, please refer to section 7.0 Accident and Incident Types and Investigations of the IIPP Complete Packet.

IMPORTANT: For all accidents/incidents, employees should contact the Company Nurse Hotline IMMEDIATELY for further instructions and to determine if medical treatment is needed.

Minor Injuries

Department Head's Accident Investigation Report (This form is optional. No action will be taken for a minor injury)

First-Aid

Department Head's Accident Investigation Report

OSHA Recordable

Employer's First Report Form (Form 5020)
Department Head's Accident Investigation Report
Employee Claim Form (DWC-1)
Employee Acknowledgement Form
To print or download all forms at one time, please click here.

Employee Hazard Reporting

To report safety hazards that may result in employee illness or injury, damage to Town property, or injury to the public, use the IIPP Hazard Reporting Form.