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Agenda packet

Kerman City Council
November 13, 2024

Document
Agenda packet
Meeting
November 13, 2024
Body
Kerman City Council
Pages
4
Original file
34.6 MB
Text extracted from the city's file for reading and search. Open the original on mccmeetings.blob.core.usgovcloudapi.net. That file is the official record.

CITY COUNCIL REGULAR MEETING AGENDA
Wednesday, November 13, 2024 at 6:00 PM
Kerman City Hall, 850 S. Madera Avenue, Kerman, CA 93630 LEVINE ACT DISCLOSURE. Pursuant to the Levine Act (Govt Code Section 84308), any party to a permit, license, contract, or other entitlement before the City Council is required to disclose on the record any campaign contribution, including aggregated contributions, of more than $250 made by the party or the party’s agents within the preceding 12 months to any City official. Participants and agents are requested to make this disclosure as well. The disclosure should be made when the agenda item is called and must include the name of the party, participant, or agent, and any other person making the contribution, the name of the recipient, the amount of the contribution, and the date the contribution was made. Council Members are also required to make such disclosures and recuse themselves.

CONFLICT OF INTEREST. City Council Members with a conflict of interest under the Political Reform Act are required to make disclosure of financial interest when the item is called and recuse themselves.

1. OPENING CEREMONIES
A. Call to Order
B. Roll Call
C. Invocation
D. Flag Salute

2. AGENDA APPROVAL/ADDITIONS/DELETIONS
To accommodate members of the public or convenience in the order of presentation, items on the agenda may not be presented or acted upon in the order listed.

3. PRESENTATIONS/CEREMONIAL MATTERS
A. Proclamation - Native American Heritage Month
B. Certificate Presentation: Kerman Christian School
C. Introduction of New Police Officers (SW)
D. Honoring Jessica Silva - Years of Service (TJ)
E. Proclamation - Small Business Saturday
1 4. PUBLIC FORUM (for matters not on agenda)
This portion of the meeting is reserved for members of the public to address the Council on items of interest that are not on the Agenda and are within the subject matter jurisdiction of the Council.

Speakers shall be limited to three minutes. It is requested that no comments be made during this period on items on the Agenda. Members of the public wishing to address the Council on items on the Agenda should notify the Mayor when that Agenda item is called, and the Mayor will recognize your discussion at that time. It should be noted that the Council is prohibited by law from taking any action on matters discussed that are not on the Agenda. Speakers are asked to please use the microphone, and provide their name and address.

5. CONSENT CALENDAR
Matters listed under the Consent Calendar are considered routine and will be enacted by one motion and one vote. There will be no separate discussion of these items. If discussion is desired, a member of the audience or a Council Member may request an item be removed from the Consent Calendar and it will be considered separately.

A. SUBJECT: Minutes - October 23, 2024
RECOMMENDATION: Council approve minutes as presented.

B. SUBJECT: Payroll (JA)
9/29/24 to 10/12/24: $239,417.76; Retro Pay & Other: $3,138.36; Overtime: $9,559.38; Standby: $1,781.86; Comp Time Earned: 33.60
RECOMMENDATION: Council approve payroll as presented.

C. SUBJECT: License Agreements with Property Owners for Mural Locations (TJ) RECOMMENDATION: Council by motion to adopt;

1. A resolution approving the license agreement with Eloy Coronado, property owner of 602 South Madera Avenue Kerman, CA 93630, APN: 023-241-015S, to install a mural and authorize the City Manager to sign the agreement; and

2. A resolution approving the license agreement with Russel D. Lindquist and Rebecca B.

Linquist, property owners of 681 South Madera Avenue Kerman, CA 93630, APN: 023-148- 07S, to install a mural and authorize the City Manager to sign the agreement.

D. SUBJECT: Community Organization Grant Program Supplemental Award – S.B.F. Kerman Portuguese Hall (JAJ)
RECOMMENDATION: Council by motion adopt resolution approving waiver of $467.01 in cost for facilitating S.B.F. Kerman Portuguese Hall - 2024 Portuguese Parade. 2 E. SUBJECT: Update of Safety Policies and Procedures and Adoption of Injury and Illness Prevention Program – Administration (JAJ)
RECOMMENDATION: Council by motion adopt resolution approving new Injury and Illness Prevention Program.

6. PUBLIC HEARINGS
These hearings are scheduled at the time stated and will be heard by the Council as close to the time stated as possible.

A. SUBJECT: Public Hearing and Authorization of Submission of Application for CDBG Funds for Fiscal Year 2025-2026 (JG)
RECOMMENDATION: Council conduct a public hearing and adopt the resolution authorizing the submission of an application for Community Development Block Grant (CDBG) funds for Fiscal Year 2025-2026 for the Kerckhoff Park Improvements.

7. DEPARTMENT REPORTS
A. SUBJECT: Discussion-Study Session on West Fresno County Solar Projects (JAJ) RECOMMENDATION: That Council hear a brief presentation regarding solar development in West Fresno County, including that of Westlands Water District, to become informed about current development proposals and any impacts to Kerman, with possible direction to staff.

B. SUBJECT: Award of Contract for the Hart Ranch Community Park Project to Avison Construction, Inc. (JG)
RECOMMENDATION: Council by motion adopt the resolution:

1. Awarding the Hart Ranch Community Park Project contract to Avison Construction, Inc. in the amount of $12,453,125.00; and

2. Authorizing a 5% construction contingency in the amount of $622,700.00; and

3. Authorizing the City Manager to sign the construction contract on behalf of the City; and

4. Authorizing the City Manager to sign change orders, up to the additional contingency amount, on behalf of the City.

C. SUBJECT: Third Amendment to Employment Agreement with City Manager (HCM) RECOMMENDATION: Council is asked to consider and determine whether to adopt a resolution approving a third amendment to Employment Agreement with City Manager.

8. CITY MANAGER/STAFF COMMUNICATIONS
3 9. MAYOR/COUNCIL REPORTS/ANNOUNCEMENTS/FUTURE AGENDA ITEMS (This portion of the meeting is reserved for the Mayor and Council Members (i) to make brief reports on boards, committees, and other public agencies, and at public events, (ii) to request updates, (iii) to initiate future agenda items at the request of a Council Member, and (iv) to take action on matters initiated under this section of the agenda items. Under this section the Council may take action only on items specifically agendized and which meet other requirements for action.)

10. CLOSED SESSION
If desired, members of the public may comment on Closed Session items. Members of the public wishing to address Council on Closed Session items should notify the Mayor when that item is called, and the Mayor will recognize your discussion at that time. It should be noted that Council is prohibited from discussing or addressing comments on Closed Session items.

A. Conference with Legal Counsel – Existing Litigation (Government Code Section 54956.9) Eric Antuna, Appellant v. City of Kerman, Respondent
Court of Appeal, Fifth Appellate District Case No. F086661

11. ADJOURNMENT
NOTICE OF AVAILABILITY OF AGENDA MATERIALS: Any writings or documents provided to a majority of the City Council within 72 hours of the meeting regarding any item on this agenda will be made available for public inspection at the City Clerk’s Office located at 850 S. Madera Ave., Kerman, CA 93630 and on the City website at www.cityofkerman.net.

ADA Compliance and Reasonable Accommodation. The Council has adopted a Reasonable Accommodation Policy, which is available on the City website at www.cityofkerman.net or upon request by emailing the City Clerk at [email protected] or calling (559) 550-1414. The Policy provides a procedure for receiving and resolving requests for accommodation to participate in this meeting. If you need assistance in order to attend this Council meeting or require auxiliary aids or services, e.g., hearing aids or signing services to make a presentation to the Council, please contact the City Clerk at (559) 550-1414 or email at [email protected] so such aids or services can be arranged. Accommodations should be requested as early as possible as additional time may be required in order to provide the requested accommodation. The meeting room is accessible to persons with physical disabilities.

AGENDA POSTING CERTIFICATION
I, Josie Camacho, City Clerk for the City of Kerman, do hereby declare under penalty of perjury that I caused the above agenda to be posted at City of Kerman Council Chambers at 850 S. Madera Ave., Kerman, CA 93630 and on the City website at www.cityofkerman.net.

Date: November 8, 2024 /s/ Josie Camacho, City Clerk
4 NATIVE AMERICAN HERITAGE MONTH
WHEREAS, in 1990, President George H. W. Bush approved a joint resolution designating November as “National American Indian Heritage Month”; and WHEREAS, the City of Kerman, California throughout the month of November, recognizes National Native American Heritage Month; and WHEREAS, National Native American Heritage Month gives cause to celebrate the rich ancestry and traditions of Native Americans and Indigenous peoples; and WHEREAS, Native American and Indigenous roots are deeply embedded in this land – a homeland loved, nurtured, strengthened, and fought for with honor and conviction, through enduring cultures and contributions of all Native American and Indigenous peoples; and
WHEREAS, with more than 500 federally-recognized Native American tribes, this month offers an opportunity to learn more about Native American tribes and to raise awareness about the unique challenges Native American and Indigenous people have faced both historically and in the present; and
WHEREAS, despite these challenges, and painful history, Native and Indigenous peoples, their governments, and their communities have persevered and flourished as teachers and scholars, scientists and doctors, writers and artists, business leaders and elected officials, and so much more.

NOW, THEREFORE BE IT RESOLVED that the Kerman City Council hereby proclaims the month of November 2024 as “National Native American Heritage Month”.

I have hereunto set my hand and caused the Official Seal of the City of Kerman to be affixed on this 13th day of November 2024.
________________________
Maria Pacheco
Mayor
5 Section 3, Item A.

“SMALL BUSINESS SATURDAY”
WHEREAS, according to the United States Small Business Administration, there are currently 32.5 million small businesses in the United States; and WHEREAS, small businesses are responsible for over 60% of net new jobs created since 1995; and
WHEREAS, small businesses employ nearly 47% of the employees in the private sector in our country, and contribute positively to the local community by supplying jobs and generating tax revenue; and
WHEREAS, along with advocacy groups, public and private organizations across the country have endorsed the Saturday after Thanksgiving as Small Business Saturday, today Kerman celebrates our local small businesses and the contributions they make to our local economy and community; and WHEREAS, it is important to support our City’s valued small businesses, which create jobs, boost our local economy, support the community, and preserve our small town charm and character.

NOW, THEREFORE BE IT RESOLVED that the Kerman City Council hereby proclaims November 30, 2024 as Small Business Saturday, and urges the residents of our community to support small businesses and merchants today and throughout the year.

I have hereunto set my hand and caused the Official Seal of the City of Kerman to be affixed on this 13th day of November 2024. ________________________
Maria Pacheco
Mayor
6 Section 3, Item E.

CITY COUNCIL REGULAR MEETING MINUTES
Wednesday, October 23, 2024 at 6:00 PM
Kerman City Hall, 850 S. Madera Avenue, Kerman, CA 93630

1. OPENING CEREMONIES
A. Call to Order - 6:01 p.m.

B. Roll Call - All present except Councilmember Yep
C. Invocation - Performed by Mayor Pacheco
D. Flag Salute – Performed

2. AGENDA APPROVAL/ADDITIONS/DELETIONS
Motion to approve agenda as presented, with the stipulation to return to the ceremonial matters at a later time during the meeting, made by Councilmember Coleman, Seconded by Councilmember Herrera.

Ayes: Coleman, Herrera, Nijjer, Pacheco
Noes: None
Abstain: None

Absent: Yep
Motion passes 4-0-0-1

3. PRESENTATIONS/CEREMONIAL MATTERS
A. Sikh American Awareness and Appreciation Month - 6:35 p.m.

Presented to Raj Pannu. Luis Martinez also presented certificates from Senator Caballero's office as well as Oneida Escobar from Assemblywoman Soria's office.

4. PUBLIC FORUM - None.

5. CONSENT CALENDAR
A. SUBJECT: Minutes - October 9, 2024
RECOMMENDATION: Council approve minutes as presented.
7 Section 5, Item A.

B. SUBJECT: Warrants (JA)

1. Nos.30249-30460 $992,039.78 ACH $112,359.63.

RECOMMENDATION: Council approve warrants and electronic bank transfers as presented. (Pursuant to Government Code 37208)
C. SUBJECT: Payroll (JA)
09/15/24 - 09/28/24: $267,179.88; Retro Pay & Other: $$24,260.41; Overtime:
$27,657.16; Standby: $1,678.30; Comp Time Earned: 100.50 RECOMMENDATION: Council approve payroll as presented.

D. SUBJECT: Monthly Investment Report (JA)
RECOMMENDATION: Council accept monthly investment report as presented.

E. SUBJECT: Auditing Services Proposal and Selection of Consultant (JA) RECOMMENDATION: Staff recommends Council adopt resolution approving consultant contract with Bryant L. Jolley, CPA Consultants in the amount not to exceed $52,000 for conducting the auditing services for Fiscal Year 2023/2024, not to exceed $54,000 for Fiscal Year 2024/2025, not to exceed $55,000 for Fiscal Year 2025/2026, not to exceed $57,000 for Fiscal Year 2026/2027 and not to exceed $58,000 for Fiscal Year 2027/2028 and authorize the City Manager to sign the Consultant Agreement. – Res. 24-90 F. SUBJECT: Ratification of Emergency Water Line Repair (MB) RECOMMENDATION: Council by motion adopt resolution ratifying emergency repairs to water line and the procurement of services for the repairs from Haydon Construction Inc. in the amount of $36,794.11. – Res. 24-91
G. SUBJECT: Revised Title and Job Description for Parks Maintenance Technician Position in Community Services Department (JAJ)
RECOMMENDATION: Council by motion adopt resolution approving revised position title of Parks Maintenance Technician I to Maintenance Worker II – Parks and Facilities and approving new job description. – Res. 24-92
H. SUBJECT: Resolution Accepting the Lions Park Recharge Project and Filing of the Notice of Completion (JG)
RECOMMENDATION: Council by motion adopt resolution accepting the Lions Park Recharge Project and authorizing the City Engineer to record the Notice of Completion. – Res 24-93
8 Section 5, Item A.

Motion made by Mayor Pro Tem Nijjer, Seconded by Councilmember Coleman.

Ayes: Nijjer, Coleman, Herrera, Pacheco
Noes: None
Abstain: None

Absent: Yep
Motion passes 4-0-0-1

6. PUBLIC HEARINGS – None.

7. DEPARTMENT REPORTS
A. SUBJECT: Approve a reimbursement agreement with Kerman Unified School District (KUSD) for the construction of a segment of 12-inch water main across State Route 180 in the amount of $230,000 (JG)
RECOMMENDATION: Council by motion adopt a resolution approving reimbursement agreement with Kerman Unified School District for installation of 12-inch water main and authorizing the City Manager to sign. – Res 24-94
Motion made by Councilmember Herrera, Seconded by Mayor Pro Tem Nijjer.

Ayes: Herrera, Nijjer, Coleman, Pacheco
Noes: None
Abstain: None

Absent: Yep
Motion passes 4-0-0-1

8. CITY MANAGER/STAFF COMMUNICATIONS
Councilmember Yep arrives at 6:30 p.m.

Presentation of Item 3.A at this time.

9. MAYOR/COUNCIL REPORTS/ANNOUNCEMENTS/FUTURE AGENDA ITEMS Staff given direction to bring forth an item to discuss creation of an Ad Hoc committee for the Darden project at the next meeting.

10. CLOSED SESSION - 6:47 p.m.

Mayor Pacheco recuses herself for item 10.A.

A. CONFERENCE WITH REAL PROPERTY NEGOTIATORS - (Gov. Code § 54956.8) Property: APN 023-481-01S
Agency Negotiator: John Jansons, City Manager
Negotiating Party: Moore Trust
Under Negotiation: Price and Terms
9 Section 5, Item A.

B. 1. Public Employee Performance Evaluation pursuant to Government Code Section 54957 Title: City Manager

2. Conference with Labor Negotiators pursuant to Government Code Section 54957.6 City Designated Representatives: Mayor Pacheco and Council Member Yep Unrepresented Employee: City Manager
Reconvene at 8:30 p.m. - Concluded with a successful evaluation of City Manager John Jansons, which includes a 5% raise and 3-year contract extension, and staff direction for City Attorney to return with a contract amendment.

11. ADJOURNMENT - 8:31 p.m.

MINUTES CERTIFICATION
I, Josie Camacho, City Clerk for the City of Kerman, do hereby declare under penalty of perjury that the above minutes are a true depiction of all actions taken at the City Council meeting held on the first date above written at Kerman City Hall, 850 S. Madera Ave, Kerman, CA.

Date: October 24, 2024 /s/ Josie Camacho, City Clerk
10 Section 5, Item A.

CITY OF KERMAN

PAYROLL REPORT

RETRO PAY GROSS COMP TIME
Salary & OTHER Hours Amount Hours Amount Hours Amount SALARY EARNED Grand Total $239,417.76 $ 3,138.36 178.65 $ 9,559.38 2.00 $ 1.00 66.00 $ 1,781.86 $255,924.23 33.60 OVERTIME HOLIDAY at 1/2 TIME STANDBY
PAY PERIOD: September 29, 2024 -October 12, 2024

Page 1 of 1 ends

Section 5, Item B.

STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: Theresa Johnson, Community Services Director SUBJECT: License Agreements with Property Owners for Mural Locations (TJ) RECOMMENDATION: Council by motion to adopt;

1. A resolution approving the license agreement with Eloy Coronado, property owner of 602 South Madera Avenue Kerman, CA 93630, APN: 023-241-015S, to install a mural and authorize the City Manager to sign the agreement; and

2. A resolution approving the license agreement with Russel D. Lindquist and Rebecca B.

Linquist, property owners of 681 South Madera Avenue Kerman, CA 93630, APN: 023- 148-07S, to install a mural and authorize the City Manager to sign the agreement.

EXECUTIVE SUMMARY:

The City of Kerman applied for and was awarded Clean California grant funding from the State Department of Transportation, intended to fund local projects beautifying California highways through several eligible activities and programs. The project scope under the Clean California grant, with assistance from local City funds, included the rehabilitation of the center medians from West C Street up to West Whitesbridge Road, removal and replacement of trees and tree wells, wayfinding signage, streetlight banners, replacement of street furniture, and installation of two murals.

On March 13, 2024, the City Council approved two professional service agreements with mural artists Jose Elias and Veyna Design Studios, Inc. to commission two murals for two pre-selected locations.

Mr. Eloy Coronado owns the La Ramada Restaurant where the mural commissioned by Veyna Design Studios is to be installed on the standalone south facing wall of 602 S. Madera Avenue.

Staff met with Mr. Coronado in October and presented the license agreement for his review and comment. Mr. Coronado accepted the agreement and authorized staff to proceed with Council approval.

Mr. Russel D. Lindquist and Mrs. Rebecca B. Lindquist own the Valley West Properties building where the mural commissioned by Jose Elias is to be installed on the south facing wall of 602 S. Madera Avenue. Staff met with Mr. & Mrs. Lindquist in October and presented the license agreement for his review and comment. Mr. and Mrs. Lindquist accepted the agreement and authorized staff to proceed with Council approval.
12 Section 5, Item C.

FISCAL IMPACT:

Measure M monies are funding the professional services agreements with Mural Artists and installation of murals.

ATTACHMENTS:

A. Resolution w/Exhibits (Eloy Coronado)
B. Resolution w/Exhibits (Russell D. Lindquist and Rebecca B. Lindquist) 13 Section 5, Item C.

Attachment ‘A’
RESOLUTION NO. 24-___

A RESOLUTION OF THE CITY OF KERMAN CITY COUNCIL APPROVING A LICENSE AGREEMENT WITH ELOY CORONADO PROPERTY OWNER OF 602 S. MADERA AVENUE KERMAN, CA 93630 APN: 023-241-01S
WHEREAS, the City of Kerman was awarded Clean California grant funding from the State Department of Transportation, District 6; and
WHEREAS, Clean California grant funding will be used towards numerous downtown revitalization efforts including the design and installation of two murals; and WHEREAS, the Planning Commission approved CUP 2024-02 with specifications and conditions relating to the mural design and size at the La Ramada Restaurant, located at 602 South Madera Avenue Kerman, CA 93630 APN: 023-241-01S; and WHEREAS, the City Council approved a Professional Service Agreement with Veyna Design Studios for the design and preparation of a mural; and WHEREAS, Eloy Coronado property owner of 602 South Madera Avenue, has provided input and agreed to the mural design, and consents to the installation of the mural at 602 South Madera Avenue; and
WHEREAS, a license agreement is necessary to determine the terms and conditions of allowing the City to install the mural at 602 South Madera Avenue.

NOW THEREFORE, the City of Kerman City Council resolves as follows; Section 1. The recitals are true and correct and incorporated herein as reference.

Section 2. The City of Kerman City Council the license agreement with Eloy Coronado, 602 South Madera Avenue property owner, included as Exhibit ‘A’.

Section 3. The City Manager is authorized to sign the License Agreement on behalf of the City.

Section 4. This resolution is effective upon adoption.
14 Section 5, Item C.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regular meeting held on the 13th day of November of 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:

The foregoing resolution is hereby approved.
_____________________________
Maria Pacheco
Mayor
ATTEST:
______________________________
Josie Camacho
City Clerk
15 Section 5, Item C.

Page 1 of 4 ends

Exhibit ‘A’

RECORDED
Fresno County Recorder’s Office
1250 Van Ness Avenue
Fresno, CA 93721
RETURN TO:

City of Kerman
City Clerk
850 S Madera Ave.

Kerman, CA 93637

LICENSE AGREEMENT BETWEEN THE CITY OF KERMAN AND ELOY CORONADO, (OWNER) OF 602 SOUTH MADERA AVENUE KERMAN, CA 93630 APN: 023-148-075 THIS LICENSE AGREEMENT (“Agreement”) is entered into by and between the City of KERMAN (“City”) and Eloy Coronado, Property Owner name as shown on grant deed (“Property Owner”) of 602 South Madera Avenue Kerman, CA 93630, APN:023-148-075 (“Premises” or “Property”).

WHEREAS, the City of Kerman, a municipal corporation in the County of Fresno, State of California, has commissioned the design and preparation of mural to be installed at 602 South Madera Avenue; and
WHEREAS, Property Owner of 602 South Madera Avenue, agrees to allow the City to install the mural at 602 South Madera Avenue, Kerman, CA consistent with the design and dimensions approved under CUP 2024-02.

NOW, THEREFORE, THE PARTIES HERETO DO MUTUALLY AGREE AS FOLLOWS:

1. Description of Property. Eloy Coronado is the owner of certain real property situated in the City of Kerman, and more commonly described as La Ramada, located at 602 South Madera Avenue, Kerman, CA 93630, with APN 023-241-015 (“Property or Premises”), and in Exhibit ‘A-1’ which is attached to this Agreement, and hereby incorporated by reference.

2. Grant of License. In consideration of the sum of one dollar ($1) per year, Property Owner grants City a license (“License”) on an exclusive use basis to install a mural on the Property on the south-facing wall of La Ramada standalone wall.

3. Incidental Rights. The License includes the following rights to use the Property: access to thewall and/or property to perform any installation, restoration, or maintenance necessary 16 Section 5, Item C.

Page 2 of 4 ends

between the hours of 7:00 AM and 6:00 PM. In exercising these rights, City must use reasonable care and may not unreasonably increase the burden on the Property Owner.

4. Installation and Maintenance. City shall have exclusive use of the premises as described above. During mural installation, any installation, restoration, and maintenance shall be the responsibility of the City including, but not limited to the following:

A. Installation of mural, panel sections and related hardware.

B. Restoration of the wall where the mural’s panels have been installed.

C. Maintenance to mural and wall including natural weathering, graffiti, or other act of god.

Upon completion of the mural installation, any later installation, restoration, or maintenance necessary due to damages to the mural or wall caused by the Property Owner or the site’s tenant(s) shall be the responsibility of the Property Owner.

City acknowledges that it is using the Premises on an “as-is” basis. City shall, at all times during the term of this License Agreement, make its best efforts to keep and maintain areas of the Premises affected by the mural installation (including improvements thereto) in good and safe manner and condition. During the term of this License Agreement, the City further agrees to assume responsibility for any repairs to the wall necessary and as a direct result of the installation of the mural. City’s responsibility for maintenance of the mural shall be limited to; repainting mural area and slurry sealing installation points on wall surface.

By commencing the mural installation, City shall be deemed to have accepted the Premises as being in acceptable condition. City agrees on the last day of the term of this License Agreement, orsooner termination of this Agreement, to clear the Premises associated with the mural installation of any debris and installation hardware, leave wall and Premises in orderly and clean condition and in the same or similar condition as when received, reasonable use and wear and tear excepted.

5. Term and Termination. This License shall commence on November 13, 2024 (“Effective Date”) and terminate on November 13, 2029.

6. Termination of Occupancy. On or before the termination date for this License specified in paragraph 6 of this Agreement, City shall remove all of mural panels and installation hardware from the Property and shall surrender possession of the Property to Property Owner in good condition.

7. Ownership. This Agreement runs with the real property. In the event there is a change in ownership, the successor Property Owner shall be responsible for assuming all terms of this agreement.
17 Section 5, Item C.

Page 3 of 4 ends

8. Indemnification. Property Owner shall indemnify, defend, and hold harmless City, its officers, agents, employees and representatives from and against any and all claims, losses, liabilities or damages, demands and actions, including payment of reasonable attorney’s fees, arising out of or resulting from its negligence under this Agreement. The foregoing obligation of Property Owner shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful or active misconduct of the City, its officers, agents, employees or representatives and (2) the actions of Property Owner or its officers, agents, employees or representatives have contributed in no part to the injury, loss of life, damage to property, or violation of law.

City shall indemnify, defend, and hold harmless Property Owner, its officers, agents, employees and representatives from and against any and all claims, losses, liabilities or damages, demands and actions, including payment of reasonable attorney’s fees, arising out of or resulting from negligent performance under this Agreement. The foregoing obligation of City shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful or active misconduct of the Property Owner, its officers, agents, employees or representatives and (2) the actions of City, its officers, agents, employees or representatives have contributed in no part to the injury, loss of life, damage to property, or violation of law.

9. Insurance. Property Owner further agrees to maintain in full force during the term of this License,at Eloy Coronado own expense, a policy of commercial general liability insurance with coverage at least as broad as Insurance Services Office (ISO) form CG 00 01, including property damage and bodily injury, which will insure Eloy Coronado against liability for injury to persons,damage to property, and death of any person occurring in or about the Property. The policy shall be approved as to form and insurance by City. The insurance shall not be less than $1,000,000.00 per occurrence, $2,000,000.00 general aggregate.

10. Attorneys’ Fees. If any legal action or proceeding arising out of or relating to this Agreement is brought by either party to this Agreement, the prevailing party shall be entitled to receive from the other party, in addition to any other relief that may be granted, the reasonable attorneys’ fees, costs, and expenses incurred in the action or proceeding by the prevailing party.

11. Entire Agreement. This Agreement constitutes the entire agreement between City and property owner as stated in grant deed relating to the License. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force and effect. Any amendment to the Agreementshall be of no force and effect unless it isin writing and signedby City and property owner as stated in grant deed.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement as follows:
18 Section 5, Item C.

Page 4 of 4 ends

CITY OF KERMAN
John Jansons,
City Manager
DATE:

PROPERTY OWNER
Eloy R. Coronado
DATE:
19 Section 5, Item C.
‘Exhibit A-1’
Mural Location – 602 S Madera Ave; surface - masonry block wall 20 Section 5, Item C.

Attachment ‘B’
RESOLUTION NO. 24-___

A RESOLUTION OF THE CITY OF KERMAN CITY COUNCIL APPROVING A LICENSE AGREEMENT WITH RUSSELL D. LINDQUIST AND REBECCA B. LINDQUIST, PROPERTY OWNERS OF 681 S MADERA AVENUE KERMAN, CA 93630 APN: 023-148-07S WHEREAS, the City of Kerman was awarded Clean California grant funding from the State Department of Transportation, District 6; and
WHEREAS, Clean California grant funding will be used towards numerous downtown revitalization efforts including the design and installation of two murals; and WHEREAS, the Planning Commission approved CUP 2024-01 with specifications and conditions relating to the mural design and size at the Valley West Properties, located at 681 South Madera Avenue Kerman, CA 93630 APN: 023-148-07S and WHEREAS, the City Council approved a Professional Service Agreement with Jose Elias for the design and preparation of a mural; and
WHEREAS, Russel D. Lindquist and Rebecca B. Lindquist property owners of 681 South Madera Avenue, has provided input and agreed to the mural design, and consent to the installation of the mural at 681 South Madera Avenue; and WHEREAS, a license agreement is necessary to determine the terms and conditions of allowing the City to install the mural at 681 South Madera Avenue.

NOW THEREFORE, the City of Kerman City Council resolves as follows; Section 1. The recitals are true and correct and incorporated herein as reference.

Section 2. The City of Kerman City Council the license agreement with Russell D.

Lindquist and Rebecca B. Lindquist, 681 South Madera Avenue property owner, included as Exhibit ‘A’.

Section 3. The City Manager is authorized to sign the License Agreement on behalf of the City.

Section 4. This resolution is effective upon adoption.
21 Section 5, Item C.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regular meeting held on the 13th day of November of 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:

The foregoing resolution is hereby approved.
_____________________________
Maria Pacheco
Mayor
ATTEST:
______________________________
Josie Camacho
City Clerk
22 Section 5, Item C.

Page 1 of 4 ends

Exhibit ‘A’

RECORDED
Fresno County Recorders Office
1250 Van Ness Avenue
Fresno, CA 93721
RETURN TO:

City of Kerman
City Clerk
850 S Madera Ave.

Kerman, CA 93637

LICENSE AGREEMENT BETWEEN THE CITY OF KERMAN AND RUSSELL D LINQUIST AND REBECCA B LINDQUIST (OWNERS) OF 681 SOUTH MADERA AVENUE KERMAN, CA 93630 APN: 023-148-07S THIS LICENSE AGREEMENT (“Agreement”) is entered into by and between the City of KERMAN (“City”) and Russell D. Lindquist and Rebecca B Lindquist, Property Owners name as shown on grant deed (“Premises” or “Property”) of 681 South Madera Avenue Kerman, CA 93630, APN: 023-148-07S.

WHEREAS, the City of Kerman a municipal corporation in the County of Fresno, State of California, has commissioned the design and preparation of mural to be installed at 681 South Madera Avenue; and
WHEREAS, Property OwnerS of 681 South Madera Avenue, agrees to allow the City to install the mural at 681 South Madera Avenue, Kerman, CA consistent with the design and dimensions approved under CUP 2024-01.

NOW, THEREFORE, THE PARTIES HERETO DO MUTUALLY AGREE AS FOLLOWS:

1. Description of Property. Russell D. Lindquist and Rebecca B. Lindquist is the owner of certain real property situated in the City of Kerman, andmore commonly described as Valley West Properties located at 681South Madera Avenue, KermanCA 93630, with APN 023-148-07S (“Property” or “Premises”), and in Exhibit ‘A-1’ which is attached to this Agreement,and hereby incorporated by reference.

2. Grant of License. In consideration of the sum of one dollar ($1) per year, Property Owners grants City a license (“License”) on an exclusive use basis to install a mural on the Property on the south-facing wall of Valley West Properties.

3. Incidental Rights. The License includes the following rights to use the Property: access to thewall and/or property to perform any installation, restoration, or maintenance necessary 23 Section 5, Item C.

Page 2 of 4 ends

between the hours of 7:00 AM and 6:00 PM. In exercising these rights, City must use reasonable care and may not unreasonably increase the burden on the Property Owners.

4. Installation and Maintenance. City shall have exclusive use of the premises as described above. During mural installation, any restoration, and maintenance shall be the responsibility of the City including, but not limited to the following:

A. Installation of mural, panel sections and related hardware.

B. Restoration of the wall where the mural’s panels have been installed.

C. Maintenance to mural and wall including natural weathering, graffiti, or other act of god.

Upon completion of the mural installation, any later installation, restoration, or maintenance necessary due to damages to the mural or wall caused by the Property Owners or the site’s tenant(s) shall be the responsibility of the Property Owners.

City acknowledges that it is using the Premises on an “as-is” basis. City shall, at all times during the term of this License Agreement, make its best efforts to keep and maintain areas of the Premises affected by the mural installation (including improvements thereto) in good and safe manner and condition. During the term of this License Agreement, the City further agrees to assume responsibility for any repairs to the wall necessary and as a direct result of the installation of the mural. City’s responsibility for maintenance of the mural shall be limited to; repainting mural area, and slurry sealing installation points on wall surface.

By commencing the mural installation, City shall be deemed to have accepted the Premises as being in acceptable condition. City agrees on the last day of the term of this License Agreement, orsooner termination of this Agreement, to clear the Premises associated with the mural installation of any debris and installation hardware, leave wall and Premises in orderly and clean condition and in the same or similar condition as when received, reasonable use and wear and tear excepted.

5. Term and Termination. This License shall commence on November 13, 2024 (“Effective Date”) and terminate on November 13, 2029.

6. Termination of Occupancy. On or before the termination date for this License specified in paragraph 6 of this Agreement, City shall remove all of mural panels and installation hardware from the Property and shall surrender possession of the Property to Property Owners in good condition.

7. Ownership. This Agreement runs with the real property. In the event there is a change in ownership, the successor Property Owner shall be responsible for assuming all terms of this agreement.
24 Section 5, Item C.

Page 3 of 4 ends

8. Indemnification. Property Owners shall indemnify, defend, and hold harmless City, its officers, agents, employees and representatives from and against any and all claims, losses, liabilities or damages, demands and actions, including payment of reasonable attorney’s fees, arising out of or resulting from its negligence under this Agreement. The foregoing obligation of Property Owners shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful or active misconduct of the City, its officers, agents, employees or representatives and (2) the actions of Property Owners or its officers, agents, employees or representatives have contributed in no part to the injury, loss of life, damage to property, or violation of law.

City shall indemnify, defend, and hold harmless Property Owners, its officers, agents, employees and representatives from and against any and all claims, losses, liabilities or damages, demands and actions, including payment of reasonable attorney’s fees, arising out of or resulting from negligent performance under this Agreement. The foregoing obligation of City shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful or active misconduct of the Property Owners, its officers, agents, employees or representatives and (2) the actions of City, its officers, agents, employees or representatives have contributed in no part to the injury, loss of life, damage to property, or violation of law.

9. Insurance. Property Owner further agrees to maintain in full force during the term of this License, at Russell D. Lindquist and Rebecca B. Lindquist's own expense, a policy of commercial general liability insurance with coverage at least as broad as Insurance Services Office (ISO) form CG 00 01, including property damage and bodily injury, which will insure Russell D. Lindquist and Rebecca B. Lindquist against liability for injury to persons,damage to property, and death of any person occurring in or about the Property. The policy shall be approved as to form and insurance by City. The insurance shall not be less than $1,000,000.00 per occurrence, $2,000,000.00 general aggregate.

10. Attorneys’ Fees. If any legal action or proceeding arising out of or relating to this Agreement is brought by either party to this Agreement, the prevailing party shall be entitled to receive from the other party, in addition to any other relief that may be granted, the reasonable attorneys’ fees, costs, and expenses incurred in the action or proceeding by the prevailing party.

11. Entire Agreement. This Agreement constitutes the entire agreement between City and property owners as stated in grant deed relating to the License. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force and effect. Any amendment to the Agreementshall be of no force and effect unless it isin writing and signedby City and property owner as stated in grant deed.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement as follows:
25 Section 5, Item C.

Page 4 of 4 ends

CITY OF KERMAN
John Jansons,
City Manager
DATE:

PROPERTY OWNERS
Russell D. Lindquist
Rebecca B. Lindquist
DATE:
26 Section 5, Item C.
‘Exhibit A-1’
Mural Location – 681 S Madera Ave; surface – CMU wall
27 Section 5, Item C.

STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: John Jansons, City Manager
SUBJECT: Community Organization Grant Program Supplemental Award – S.B.F. Kerman Portuguese Hall (JAJ)
RECOMMENDATION: Council by motion adopt resolution approving waiver of $467.01 in cost for facilitating S.B.F. Kerman Portuguese Hall - 2024 Portuguese Parade.

EXECUTIVE SUMMARY:

In April of 2024, the City Council approved sponsorship of S.B.F. Kerman Portuguese Hall 2024 Portuguese Parade in the amount of $1,000. Upon final reconciliation, City support costs totaled $1,467.01. At the request of the Kerman S.B.F. Portuguese Hall, the recommendation is to waive or “forgive” the additional $467.01 over the $1,000 granted to S.B.F. Kerman Portuguese Hall for the 2024 Parade.

The current request continues to fulfill City grant criteria that includes:
 Benefit the City of Kerman residents and businesses.
 Applicant successfully explained how the proposed program/project will serve the City of Kerman residents.
 S.B.F. Kerman operates as a registered 501(c) (3) non-profit  Event is held within Kerman City limits and is open to the public.  Serves a charitable, cultural, or educational purpose.  Grant funds are being requested to comply with applicable permits and regulations.

FISCAL IMPACT:

If approved, the additional $467.01 will be transferred from the Community, Employee and Public Relations Account to the Public Works Department budgets.

ATTACHMENTS:

A. Resolution
B. April 2024 Staff Report, Resolution and 2024 Community Organization Grant Program Application – S.B.F. Kerman Portuguese Hall
C. Invoice
28 Section 5, Item D.

Attachment ‘A’
RESOLUTION NO. 24-__

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF KERMAN APPROVING GRANT OF $467.01 TO THE S.B.F. KERMAN PORTUGUESE HALL FOR CITY SUPPORT SERVICES FOR THE 2024 PORTUGUESE PARADE
WHEREAS, on April 2024, the City Council of the City of Kerman adopted Resolution No. 24-28 awarding the S.B.F. Kerman Portuguese Hall $1,000 to defray City costs to facilitate a Kerman Portuguese Community Parade; and
WHEREAS, the City Council made that award under the guidelines of the City’s Community Organization Grant Program; and
WHEREAS, an after-event reconciliation revealed the City’s support costs to total $1,467.01; and
WHEREAS, now the S.B.F. Kerman Portuguese Hall respectfully requests wavier of the remaining balance of City costs in the amount of $467.01; and WHEREAS, the completed event fulfilled the goals of the Community Organization Grant Program and is in the public interest of the City of Kerman.

NOW, THEREFORE, the City Council of the City of Kerman resolves as follows:

Section 1. The forgoing recitals are true, correct, and incorporated by reference.

Section 2. The Council approves a supplemental grant award of $467.01 to the S.B.F.

Kerman Portuguese Hall to retire the costs of city permits and city staffing for the Annual Portuguese Parade.

Section 3. Staff is authorized to transfer the funds from the Community, Employee, and Public Relations Account to the Public Works Department.

Section 4. This resolution is effective upon adoption.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regularly scheduled meeting held on the 13th day of November 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:
29 Section 5, Item D.

The foregoing resolution is hereby approved.
_________________________
Maria Pacheco
Mayor
ATTEST:
__________________________
Josie Camacho
City Clerk
30 Section 5, Item D.

STAFF REPORT
MEETING DATE: April 10, 2024
PRESENTER: Theresa Johnson, Community Services Director SUBJECT: Community Organization Grant Program Application - S.B.F. Kerman Portuguese Hall (TJ)
RECOMMENDATION: Council by motion adopt resolution approving up to $1,000 to the S.B.F.

Kerman Portuguese Hall to Defray City-Related Costs for the 2024 Portuguese Parade.

EXECUTIVE SUMMARY:

The S.B.F. Kerman Portuguese Hall submitted a Community Organization Grant Program application requesting an in-kind donation for the approximate cost of City personnel from the Police and Public Works departments to assist with traffic control for the annual Portuguese Parade to be held on Sunday, May 12, 2024. The application was reviewed by the Ad hoc committee consisting of interim City Clerk, Josie Camacho, the Community Services Director, Theresa Johnson and City Manager, John Jansons. It was determined that the S.B.F. Kerman Portuguese Hall application adheres to following criteria:
• Benefit the City of Kerman residents and businesses.
• Applicant successfully explained how the proposed program/project will serve the City of Kerman residents.
• S.B.F. Kerman operates as a registered 501(c) (3) non-profit • Event is held within Kerman City limits and is open to the public. • Serves a charitable, cultural, or educational purpose. • Grant funds are being requested to comply with applicable permits and regulations.

Bases on these criteria the Ad hoc committee is recommending approval of the S.B.F. Kerman Portuguese Hall Community Organization Grant application.

In 2023 City Council approved a similar request in the amount of $1,000.00 for personnel and permitting requirements for the parade.

FISCAL IMPACT:

Approximately $1,000.00 from the Community, Employee and Public Relations Account will be transferred to the respective department budgets.

ATTACHMENTS:

A. Resolution w/Community Organization Grant Program Application - S.B.F. Kerman Portuguese Hall
Attachment 'B'
31 Section 5, Item D.
32 Section 5, Item D.
33 Section 5, Item D.
34 Section 5, Item D.
35 Section 5, Item D.
36 Section 5, Item D.

I

BILL TO

SOCIADADE BOA FE
POBOX23
KERMAN, CA 93630-0023

DESCRIP TION

PREVIOUS OUTSTANDING BALANCE
I

QUANTITY I
Attachment 'C'

EFFECTIVE RATE IAMOUNT IDISCOUNT I
Employees Hours for Portuguese Parade 2024 Total is $1467.01 Includes City Donation of$1000. Total to Pay $467.01:

Emp Hrs A.Morales J Lopez C Ortiz A
Garcia

1.00 467.01
INVOICE TOTAL:
467.0I 0.00
467.01 0,00

PLEASE DETACH BOTTOM PORTION & REMIT WITH YOUR PAYMENT
Customer Name:

Customer No:

Aecount No:

For questions please contact us at (559) 846-9384

SOCIADADE BOA FE
009443
0000148
Please remit payment by the due date to:

City of Kerman
850 S. Madera Ave.

Kerman, CA 93630-1741

DUE DATE
11/23/2024
Invoice Total:

Discounts:

Credit Applied:

Ending Balance:

INVOICE BALANCE:

AMOUNT PAID:

DATE INVOICE NO
10/23/2024 0001001

DUE DATE
11/23/2024

CREDIT BALANCE

0.00 0.00 467.0I

0.00 467.01

INVOICE NO
0001001
467.0l

0.00 0.00
467.0l
$467.01
37 Section 5, Item D.

STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: John Jansons, City Manager, Personnel Director SUBJECT: Update of Safety Policies and Procedures and Adoption of Injury and Illness Prevention Program – Administration (JAJ)
RECOMMENDATION: Council by motion adopt resolution approving new Injury and Illness Prevention Program.

DISCUSSION:

The City recently conducted a review of the Safety Policies and Procedures - Injury and Illness Prevention Program. Human Resources first sought assistance from the CSJVRMA Risk Control Manager to go through the document page by page to find any outdated details and provide overall advice on updating the document. Human Resources then provided each department citywide with the document to then review its department specific details to ensure the document is current. Human Resources then met with each department representative to go over the details to make any necessary adjustments.

The proposed Injury and Illness Prevention Program is presented as Exhibit ‘A’ and is built on the current Safety Policies and Procedures. Attachment ‘B’ represents the outdated version, which was called Safety Policies and Procedures with recommended mark-ups.

FISCAL IMPACT:

The fiscal impact would be an increase to Boot Allowance by $150 to make the allowance $250 per year. This would be a total increase of $4,500.00. There are currently 30 employees on the list from Public Works, Community Services and Community Development.

ATTACHMENTS:

A. Resolution w/Exhibit
B. Redline Strike-Out w/Changes
38 Section 5, Item E.

Attachment ‘A’
RESOLUTION NO. 24-___

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF KERMAN APPROVING

CITY OF KERMAN INJURY AND ILLNESS PREVENTION PROGRAM
WHEREAS, the City recently conducted a thorough audit of Safety Policies and Procedures - Injury and Illness Prevention Program; and
WHEREAS, the existing Safety Policies and Procedures - Injury and Illness Prevention Program is outdated; and
WHEREAS, a clear and current version is required for optimal employee safety performance and to comply with OSHA standards; and
WHEREAS, the proposed update does result in a total increase of $4,500.00 fiscal impact to the city.

NOW, THEREFORE, the City Council of the City of Kerman resolves as follows:

Section 1. The above recitals are true and correct and incorporated herein by reference.

Section 2. The City Council approves of the Injury and Illness Prevention Program attached as Exhibit ‘A’ and incorporated by reference.

Section 3. The Injury and Illness Prevention Program supersedes any prevision versions of the City’s Safety Policies and Procedures.

Section 4. This resolution is effective upon its adoption.

The foregoing resolution adopted by the City Council of the City of Kerman at a regularly scheduled meeting held on the 13th day of November 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:
39 Section 5, Item E.

The foregoing resolution is hereby approved.
_____________________________
Maria Pacheco
Mayor
ATTEST:
______________________________
Josie Camacho
City Clerk
40 Section 5, Item E.

SAFETY POLICIES
AND

PROCEDURES
2024
SUPERCEDES 05-17-17
EFFECTIVE 11-13-24
Exhibit 'A'
41 Section 5, Item E.

CITY OF KERMAN SAFETY POLICIES AND PROCEDURES
Table of Contents
INJURY AND ILLNESS PREVENTION PROGRAM .............................................................................................1 I. Policy Statement..................................................................................................................................1 II. Purpose................................................................................................................................................2 III. Responsibility ......................................................................................................................................2 A. IIPP Administrator............................................................................................................................2 B. Safety Coordinator...........................................................................................................................2 C. Department Heads and Supervisors ................................................................................................2 D. Employees........................................................................................................................................2 IV. Compliance..........................................................................................................................................3 A. Management Responsibility.............................................................................................................3 B. Employee Responsibility ..................................................................................................................3 C. Performance Evaluations.................................................................................................................3 D. Employee Correction........................................................................................................................3 V. Communication ...................................................................................................................................3 A. Two-Way Communication................................................................................................................3 B. System of Communication ...............................................................................................................3 C. Safety Suggestions and Hazard Reporting .......................................................................................4 VI. Hazard Assessment..............................................................................................................................4 A. Safety Inspections............................................................................................................................4 B. Additional Inspections......................................................................................................................4 VII. Accident/Exposure Investigations.......................................................................................................5 A. Investigation.....................................................................................................................................5 B. Reporting..........................................................................................................................................5 C. Reporting to Cal-OSHA.....................................................................................................................5 VIII. Hazard Correction................................................................................................................................5 IX. Training and Instruction ......................................................................................................................6 A. Orientation for Establishment of IIPP and/or Substantial Amendment..........................................6 B. New Employee Initial On-The-Job Training......................................................................................6 C. Specific Kerman Training Programs .................................................................................................6 D. Retraining.........................................................................................................................................6 E. Specialized Training..........................................................................................................................6 X. Recordkeeping.....................................................................................................................................7 XI. Injury and Illness Prevention Forms....................................................................................................8 Hazard Alert Form ...............................................................................................................................9 42 Section 5, Item E.

Hazard Alert Response Form.............................................................................................................10 Employee’s Report of Incident..........................................................................................................11 Supervisor’s Report of Employee Injury............................................................................................13 Orientation Safety Check List ...........................................................................................................14 Office Hazard Inspection Checklist/Action Form...............................................................................15 MODULE 1 - BLOODBORNE PATHOGEN PROGRAM ...................................................................................17 I. Purpose..............................................................................................................................................17 II. Scope .................................................................................................................................................17 III. Definitions .........................................................................................................................................17 IV. Exposure Determination ...................................................................................................................18 A. Police Department .........................................................................................................................18 B. Public Works Department..............................................................................................................19 C. Parks & Recreation Department....................................................................................................19 V. Methods of Compliance ....................................................................................................................19 A. Universal Precautions.....................................................................................................................19 B. Hand washing and Other General Hygiene Measures...................................................................19 C. Sharps Management......................................................................................................................20 D. Personal Protective Equipment .....................................................................................................20 E. Protection for Hands......................................................................................................................20 F. Protection for Eyes/Nose/Mouth...................................................................................................21 G. Equipment, Environmental and Working Surfaces........................................................................21 H. Special Sharps Precautions.............................................................................................................21 VI. Hepatitis B Vaccination......................................................................................................................21 A. General Statement of Policy ..........................................................................................................21 B. Hepatitis B Vaccination ..................................................................................................................21 VII. Reporting and Treatment of Exposure Incidents..............................................................................22 A. City's Reporting Responsibility.......................................................................................................22 B. Exposure Treatment.......................................................................................................................22 C. Documentation ..............................................................................................................................23 VIII. Procedures for Evaluation and Follow-Up of Exposure Incidents.....................................................23 IX. Employee Training.............................................................................................................................24 X. Recordkeeping Procedures ...............................................................................................................24 A. Medical Records.............................................................................................................................24 B. Training Records.............................................................................................................................25 XI. Bloodborne Pathogen Forms.............................................................................................................26 Hepatitis B Vaccine Consent/Declination ...................................................................................................27 First Aid Incident Report for Bloodborne Pathogens........................................................................28 Sharps Injury Log ...............................................................................................................................29 43 Section 5, Item E.

MODULE 2 - HAZARD COMMUNICATION PROGRAM .................................................................................30 I. General Information..........................................................................................................................30 A. Container Labeling .........................................................................................................................30 B. Material Safety Data Sheets (MSDS) or Safety Data Sheets (SDS).................................................30 C. Employee Training and Information ..............................................................................................30 II. Hazardous Non-Routine Tasks – Confined Spaces Entry...................................................................31 III. Informing Contractors.......................................................................................................................31 IV. Emergency Spill Procedures..............................................................................................................32 MODULE 3 - EMERGENCY ACTION PLAN.....................................................................................................33 I. Scope and Application.......................................................................................................................33 II. Emergency Action Plan Information Sheet .......................................................................................34 III. Definitions .........................................................................................................................................35 IV. Elements............................................................................................................................................35 A. Emergency Evacuation Procedures & Route Assignments............................................................35 B. Procedures for Employees Who Remain to Operate Critical Operations Before Evacuation .......35 C. Evacuation of Persons with Disabilities..........................................................................................36 D. Employee Accountability Procedures after Evacuations ...............................................................36 E. Rescue and Medical Duties............................................................................................................37 V. Alarm System.....................................................................................................................................37 VI. Evacuation for Emergencies..............................................................................................................37 A. Fire Emergency...............................................................................................................................37 (Do not attempt any action that places you or another person at risk or injury).................................37 B. Earthquake .....................................................................................................................................37 C. Lockdown .......................................................................................................................................38 D. Other Emergencies.........................................................................................................................38 VII. Training..............................................................................................................................................38 MODULE 4 - HEAT ILLNESS PREVENTION PLAN (Effective 05/01/15).........................................................39 I. Purpose..............................................................................................................................................39 II. Monitoring the Weather...................................................................................................................40 A. Weather forecast ...........................................................................................................................40 B. Weather Monitoring Prior To Workday During Times Of Risk.......................................................40 III. Monitoring Employee Acclimatization For Working Outdoors In Heat ............................................40 IV. Providing Clean Drinking Water........................................................................................................41 V. Providing Adequate Shade ................................................................................................................41 VI. Addressing High-Heat Procedures.....................................................................................................42 VII. Handling An Ill Employee And Emergency Procedures.....................................................................42 VIII. Providing Supervisor and Employee Training....................................................................................43 A. Employees......................................................................................................................................43 44 Section 5, Item E.

B. Supervisors.....................................................................................................................................43 IX. Definitions .........................................................................................................................................44 City of Kerman Heat Illness Employee - Training Handout ...............................................................45 Types of Heat Illness..........................................................................................................................46 MODULE 5 - FIRE PREVENTION PLAN..........................................................................................................47 I. Scope and Application.......................................................................................................................47 II. Elements............................................................................................................................................47 A. Potential Fire Hazards....................................................................................................................47 B. Personnel Responsible for Maintenance of Fire and Emergency Equipment ...............................47 C. Personnel Responsible for Control of Flammable/Combustible Materials ...................................47 III. Housekeeping....................................................................................................................................47 IV. Training..............................................................................................................................................48 V. Maintenance......................................................................................................................................48 MODULE 6 - CITY HALL ROBBERY PROCEDURE...........................................................................................49 MODULE 7 - ERGONOMIC PROGRAM.........................................................................................................50 I. Purpose..............................................................................................................................................50 II. Policy .................................................................................................................................................50 III. Ergonomic Program Coordinator ......................................................................................................50 IV. Identifying Workstation Risk Factors.................................................................................................50 V. Hazard Prevention and Control.........................................................................................................51 VI. Medical Management .......................................................................................................................51 VII. Training..............................................................................................................................................51 Ergonomic Symptoms Survey............................................................................................................53 Office Ergonomic Evaluation Form....................................................................................................54 Helpful Stretches ..............................................................................................................................56 MODULE 8 - OCCUPATIONAL NOISE EXPOSURE PROGRAM.......................................................................58 I. Purpose..............................................................................................................................................58 II. Requirements....................................................................................................................................58 III. Responsibilities..................................................................................................................................58 IV. Monitoring Limits & Testing Procedure ............................................................................................58 V. Recordkeeping...................................................................................................................................59 VI. Training..............................................................................................................................................59 MODULE 9 - LOCKOUT AND TAGOUT SAFETY PROGRAM...........................................................................60 I. Purpose..............................................................................................................................................60 II. Lockout..............................................................................................................................................60 III. Tagout (Hazard Safety Tag) ...............................................................................................................60 IV. Restoring Equipment (Lockout/Tagout Removal).............................................................................61 V. Procedure for More Than One Person ..............................................................................................61 45 Section 5, Item E.

VI. Things to Remember.........................................................................................................................61 VII. Documentation..................................................................................................................................61 VIII. Lockout and Tagout Program List of Source......................................................................................62 MODULE 10 – PERSONAL PROTECTIVE EQUIPMENT POLICY (ADOPTED 08-07-2013) ...............................63 I. Purpose...........................................................................................................................................65II.

Applicability .......................................................................................................................................65 III. Policy .................................................................................................................................................65 IV. Responsibilities..................................................................................................................................65 A. Safety Officer and Risk Management Officer Shall .........................................................................65 B. Supervisors Shall..............................................................................................................................65 C. Employee Shall ................................................................................................................................65 D. Safety Officer Shall ..........................................................................................................................66 V. Procedure ..........................................................................................................................................66 A. Hazardous Assessment and Equipment Selection...........................................................................66 B. Protective Devices ...........................................................................................................................66 C. Eye and Face Protection ..................................................................................................................67 D. Voluntary Respirator Use.................................................................................................................67 E. Emergency Eyewash and Safety Shower Facilities..........................................................................67 F. Head Protection...............................................................................................................................67 G. Hand Protection...............................................................................................................................67 H. Foot Protection................................................................................................................................68 I. Body Protection ...............................................................................................................................68 J. Life Rings and Personal Flotation Devices.......................................................................................69 K. Cleaning and Maintenance ..............................................................................................................69 L. Signage.............................................................................................................................................69 M. Training ............................................................................................................................................69 N. Recordkeeping .................................................................................................................................69 VI. PERSONAL PROTECTIVE EQUIPMENT POLICY FORMS.......................................................................70 Hazard Assessment Certification Form .............................................................................................71 Personal Protective Equipment Issuance Form.................................................................................72 EMPLOYEE ACKNOWLEDGEMENT FORM....................................................................................................73 SIGNS FOR POSTING....................................................................................................................................74 46 Section 5, Item E.
1 INJURY AND ILLNESS PREVENTION PROGRAM
I. Policy Statement
It is the policy of the City of Kerman to provide a safe and healthful environment for our employees and general public. We strive to eliminate unnecessary hazards by providing specific safety policies and procedures and creating an atmosphere that promotes safety.

The following Injury and Illness Prevention Program (IIPP) has been developed to provided safety and loss control guidelines to protect people from injury or illness; to reduce the risk of loss to real property and business assets; and to meet the regulatory requirements of federal, state and local governmental agencies.
___________________________________ ___________________________________ John Jansons, City Manager Date
47 Section 5, Item E.
2 II. Purpose
Every California employer must establish, implement and maintain a written Injury and Illness Prevention (IIPP) Program and a copy must be maintained at each worksite. The requirements for establishing, implementing and maintaining an effective written Injury and Illness Prevention Program are contained in Title 8 of the California Code of Regulations, Section 3203 (T8 CCR 3203). This program complies with the requirements of the California Code of Regulations and consists of the following eight elements:
 Responsibility
 Compliance
 Communication
 Hazard Assessment
 Accident/Exposure Investigation
 Hazardous Correction
 Training and Instruction
 Recordkeeping
III. Responsibility
A. IIPP Administrator
The City’s representative on the Risk Management Authority shall be the IIPP Administrator. The IIPP Administrator is Josefina Alvarez, Finance Director,559-550-0714 or [email protected] has the authority and the responsibility for ensuring the implementation and maintenance of the City’s Injury and Illness Prevention Program and for answering questions about the Program.

B. Safety Coordinator
The City’s Safety Coordinator will direct the City’s safety programs, conduct hazardous inspections, update the Material Safety Data Sheet binders, and insure that Federal and State regulation updates are added to the IIPP program. The Safety Coordinator will also be the Chair of the Safety Committee and advise the IIPP Administrator of problems, concerns, and corrections. Akayla Cheema, 559-550-2080 or [email protected] currently holds the position of Safety Coordinator.

C. Department Heads and Supervisors
Department Heads and Supervisors are responsible for training employees to perform their jobs properly and safely and shall teach, demonstrate, observe and enforce compliance with established safety standards.

D. Employees
Each employee is responsible to comply with the IIPP and to perform their work duties in a safe manner at all times. Employees should ask for additional training or assistance when they feel there is a gap in their ability, knowledge or training with respect to safely performing their duties.

RETRUN TO TABLE OF CONTENTS
48 Section 5, Item E.
3 IV. Compliance
A. Management Responsibility
Management is responsible for ensuring that organizational safety and health policies are clearly communicated and understood by employees. Managers and supervisors are also expected to enforce these rules fairly and uniformly.

B. Employee Responsibility
All employees are responsible for using safe work practices, assisting in the maintenance of a safe work environment and for following directives, policies and procedures regarding safety and health.

C. Performance Evaluations
Employee performance evaluations include an evaluation of compliance with safe work practices and procedures.

D. Employee Correction
Employees who fail to follow safe work practices and/or procedures, or who violate safety rules or directives, will be subject to disciplinary action, in accordance with the Personnel Rules & Regulations (Section 4.1/4.2) and/or the applicable memorandum of understanding.

V. Communication
A. Two-Way Communication
Management recognizes that open, two-way communication between management and staff on safety and health issues is essential to maintaining an injury-free, productive workplace.

B. System of Communication
The following system of communication is designed to facilitate a continuous flow of safety and health information between management and staff in a readily understandable manner:

1. An orientation program will be provided to all new employees by the designee appointed by the Department Head (See Orientation Safety Check List) that includes a review of the IIPP and a discussion of safety policies and procedures that the employee is expected to follow.

2. The City will conduct safety meetings where safety is freely and openly discussed. Employees are expected to attend and are encouraged to participate in such meetings.

3. From time to time, written safety notifications will be distributed or posted on bulletin boards.

4. Other appropriate methods of communicating pertinent safety and health information will be implemented as such methods are identified.

RETRUN TO TABLE OF CONTENTS
49 Section 5, Item E.
4 C. Safety Suggestions and Hazardous Reporting

1. All employees are requested and encouraged to inform their supervisors or other management personnel of any matter which they perceive to be an actual or potential workplace hazardous. Employees are also encouraged to make suggestions for safety improvements to the City. While the City prefers that safety reports and suggestions are made in writing, employees can also make such suggestions and reports orally. All safety reports or suggestions should be made to the reporting employee's supervisor, the IIPP Administrator, or to other management personnel.

2. If an employee wishes to report a hazardous, safety suggestion, or other safety problem anonymously, he or she can complete a "Hazardous Alert Form" which does not require the employee's name or job title.

3. No employee shall be retaliated against for reporting potential or actual hazardous or for making safety suggestions.

4. Management will review all safety suggestions and hazardous reports.

5. If an employee's name is included with a hazardous report or safety suggestion, the reporting employee will be notified about any non-confidential corrective action that is taken with respect to the hazardous report or safety suggestion.

6. The resolution of safety issues will be communicated to employees through "Hazardous Response Forms" and/or communication at Safety Meetings.

7. A folder on the City's public employee drive may be used for program documents and safety information.

This folder is to be accessible to all employees. The safety folder will consist of the following:
• Blank "Hazardous Alert Forms"
• PDF Program/Plan Documents
• Directions to access Internet based safety training materials VI. Hazard Assessment
Inspection of the workplace is the primary tool used to identify unsafe working conditions and practices. While the City encourages all employees to continuously identify and correct workplace hazards and poor safety practices, certain situations require formal evaluation and documentation on the “Hazardous Inspection Checklist/Action Form”.

A. Safety Inspections
Safety inspections will be conducted by a manager and/or supervisor and at least one non-supervisory employee. When possible, it is the intent of the City to abate any hazard which gives rise to a risk of imminent harm to any person. Any recommendations for future corrective action will be timely filed with the IIPP Administrator or the assigned safety representative for the specific area.

B. Additional Inspections
Inspections will also be conducted in accordance with the following:

1. Whenever new substances, processes, procedures, or equipment presenting a new safety or health hazard are introduced into the workplace.

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50 Section 5, Item E.
5 2. Whenever management becomes aware of a new or previously unrecognized hazard, either independently or by receipt of information from an employee.

VII. Accident/Exposure Investigations
A. Investigation
All workplace accidents resulting in injury or property damage, however slight, will be timely investigated to determine the primary and contributing causes. The primary and contributing causes will be documented and analyzed to assist the City in taking corrective action to prevent similar accidents from occurring in the future.

The IIPP Administrator is responsible for ensuring that workplace accidents are reported on the “Employee Report of Incident Form” and properly investigated.

B. Reporting
All facts, findings, and recommendations uncovered during workplace investigations will be documented on the "Supervisor's Report of Employee Injury Form". Management will review all reports with a view towards determining adequacy of corrective action.

C. Reporting to Cal-OSHA
The following incidents must be directly reported to the closest area office of Cal-OSHA within 8 hours of occurrence by the IIPP Administrator or designee:

1. Accidents causing fatalities;

2. Accidents causing hospitalization and

3. Amputation of any body part.

The following information must be provided with any such report:
• Establishment name;
• Location of incident;
• Time of the incident;
• Number of fatalities or hospitalized employees;
• Contact person;
• Phone number; and
• Brief description of the incident.

VIII. Hazard Correction
Unsafe or unhealthy working conditions, practices, or procedures shall be corrected in a timely manner depending upon the severity of the hazards. Hazards shall be corrected according to the following procedures:
 When hazards are observed or discovered.
 When an imminent hazard exists that cannot be immediately abated without endangering employees and/or property.
o The City will ensure that all exposed workers are removed from the area except the personnel necessary to correct the hazard; who have been provided with the necessary safeguards and training to correct the hazard.

All corrective actions taken shall be documented on the appropriate City incident forms.

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51 Section 5, Item E.
6 IX. Training and Instruction
A. Orientation for Establishment of IIPP and/or Substantial Amendment The IIPP Administrator or designee will conduct the initial orientation of the IIPP. Employees will sign acknowledgement forms for all safety materials that they receive during such an orientation. When substantially amended, additional training will be conducted and copies of the amended IIPP provided.

B. New Employee Initial On-The-Job Training
Shortly after an employee begins their employment with the City, a manager or supervisor will provide the employee with access to an electronic copy of the IIPP (hard copies available in each department) and train the employee in all aspects of required safety procedures that are designed to mitigate hazardous of their job.

This training will be documented on the “Orientation Checklist". The manager or supervisor conducting the training and the new employee will both sign the Checklist when the training is completed. The Checklist will become a permanent part of the employee's personnel file.

C. Specific Kerman Training Programs
The following describes training programs applicable to certain Kerman employees:
 Emergency Action Plan - This training includes a discussion of Kerman's disaster preparedness structure and how the employee fits within the structure (i.e., what the employee is to do under specific circumstances, such as fire, earthquake, medical emergency). Refresher training/evacuation drills will take place annually.
 First Aid, CPR and Bloodborne Pathogens Training - All employees will receive training in First Aid, CPR and/or Bloodborne Pathogens.
 Defensive Driver Training - City Employees required to drive pursuant to their job duties will participate in defensive driver training. Additional safe driving subjects will be covered in safety meetings on an asneeded basis.  Hazardous Communication Program - Employees will receive training on: hazardous chemicals they may be exposed to in their workplace operations; proper labeling requirements for these chemicals; physical and health effects of the hazardous chemicals; ways to lessen or prevent exposure and the steps the City has taken to achieve reduction in exposure; as well as where to obtain and how to read the Safety Data Sheets (SDS).

D. Retraining
Retraining will be conducted by managers, supervisors and/or the IIPP Administrator or designee when an existing employee changes job functions as refresher training. Retraining shall cover general workplace safety, job-specific hazards, and/or hazardous materials, as applicable.

E. Specialized Training

1. Supervisors will be trained to understand their responsibilities with respect to the safety and health of the employees that they supervise, as well as training in the hazards and risks faced by the employees under their immediate direction. Such training will include both safety management and technical subjects.

2. Managers/Supervisors and/or IIPP Administrator are responsible for:
 Determine safety-training needs;

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52 Section 5, Item E.
7  Implement new training programs; and
 Evaluate the effectiveness of these programs
In addition, training will be provided whenever:
 New substances, processes, procedures, or equipment pose a new hazardous and there is a lack of adequate skill or knowledge to deal with the new hazardous;  Management and/or the IIPP Administrator become aware of a previously unrecognized hazardous and there is a lack of adequate skill or knowledge to with the hazardous; and  A new facility or a new part of a facility is opened.

X. Recordkeeping
The City maintains records for the purpose of:
 Tracking and evaluating the City's loss experience and loss exposures.  Tracking and evaluating the safety activities that have been accomplished.  Documenting Safety Activities.

All such documentation will be maintained in accordance with the City's records retention schedule.

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53 Section 5, Item E.
8 XI. Injury and Illness Prevention Forms

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54 Section 5, Item E.
9 Hazard Alert
Date: _______________
Department Where Hazard is Located: ____________________________________________ Supervisor or Recipient of Hazardous Alert Form: ___________________________________________________________ Hazards posing an immediate danger to life and health should be reported as soon as possible to your supervisor, the IIPP Administrator or other manager.

Location of Hazard (i.e. building, room area) ___________________________________________________________ ________________________________________________________________________________________________ Description of Hazard (include whether it is chemical, biological, physical etc.) ________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Recommendation for correction: _____________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Has this hazard been reported to your supervisor Yes No OPTIONAL (if employee would like to remain anonymous, leave this area blank):

Employee Name: __________________________________________________________________________________ Department/Location: ______________________________________________________________________________ Telephone Number: ________________________________________________________________________________ NOTE: It is illegal for any employer to take action against employees who exercise their right under the law to report unsafe conditions. Employees are encouraged to report hazards and are commended for their safety awareness.

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55 Section 5, Item E.
10 Hazard Alert Response
To be completed by the Department Manager where the hazard is located, and reviewed by the IIPP Administrator.

Manager description and evaluation of hazard reported: ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ _______________________________________________________________________________________________ Corrective Action:

Corrective Action Taken (describe): ___________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ _______________________________________________________________________________________________ Date corrective action was completed: ________________________________________________________________ Who carried out corrective action? ___________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Discussed at Safety Meeting – Date: __________________________________________________________________ Response provided to Hazard Report: ________________________________________ Date: ___________________ Manager Signature: _______________________________________________________ Date: __________________ IIPP Administrator Signature: ________________________________________________ Date: __________________

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56 Section 5, Item E.
11 Employee’s Report of Incident
Date: ___________________ Supervisors Name:
______________________________________________________
Employee Name: __________________________________________________________________________________ Date of Incident: ___________________________________________ Time of Incident: ________________________ Address and description of where/how incident occurred: ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Describe symptoms and specific part(s) of body affected: _________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Please check ‘Yes’ or ‘No’ to the following questions relating to the incident being reported:

I lost time from my normal work shift after the day the incident occurred. ☐Yes ☐No
I anticipate losing time from work as a result of symptoms from this incident. ☐Yes ☐No
I need or desire medical treatment beyond on-site first aid. ☐Yes ☐No The incident involved exposure to a hazardous substance. ☐Yes ☐No
If ALL answers to the above questions are ‘No’ an injury, as defined by the Labor Code, has not occurred. A report to Workers’ Compensation is not required at this time. If any answer is ‘Yes’ an injury may have occurred. A DWC-1 Employee’s Claim for Workers’ Compensation Benefits is needed so that a report to Workers’ Compensation can be made.

If, as a result of this incident, you subsequently develop (1) symptoms for which you require, or desire medical care; or (2) symptoms that cause you to be unable to report for work, you must notify your Supervisor or Human Resource Department immediately. You should also contact AMC Call Connect at 844-691-4111 to report the incident/injury. If medical care is requested or required, AMC Call Connect will direct you to appropriate medical care. You will be provided with an Injury Claim Form and we will direct you to appropriate medical care.

Be advised that certain Statute of Limitations apply to Workers’ Compensation benefits. Labor Code 5400 provides that no claim to recover compensation shall be maintained unless within 30 days after the occurrence of the injury which is claimed to have caused disability or death there is served upon the employer notice in writing, signed by the person injured or someone on his behalf.

Signature of Employee: ______________________________________________________ Date: _______________

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57 Section 5, Item E.
12 Signature of Supervisor: _____________________________________________________ Date: _______________

ONE COPY TO EMPLOYEE ORIGINAL TO HUMAN RESOURCES FILE
58 Section 5, Item E.
13 Supervisor’s Report of Employee Injury
Name of Employee: _______________________________________________________________________________ Job Title: ________________________________________________________________________________________ Date of Injury: ______________________________________ Time _____________________________am______pm Date Reported: _____________________________________ Time _____________________________am______pm Accident Location (full address): _____________________________________________________________________ ________________________________________________________________________________________________ Specific Injury/Illness with part of body affected: ________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Time employee began work: _________________am______pm
Did injured leave work? Yes No Date:___________________ Time _____________________am______pm Did injured return to work? Yes No Date:________________ Time _____________________am______pm Did employee seek medical attention? Yes No
Name of medical facility/physician: __________________________________________________________________ Describe activity performing when event/exposure occurred: ______________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Describe how accident occurred and materials used: _____________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Name(s) of witnesses: ______________________________________________________________________________ ________________________________________________________________________________________________ What steps have been taken to prevent similar accidents? ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Supervisors Name (printed) ________________________________________________ Dept. Head Initials: ________ Supervisors Signature: ____________________________________________________________________________ Employer: City of Kerman, 850 S. Madera Avenue, Kerman, CA 93630

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59 Section 5, Item E.
14 Orientation Safety Check List
Employee Name (print): _______________________________________________ Date: _____________ Key Points discussed during Orientation:
 Promote a safe & healthy workplace
Line crew –
 Back safety
 Ladder safety
 Power Tool safety
 Personal Protective Equipment Policy
 Compressed air - Gas tank must be chained, even empty ones  Forklift – If not certified, do not drive. Seatbelts are required at all times Office –
 Ergonomics Factors
 Stair safety - Slow, use handrail, keep handheld items to a minimum  Transporting items – Use stairs; make as many trips as necessary  Holdup - Give them what they want, don’t be a hero
o Remember information/description of incident/people
o If safe to do, push emergency button
OSHA Requirements –
 Report Areas of Safety Hazard Infringements
 Complete Monthly Fire Extinguisher check; review for signatures Vehicle Safety –
 Annual training/meeting on vehicle safety
 Obey all traffic laws
 Seatbelts – Always wear
 Speed limits – Follow all speed limits
Trenches and Excavation Safety
 Ditches – Do not enter without proper sloping
 Hard hats - Required, especially ground work, as required in the Personal Protective Equipment Policy (PPE) Employee Signature: __________________________________________________________________ Trainer/Department Representative Signature: _______________________________________________

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60 Section 5, Item E.
15 Office Hazardous Inspection Checklist/Action Form
Date Inspected ___________________________________________________________________ 3-Year Retention after inspection date.

Department: __________________________________________ Location ______________________________________________ OK
1 2
3 4
5 6
7 8
9 10
1 2
3 4
5 1
2 3
4 5
6 1
2 3
4 5
6 7
8 Is the emergency lighting operable
Are combustibles properly stored in work areas
Is the fire suppression system inspected annually
Fire Hazard
Are all work areas equipped with fire extinguishers
Are the monthly and annual inspections of fire extinguishers performed and documented
Are conduit properly attached to all supports and tightly connection to junction and outlet boxes (visual inspection only)
Are the lighting fixtures in good condition and working Are electrical switch cover plates and outlets in good condition Are electric outlets safe and not overloaded
Electrical Hazard
Are all electrical outlets or strips utilized in a neat and safe manner Is the electrical equipment in good condition, properly grounded and turned off when not in use
Are all chemicals and/or liquids stored in a neat and safe manner Is the lounge area in a neat and sanitary condition
Are the restrooms in a neat and sanitary condition and in good working order Housekeeping Hazards
Are all floors, aisles, exits, and fire extinguishers unobstructed Are all floor mats and/or rugs placed in a location or position that does not create an unsafe condition
Deficiency
Noted
Dated
Corrected
Are evacuation signs identifying escape routes and emergency information in place Are there stepstools or stepladders available for use in all buildings and do they have safety treads
Are all scissors, letter openers, or any other sharp objects stored safely with points facing away from user
Are materials stored on top of cabinets or shelves in an orderly fashion or at heights that do not create a potential hazard
Is the ventilation system properly maintained and are vents cleaned regularly Are emergency phone numbers posted
Item to be Checked
( Use the last page to record a brief description of necessary repairs) General Work Area
Are all telephone or power cords covered or routed as to prevent tripping hazards Are all work areas equipped with First Aid Kits
Is an equipped Lockout/Tagout station available for use in all buildings Is the lighting in all work areas in working condition and provide good working light Other -
Other -
Other

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16 Item
#
Office Hazard Inspection Checklist/Action Form
Deficiency Corrective Action Taken

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62 Section 5, Item E.
17 MODULE 1 - BLOODBORNE PATHOGEN PROGRAM
I. Purpose
This exposure control program has been established in order to minimize and to prevent, when possible, the exposure of City of Kerman employees to disease-causing microorganisms transmitted through human blood or other potentially infectious materials. This program identifies employees who are subject to occupational exposure to bloodborne pathogens, establishes information and training standards for those employees, and establishes an immunization program for the Hepatitis B virus. This program will comply with the Bloodborne Pathogens Standard, Title 8, California Code of Regulations, §5193.

II. Scope
All City employees who may be exposed to blood and other potentially infectious materials as part of their job duties are identified and included in this program. Those who have been identified by the City as "reasonably anticipating" exposure to bloodborne pathogens will follow an exposure control plan designed to minimize exposure. The term "employees" includes all full-time, part-time, and temporary status personnel who are employed by the City of Kerman. Any employee, who believes that the exposure exists for them, and has not been identified, should bring their concerns to the attention of their supervisor.

III. Definitions
 "Blood" means human blood, human blood components, and products made from human blood.  "Bloodborne Pathogens" means Pathogenic microorganisms that are present in human blood and can cause disease in humans. These Pathogens include, but are not limited to Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).
 "Contaminated" means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
 "Contaminated Laundry" means laundry, which has been soiled with blood or other potentially infectious materials or may contain sharps.
 "Contaminated Sharps" means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.  "Decontamination" means the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.  "Engineering Controls" means controls (e.g., sharps disposal containers, self-sheathing needles) that isolate or remove the bloodborne pathogen hazard from the workplace.  "Exposure Incident" means a specific eye, mouth, or other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that result from the performance of an employee's duties.
 "Hand washing Facilities" means a facility providing an adequate supply of running potable water, soap, and single use towels or hot air drying machines.
 "HBV" means Hepatitis B Virus.
 "HIV" means Human Immunodeficiency Virus.
 "Occupational Exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
 "Other Potentially Infectious Materials" (OPIM) means:

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18 o The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;
o Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and o HIV - containing cell or tissue cultures, organ cultures, and HIV - or HBV containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.  "Parenteral" means piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.
 "Personal Protective Equipment" (PPE) are specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g. uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard is not considered to be personal protective equipment.  "Regulated Waste" means liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infections materials.  "Source Individual" means any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. Examples include, but are not limited to: hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing facilities; human remains; and individuals who donate or sell blood or blood components.
 "Sterilize" means the use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.
 "Universal Precautions" is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.
 "Work Practice Controls" means controls that reduce the likelihood of exposure by altering the manner in which a task is performed.

IV. Exposure Determination
The following tasks and procedures are reasonably anticipated to involve exposure to blood, body fluids, or other potentially infectious materials:
 Performing first aid duties and/or emergency medical treatment;  Performing mouth-to-mouth resuscitation;
 Performing custodial duties in bathrooms, parks, or other public areas where needles may have been disposed of in trash receptacles; or
 Performing work within sewers and/or coming into possible contact with untreated sewage All personnel in the following job classifications are identified as "reasonably anticipated to involve exposure" (determined to have Occupational Exposure or Potential Occupational Exposure):

A. Police Department
 Police Chief
 Lieutenant
 Corporal
 Records Clerk
 Records Manager
 Animal Control Officer

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64 Section 5, Item E.
19  Animal Shelter Attendant
 Police Sergeant
 Police Officer
 Police Officer Reserve
 Community Service Officer
B. Public Works Department
 Fleet Services Supervisor
 Fleet Mechanic (I, II)
 Public Works Operations Coordinator
 Public Works Lead Supervisor
 Maintenance Worker (I, II, III)
 Administrative Analyst
 WWTP Operators (Grade I, II & III)
 WWTP Maintenance Worker (I, II, III)
C. Parks & Recreation Department
 Buildings & Facilities Supervisor
 Recreation Supervisor
 Recreation Coordinator
 Senior Services Coordinator
 Parks Maintenance Worker (I, II)
V. Parks Maintenance SpecialistMethods of Compliance
The following methods of compliance are for use for all City employees not falling within the Police Department specific policy/procedures documents.

A. Universal Precautions
All blood or other potentially infectious materials shall be handled as if contaminated by a bloodborne Pathogen. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.

B. Hand washing and Other General Hygiene Measures
Employees will wash hands thoroughly using soap and water whenever hands become contaminated and as soon as possible after removing gloves or other personal protective equipment. When other skin areas or mucous membranes come in contact with blood or other potentially infectious materials, the skin shall be washed with soap and water, and the mucous membranes shall be flushed with water, as soon as possible.

Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious material.

Likewise, employees should not engage in any of these activities until proper washing with soap and water is performed.

Employees shall use practices to minimize splashing, spraying, spattering, and generation of droplets during procedures involving blood or other potentially infectious materials.

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65 Section 5, Item E.
20 C. Sharps Management
It is understood that City employees are not required to administer medication with hypodermic needles, which are generally considered sharps. However, employees should also be aware that a nail soaked with blood that has recently been stepped on or even exposed broken glass, qualifies as a contaminated sharp and should be protected and disposed of in accordance with this program.

Contaminated needles or other contaminated sharps shall not be bent, recapped, or removed. Shearing or breaking of contaminated needles is prohibited.

Contaminated disposable sharps shall be discarded, as soon as possible after use, in disposable sharps containers. Contaminated broken glass is also to be placed in disposable sharps containers.

D. Personal Protective Equipment
All personal protective equipment (PPE) will be provided, repaired, cleaned, and disposed of by the employer (each department) at no cost to employees. Each department will provide instructions on appropriate use of personal protective equipment. Employees shall wear personal protective equipment when performing procedures in which exposure to the skin, eyes, mouth, or other mucous membranes are anticipated. The articles to be worn will depend on the expected exposure. Employees who have allergies to regular gloves may obtain hypoallergenic gloves.

All personal protective equipment shall be removed before leaving the work area and placed in an assigned container for storage, washing, decontamination or disposal.

If a garment is penetrated (soaked through) by blood or other potentially infectious material, the garment shall be removed as soon as possible and placed in a designated container for disposal. Garments which only are lightly splashed or dripped on where the blood or other potentially infectious material have not soaked through are to be removed as soon as possible and placed in an appropriate container for cleaning. – See Personal Protective Equipment Policy V- K.

E. Protection for Hands
Gloves shall be worn in the following situations:
 When it can be reasonably anticipated that hands will contact blood or other potentially infectious materials, mucous membranes, and non-intact skin; or
 When handling or touching contaminated items or surfaces.

Disposable Gloves
 Replace as soon as feasible when gloves are contaminated, tom, punctured or when their ability to function as a barrier is compromised.
 Do not wash or decontaminate single use gloves for re-use.

Utility Gloves
 Decontaminate for re-use if the gloves are in good condition.  Discard when gloves are cracked, peeling, torn, punctured or show othersigns of deterioration (whenever their ability to act as a barrier is compromised).

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21 F. Protection for Eyes/Nose/Mouth
Employees shall wear masks in combination with eye protection devices (goggles or glasses with solid side shields) or chin-length face shields whenever splashes,spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, mouth contamination can be reasonably anticipated.

G. Equipment, Environmental and Working Surfaces
Clean all contaminated work surfaces with appropriate disinfectant after completing procedures, and immediately or as soon as feasible, when overtly contaminated or after any spill of blood or other potentially infectious material.

Regularly inspect/decontaminate all reusable bins, pails, cans, and similar receptacles which may become contaminated with blood or other potentially infectious material. If these articles become visibly contaminated, they should be decontaminated immediately or as soon as feasible.

H. Special Sharps Precautions
Clean up broken glass that may be contaminated using mechanical means such as a brush and dustpan, tongs, or forceps. DO NOT pick up directly with the hands. Report any exposure incident on the “Sharps Injury Log”.

Reusable containers are not to be opened, emptied, or cleaned manually or in any other manner which will expose employees to the risk of injury administered or absorbed through the skin. DO NOT reach by hand into a container which stores reusable contaminated sharps. Full containers should be dropped off at the Public Works Office, 15201 W. California Avenue.

VI. Hepatitis B Vaccination
A. General Statement of Policy
The City of Kerman complies with OSHA mandate by providing the Hepatitis B vaccination series to all City employees in a classification identified as "reasonably anticipated" to involve exposure to bloodborne pathogens at no cost to them. In addition, these employees will be offered post-exposure evaluation and follow-up at no cost should they experience an exposure incident on the job. All employees that have been identified as "reasonably anticipated" to involve exposure are encouraged to participate in the program.

Although the City and/or the departments cannot require anyone to receive the immunization, it is strongly recommended.

All medical evaluations and procedures including the Hepatitis B vaccination series, whether prophylactic or post-exposure, will be made available to the employee at a reasonable time and place. This medical care will be performed by or under the supervision of a licensed physician, physician's assistant, or nurse practitioner.

Medical care and vaccination series will be according to the most current recommendations to the U.S. Public Health Service.

B. Hepatitis B Vaccination
The vaccination is a series of three injections. They are as follows:
 Initial injection;
 Second injection - thirty (30) days following the initial injection; and  Third injection - five (5) months following the second injection.

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22 For maximum benefit from the vaccine, the second injection should be given within a seven (7) day period before or after due date (30 days following the first injection). In the event the employee does not take the initiative to have the second injection from 30 to 60 days following their first injection, the series must be restarted.

The vaccination will be made available to employees after they have attended training on bloodborne pathogen and within 10 working days of initial assignment to a job category with exposure.

The vaccination series will not be made available to employees who have previously received the complete Hepatitis B vaccination series, or any employee for whom the vaccine is medically contraindicated will need to retake it.

An employee, who is required to have the Hepatitis B vaccine but chooses not to, will be required to sign a “Hepatitis B Vaccine Consent/Declination”. If an employee has declined the Hepatitis B vaccination, but later changes their mind and wishes to have the vaccination, the City will proceed with the vaccination series at no cost to the employee.

VII. Reporting and Treatment of Exposure Incidents
A. City's Reporting Responsibility
The City has a responsibility, under various federal and state laws and regulations to report occupational illness and injuries, existing programs in the National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services, the Bureau of Labor Statistics, Department of Labor, and the Occupational Safety and Health Administration receive such information for the purposes of surveillance and other objectives. State Health Departments report cases of infectious disease, including HIV, HBV, HCV and TB to the Centers for Disease Control.

All post-exposure testing and treatment will be in accordance with the City's Worker's Compensation Program.

Employees undergoing follow-up for post exposure reasons must attend all medical appointments and will be provided with the necessary time off to attend such appointments. Employees who experience an exposure incident must immediately report their exposure to their immediate supervisor.

B. Exposure Treatment
When an exposure has occurred, the exposed area shall be thoroughly washed immediately using water on all mucosal surfaces, and soap and running water on skin surfaces. If soap and running water are not available, a waterless skin cleaning agent shall be used until soap and running water can be obtained. When there is contamination of personal protective equipment, the personal protective equipment should be disposed of or decontaminated, if appropriate.

The City's Designated Infection Control Officer is the Injury & Illness Prevention Program Administrator.

Following a "significant" exposure, contact the City's Designated Infection Control Officer. "Significant" exposure is defined as: Any situation in which the body fluids of an individual (such as blood or other potentially infectious material including synovial fluid, amniotic fluid, peritoneal fluid, pleural fluid or any fluid that contains visible blood), are suspected of having entered the employee's body through either a body opening (such as your nose, mouth, or eye), or a break in your skin (such as a cut, rash, or abrasion); a needle stick with a contaminated or used needle; intimate respiratory contact (such as CPR without a barrier); or any other situation in which an individual's body fluids may have entered the employee's body.

Did an exposure occur? The following short answer questionnaire can assist in determining if an employee should receive follow-up.

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68 Section 5, Item E.
23 1. Is the fluid or substance with which the employee is in contact with one of the following? • Blood
• Semen
• Vaginal Secretions
• Any body fluid/matter visibly contaminated with blood • Respiratory secretions (droplets, aerosolized particles)

2. Did the fluid or substance (identified above in 1) enter the employee's body through the following? • Needle stick injury
• Laceration by contaminated object
• Open cut wound, non-intact skin
• Splash or contact with eyes, mouth or nose (mucous membrane) • Prolonged respiratory contact
If answers to BOTH 1 and 2 are yes, the employee should be considered to have sustained a "significant" exposure and needs to seek medical treatment.

C. Documentation
When an employee has an exposure to a communicable disease, the incident must be documented as soon as possible and a report submitted within twenty-four hours of the suspected exposure using the “First Aid Incident Report for Bloodborne Pathogens" or "Supervisor Report of Employee Injury". It is the responsibility of the employee to document the exposure.

The infection exposure report will include the details of the task being performed, the means of transmission, the portal of entry, and the type of PPE in use at the lime. The supervisor will review the exposure report and forward originals to the City's Designated Infection Control Officer/City Risk Management along with the applicable Worker's Compensation documentation.

VIII. Procedures for Evaluation and Follow-Up of Exposure Incidents Following a report of an exposure incident, the City shall make immediately available to the exposed employee a confidential medical evaluation and post-exposure follow-up. Post-exposure follow-up medical evaluations will be conducted through the City of Kerman’s designated health facility. The evaluation and follow-up will include the items listed below:
 Documentation of the significant exposure - the routes of exposure and the circumstances under which the exposure incident occurred.
 Identification of the source individual and their transport destination, unless it can be established that identification is infeasible or prohibited by law.
o The source individual's blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV, HCV and HIV infectivity.
o If consent cannot be obtained, the employer shall document that legally required consent cannot be obtained.
o When law does not require the source individual's consent, the source individual's blood shall be tested and the results documented.
 The exposed employee will be informed of the results of the source individual's testing.  The exposed employee will be offered counseling and medical evaluation of any reported illness.

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69 Section 5, Item E.
24  The information listed below will be provided to the healthcare professional evaluating an employee after exposure.
o A description of the exposed employee's duties as they relate to the exposure incident. o Documentation of the route(s) of exposure and circumstances under which the exposure occurred. o Results of the source individual’s blood testing, if available. o All medical records relevant to the appropriate treatment of the employee including vaccination status.

IX. Employee Training
Employees in the classifications identified as "reasonably anticipated" to involve exposure receive training at no cost to the employee, provided during working hours. The department provides training on bloodborne pathogens at the time of initial assignment to tasks where exposure may occur and annually thereafter. Training includes, at a minimum, the following elements:
 A copy of the Bloodborne Pathogens Program and an explanation of the contents;  A general explanation of the epidemiology and symptoms of bloodborne diseases;  An explanation of the modes of transmission of bloodborne pathogens;  An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials;  An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering , administrative or work practice controls, and personal protective equipment;  Information on the types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment;
 An explanation of the basis for selection of personal protective equipment;  Information on Hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination shall be offered free of charge;  Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potential infectious materials;
 An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident, and the medical follow-up that will be made available;  Information on the post-exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident; and
 An opportunity for questions.

X. Recordkeeping Procedures
A. Medical Records
Medical records of all current and former employees or employees being assigned or transferred to work where there will be exposure to toxic substances or harmful physical agents will be retained for the length of employment plus thirty years (in accordance with Title 8, 3204 of CalOSHA regulations). This time period is consistent with OSHA standards for retention of employee occupational medical records. Exposure records and post-exposure follow-up records will be maintained in the individual's medical file.

The records will be kept confidential. The contents will not be disclosed or reported to any person within or outside the workplace without the employee's express written consent, except as required by law or regulation.

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25 B. Training Records
Training records shall be maintained a minimum of three years from the date of training and in accordance with the City's records retention schedule. The training records will include: the dates of the training sessions; contents or a summary of the training sessions; names and qualifications of trainers; and names and job titles of all persons attending.

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71 Section 5, Item E.
26 XI. Bloodborne Pathogen Forms
72 Section 5, Item E.
27 Hepatitis B Vaccine Declination
Date:

DECLINATION - RECORD OF HEPATITIS “B” VACCINE DECLINATION (IF you Decline the Vaccine it is MANDATORY for you to complete this section) Date:

I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to me. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If in the future, I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

Print Name: __ Department:

Employee Signature:

Employer Representative:

Please check all that apply:

I decline the hepatitis B vaccination at this time
I have previously received a complete series of the HBV vaccinations Antibody testing has revealed that I am immune
The vaccine is contraindicated for medical reasons

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73 Section 5, Item E.
28 First Aid Incident Report for Bloodborne Pathogens
Date of incident: Time: a.m. p.m.

Date incident reported: Time: a.m. p.m.

Describe the first-aid incident:

Was there blood or other body fluids present? Yes No
Did an exposure incident occur? Yes No
If yes, please describe it.
(Cal/OSHA – “An exposure incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of one’s duties.”) Did the first aid providers use PPE? Yes No
Print names of persons who provided first aid:

If there was an exposure incident as defined by Cal/OSHA, were they immediately referred for post-exposure evaluation and follow-up? Yes No
Was there blood or other body fluids present? Yes No
If unvaccinated, were they offered the hepatitis B vaccination? Yes No Supervisor’s Signature: Date:

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74 Section 5, Item E.
29 Sharps Injury Log
Supervisors: Complete for each employee exposure incident involving a sharp. This form is to be completed with the employee but not by the employee. Fill in the most appropriate boxes. A sharp includes, but is not limited to, needles, needle devices, scalpels, lancets, X-acto blades, and broken glass.

Employee Name Date/Time of Exposure Incident:
________
Job Classification/Title: ________ Department:
___________________________
Location Where Exposure Occurred: _________________ __ ______ ___
What procedure was being performed when the incident occurred? Check all body parts that were involved
Finger Hand Arm Face/Head Torso Leg
Other
_______
How did the exposure incident occur:

During use of sharp Disassembling After use and before sharps container While putting sharp into sharps container Sharp left, inappropriate place Other
_______
Identify sharp object involved:

Type: Brand: Model:

Was sharp injury protection device attached? Yes No
Was protective mechanism activated? Yes No
Did the exposure occur: Before During After activation
If the sharp had no engineered sharps injury protection, do you feel that such a mechanism could have prevented the injury? Yes No
What other engineering, administrative, or work practice controls could have prevented this injury?

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75 Section 5, Item E.
30 Attach this form to the “Supervisor’s Report of Employee Injury Form”. Send both originals to Human Resources within 24 hours of the incident.

MODULE 2 - HAZARD COMMUNICATION PROGRAM
I. General Information
This Hazard Communication Program has been established for the City of Kerman. The written program is available on the City’s General Shared drive (GenShare) or a hard copy can be reviewed by any interested employee by asking their supervisor to view the binder. This program is based upon the requirements of Title 8, California Code of Regulations, Section §5194 of the General Industry Safety Orders and describes how criteria for labels and warnings, Material Safety Data Sheets (MSDS), and employee information and training will be met.

A. Container Labeling
 The Manager or designee will verify that all containers received will:
o Be clearly labeled as to the contents
o Note the appropriate hazard warnings,
o List the name and address of the manufacturer.

No containers will be released for use until the above data is verified.  The Manager or designee will ensure that all secondary containers are labeled with either:
o An extra copy of the original manufacturer's label, or o A generic label which includes the identity and hazard warning.  Exceptions - Labeling standards are not required for the following substances under the Hazardous Communication Program because these substances fall under other regulations:
o Pesticides - when subject to the labeling requirements issued under the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA);
o Foods, food additives, color additives, drugs or cosmetics that come under the Federal Food, Drug and Cosmetic Act labeling requirements (FD&C);
o Any distilled spirits that are subject to the labeling requirements of the Federal Alcohol Administration Act (FAA); and
o Any consumer product or hazardous substance defined by the Consumer Product Safety Act (CPSA) and the Federal Hazardous Substances Act (FHSA) when they are subject to the labeling requirements of those acts.

B. Safety Data Sheets (SDS)
 The Manager or designee will be responsible for maintaining the SDS system for the City, and will review incoming SDS for new and significant health/safety information. He/she will see that any new information is passed on to the affected employees.
 Copies of SDS for all hazardous chemicals to which employees of the City may be exposed are available at the City Public Works Corporate Yard and at the Waste Water Treatment Plant or by contacting the Public Works Administrative Assistant.

C. Employee Training and Information
 The IIPP Administrator, Manager or their designee is responsible for the employee training program.

He/she will ensure that the elements specified below are carried out.

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31  Prior to starting work, each new employee of the City of Kerman will attend a health and safety orientation in their department and will receive information and training on the following:
o An overview of the requirements contained in the Hazardous Communication Program; o Chemicals present in their workplace operations;
o Location and availability of the written hazardous communication program; o Physical and health effects of the hazardous chemicals; o Methods and observation techniques used to determine the presence or release of hazardous chemicals in the work area;
o How to lessen or prevent exposure to these hazardous chemicals through usage of control/work practices and personal protective equipment;
o Steps the City has taken to lessen or prevent exposure to these chemicals; o Emergency procedures to follow if they are exposed to these chemicals; o Location of first aid stations or first aid kit;
o How to read labels and review SDS to obtain appropriate hazardous information; and o Where the SDS are located along with the hazardous chemical list.

II. Hazardous Non-Routine Tasks – Confined Spaces Entry On occasions, employees are required to perform tasks in confined spaces. The requirements of Title 8 California code of Regulations §5157, Permit Required Confined Spaces, and §5158, Other Confined Space Operations, will be complied with. Prior to starting work in such a space, each supervisor will:
 Conduct pre-entry atmospheric testing using the oxygen analyzer. This must be done within 15 minutes of potential entry. Insure that oxygen level is in a safe range prior to entry.  Insure all associated electrical equipment is locked out. Any electrical equipment used for working inside the confined space must be properly grounded.
 Insure any steam or liquid entry lines into the confined space are disconnected or the valves of such lines closed and pad locked with Lockout/Tagout System.
 Insure personnel entering confined space is properly trained in all duties to be performed in the confined space.
 Insure entrant is wearing appropriate personal protective equipment including eye/face protection, gloves, safety boots, hearing protection, head protection and self-contained breathing apparatus (SCBA) if necessary.  Confined space attendant should be properly trained in communicating with the entrant and emergency procedure if problems arise.
 Entrant and Entrant Supervisor are both responsible to notify the department supervisor when the confined space project is completed so it can be properly closed out.

III. Informing Contractors
It is the responsibility of the Manager or designee to provide contractors and vendors with the following information:
• A list of hazardous chemicals to which they may be exposed while on City premises; and • Availability of SDS for all hazardous chemicals on file, and where a copy may be obtained The Manager or designee will also obtain from the contractor a list of hazardous chemicals, with appropriate SDS, that they will bring into City facilities.

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32 IV. Emergency Spill Procedures
All employees who encounter a hazardous material spill will immediately evaluate if the spill requires an emergency signal for immediate evacuation. If the spill is determined to be a major health and safety hazardous, employees should follow procedures outlined in the City of Kerman Emergency Action Plan. Those procedures involve:
 Sounding the emergency signal. Pulling the nearest fire alarm.  Contacting the emergency authorities.
o 911- Police, Ambulance, etc.
o Dial, as soon as safely possible, O.E.S. (Office of Emergency Services 1-800-424-8802)  Evacuate the premises.

If the hazardousspill does not warrant an emergency signal, then a supervisor will be notified immediately so that assignment of cleanup activities can be determined. If it is necessary to use the emergency spill kit for cleanup, then it is required by law to contact O.E.S. (Office of Emergency Services) at 1-800-424-8802.

EMERGENCY SPILL KIT
The City of Kerman has strategically placed an emergency cleanup kit (Envirosorb) in our chemical storage area in the main shop at the warehouse – 15275 W. California, (big yellow bucket in the main shop). Most chemical spills can be contained by the contents of this kit. The kit contains:

First Response Equipment Kit
 1 - Apron
 1 - Pair Gloves
 1 - Face Shield
 1 - Respirator
 1 - Accutint Litmus Indicator
 1 - Top Gun Hand Cleaner
First Response Spill Kit
 1 - First Response Equip Kit
 2 – 15 lb. Bags Counteract
 4 – 15 lb. Bags Spill Sorb
 2 – 12 ft. Absorbent Booms
The cleanup kit shall be used as follows:
1)Put on safety equipment
2)Spread Counteract on spill area.
3)Spread SPILL-SORB over entire spill area. Give material sufficient time to absorb. 4)Sweep or shovel up absorbed material.
5)Store in disposable bags until material can be disposed of according to federal, state, and local regulations.

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33 MODULE 3 - EMERGENCY ACTION PLAN
I. Scope and Application
This Emergency Action Plan is in compliance with the California Code of Regulations, Title 8, §3220 and covers actions that must be taken to ensure employee safety from fire and other emergencies.

Emergencies, disasters, accidents, and injuries may occur at any time, usually without warning. The purpose of this plan is to ensure accountability for all employees by providing employees with procedures for handling possible emergencies and disasters. All managers, supervisors, and employees must review the plan and familiarize themselves with the procedures contained in this plan.

The Emergency Action Plan Information Sheet is to be completed by the Supervisor of each department area/location. This information is site-specific to each working environment and will be used as a tool in the event of an emergency.

This plan defines the information and actions needed by each individual department to ensure appropriate response and procedures in the event of an emergency. See Emergency Action Plan Information Sheet.

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34 II. Emergency Action Plan Information Sheet
(To be completed by each Department Head)
BUILDING LOCATION/FLOOR: ________________________________________________________________________ DESIGNATED RESPONSIBLE COORDINATOR/SUPERVISOR FOR __________________________________ DEPARTMENT Name: ___________________________________________________ Phone: _________________________________ ALTERNATE RESPONSIBLE SUPERVISOR:

Name: ___________________________________________________ Phone: _________________________________ CITY EMERGENCY EVACUATION COORDINATOR: _________________________________________________________ PREDETERMINED EMERGENCY MEETING LOCATION: _____________________________________________________ ALTERNATIVE MEETING LOCATION (if initial predetermined location is inaccessible): ____________________________ ________________________________________________________________________________________________ LIST OF INDIVIDUALS ASSIGNED TO ASSIST PHYSICALLY IMPAIRED INDIVIDUALS (if applicable) Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________

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35 III. Definitions
Accountability: A system to account for all employees within a small geographical area (workplace) during an emergency.

Meeting Location: A predetermined, distinct part or section, as of a building or outdoor area, set aside for a purpose or specific function; a safe location for employees to meet during an emergency.

Alternate Meeting Location: A secondary predetermined location for meeting during an emergency. This location is a necessity in the event the initial meeting location is inaccessible.

Evacuation: An immediate exit, by all employees and visitors in the facility, due to a threat to life and safety during an emergency.

Evacuation Route: A predetermined route designed to evacuate employees and visitors to a safe meeting location.

Evacuation Route Map: A floor plan (diagram) posted in buildings/work areas identifying primary and secondary evacuation routes, building exits, fire extinguisher locations, and predetermined meeting locations.

Lockdown: An emergency protocol, closing/locking a facility/building, keeping employees/visitors within the locked facility/building away from the threat of a dangerous external event.

IV. Elements
A. Emergency Evacuation Procedures & Route Assignments
Evacuation of the building is required when the building's alarm system sounds or when employees are instructed to do so. Emergency evacuation procedures and route assignments are posted in each work area and all employees have been trained in the correct procedures to follow. New employees are trained when assigned to a work area. Evacuation route maps include: exit locations and evacuation routes; fire extinguisher locations; and predetermined meeting locations.

Building evacuation should proceed as follows:
 Determine in advance the nearest exit in your location;  Calmly and quickly exit per the evacuation route OR proceed to the nearest safe exit;  Instruct visitors who are present to exit with you;
 Assist anyone having difficulty exiting the building (be mindful of persons who have impairments and may need assistance in evacuating the building or reaching the meeting location);  In case of fire, do not use the elevator (if applicable);  After exiting the building, follow the evacuation route to the predetermined meeting location;  Once at the meeting location, report to your supervisor or designee;  Remain at the meeting location until the designated responsible coordinator has given the "all clear" notification to re-enter the building.

B. Procedures for Employees Who Remain to Operate Critical Operations Before Evacuation During some emergency situations, it may be necessary for specifically assigned and properly trained employees to remain in work areas that are being evacuated long enough to perform critical operations. These assignments are necessary to ensure proper emergency control. The selected individuals will receive special

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36 instructions and training by their immediate supervisors to ensure their safety in carrying out the designated assignments.

C. Evacuation of Persons with Disabilities
In cases of emergencies, individuals with mobility or sensory impairments (hearing or vision) may need assistance or guidance with evacuating a building. If there is a fire or situation that could affect electricity/power, do not use elevators.
• To Assist Visually-Impaired Persons
o Explain the nature of the emergency. Alarms or confusion may disorient a person, even when normally familiar with an area. Tell the person what needs to be done in order to evacuate. o Guide the person with you. Allow the person to take your arm below the elbow and instruct them to follow you. Remember to move slowly and communicate clearly with the individual. o Advise the individual of any hazardous or obstacles in the path. o When you have reached safety, advise the individual of their location and stay with them if necessary. • To Assist Hearing-Impaired Persons
o To get an individual's attention, you can flash room lights, wave your arms, or tap on the individual's shoulder.
o Gesture about what is happening and what to do (i.e. follow me, get down). o Write the nature of the emergency or evacuation route on a board or paper. • To Assist Mobility-Impaired Persons
o Ask the individual if they have medical/health needs or requirements. o Individuals using wheelchairs can be pushed or accompanied to safety. Do not use elevators. If needed, seek help to safely assist the person.
o If located in a building where stairs are to be used as the emergency exit for mobility-impaired persons, take that person to a safe area (Le. stairwell landings, offices, or balconies) and explain to them that you will get help to evacuate them from the building. Do not put yourself in extra danger. o Individuals using canes, crutches, or walkers should evacuate themselves, except in the event that rapid evacuation is deemed essential.
o If in need of assistance, call "911". Do not attempt to transfer a person from a wheelchair unless absolutely necessary.

D. Employee Accountability Procedures after Evacuations • Each supervisor is responsible for accounting for all assigned employees, personally or through a designee, by having all such employees report to a predetermined meeting location and conducting a head count. • During an evacuation, each supervisor will conduct a sweep of all cubicles, rooms, and restrooms in their area to ensure all employees and visitors have evacuated the building. • All supervisors and employees must report to their designated location immediately following an evacuation.
• Each assigned employee must be accounted for by name and is responsible for reporting to his or her designated Emergency Evacuation Coordinator to ensure an accurate head count. • The Emergency Evacuation Coordinator will determine the method to be utilized to locate any missing personnel in each situation.

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37 E. Rescue and Medical Duties
Rescue and medical duties will be performed by the emergency responders.

V. Alarm System
During an emergency evacuation, employees will be notified of the emergency condition by an audible alarm or verbal notification. Emergency responders will be notified when the fire alarm system is activated or by a call placed to "911".

VI. Evacuation for Emergencies
A. Fire Emergency
(Do not attempt any action that places you or another person at risk or injury) • When fire is discovered:
o Activate the nearest fire alarm; and
o Call "911 ".
• Provide the following information:
o Brief description of the type and location of the fire; o Building address; and
o Your name and phone number from which you are calling. • Upon being notified about the fire emergency, all employees/visitors must:
o Leave the building using the identified evacuation routes; o Assemble in the predetermined meeting location; and
o Remain at the meeting location until the designated responsible coordinator has given the "all clear" notification to re-enter the building.
• Designated Coordinator/Supervisor must:
o Coordinate an orderly evacuation of personnel;
o Ensure that all employees and visitors have evacuated the areas/floors; o Perform an accurate head count of personnel reported to the meeting location; o Provide emergency personnel with any necessary information about the facility. • Assistants to Physically Impaired should:
o Assist all physically impaired individuals in emergency evacuation.

B. Earthquake
In order to minimize panic, confusion and possible injuries, it is important to know how to respond properly during an earthquake.
 During an earthquake, immediately move away from windows, tall file cabinets, bookshelves, and light fixtures. Find shelter under a sturdy desk or table, if possible. Kneel down in a hunched position. Place hands over your head for added protection. Remain there until shaking stops. Be aware of possible power outages that may affect lighting.
 Do not evacuate unless told to do so or if danger of building collapse is imminent. If instructed to leave the building, follow the evacuation route or use the nearest safe exit. o Be aware of the exit nearest to your workstation and the route to that exit. Establish an alternate route should your first choice be blocked or unsafe to use. o Move away from the building as quickly as possible to an open area away from all buildings. Stay away from power lines, windows, brick walls or any object that could topple.

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38 o Due to possible gas leaks, do not light matches or use cigarette lighters.  Once evacuated, do not re-enter the building until the designated responsible coordinator has given the "all clear" notification to reenter.
 After the initial earthquake:
o Be prepared for aftershocks;
o Report damage, fires, electrical shorts, gas and water leaks to the supervisor in charge; o Check for injured individuals and provide assistance - but do not attempt to move a seriously injured person unless they are in immediate danger; and
o If instructed to re-enter a building, open doors carefully and watch for hazardous.

C. Lockdown
 If a situation arises, due to a hostile threat from an intruder or intruders, please conduct the following:
o Call "911 ".
o Quickly check for employees/visitors unaware of the threat and bring them inside. o Lock doors and close any blinds.
o Place employees/visitors in an area that is "out of view" of the possible intruder. o Turn off lights and computers.
o Keep everyone quiet.
o Wait for police to confirm an "all clear".

D. Other Emergencies
For all other emergencies (medical, etc.), report immediately by dialing "911".

VII. Training
Managers and supervisors are responsible for ensuring that documented training is provided to their employees regarding the provisions of this plan. Also, managers and supervisors must ensure that their facility's evacuation route maps are current and posted in conspicuous places, and that all employees are aware of the locations of fire extinguishers and fire pull boxes within their sections.

Evacuation drills will be held. All employees will participate in drills. Employees will evacuate the building during the drill and will not re-enter the building until notified to do so.

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39 MODULE 4 - HEAT ILLNESS PREVENTION PLAN (Effective 05/01/15) I. Purpose
This program is in place to protect all employees from heat hazardous posed by working in the outdoor environment, as required by the heat illness prevention regulation (Title 8 CCR 3395), and to serve as a supplement to the City of Kerman’s Injury and Illness Prevention Program (IIPP). This information is intended to be used as part of and in conjunction with the IIPP. The Heat Illness Prevention Plan ensures that City employees are knowledgeable in the prevention and recognition of heat illness to ensure their safety and the safety of others.

All supervisors and employees must review the plan and familiarize themselves with the Heat Illness Prevention principles and procedures contained in this plan.

The City of Kerman is committed to preventing heat-related illnesses (see Definitions and Descriptions of Heat Illness) that can occur to employees working outdoors by implementing the following key steps:
 Identifying outdoor work environments and conditions
 Monitoring weather conditions
 Monitoring employee acclimatization for working outdoors in heat  Providing clean drinking water
 Providing adequate shade
 Addressing high-heat procedures
 Handling an ill employee and initiating emergency procedures  Providing supervisor and employee training; see “Heat Illness Employee Training Handout”.

The following positions have been identified as working in outdoor environments that could potentially expose employees to illnesses associated with high heat.

Police Department
 Patrol Sergeants
 Police Officers
 Animal Control Officer
 Animal Shelter Attendant
 Community Service Officer
Public Works Department
 Fleet Services Supervisor
 Fleet Mechanic (I, II)
 PW Operations Coordinator
 PW Lead Supervisor
 Maintenance Worker (I, II, & III)
 WWTP Water Distribution/Waste Water Manager
 WWTP Lead Supervisor
 WWTP Maintenance Worker (I, II, & III)
 Administrative Analyst
 WWTP Operators (Grade I, II )
Parks & Recreation Department
 Building & Facilities Supervisor
 Recreation Supervisor

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85 Section 5, Item E.
40  Recreation Coordinator
 Senior Services Coordinator
 Parks Maintenance Worker (I, II)
Planning Department
 Building Official
 Code Enforcement Official
II. Monitoring the Weather
A. Weather forecast
When environmental risk factors create the possibility for heat illness, the supervisor will monitor the twoweek forecast for the work area. The supervisor will review the forecasted temperature and humidity for the worksite and compare it against the National Weather Service Heat Index to evaluate the risk level for heat illness. It is important to keep in mind that the temperature at which these warnings occur must be lowered as much as 15 degrees if the workers under consideration are in direct sunlight.

Weather information will be obtained by accessing the National Weather Service at www.weather.gov, calling the local National Weather Service office, or watching the Weather Channel TV network. Work schedules will be planned in advance, based on the forecast. Modifications will be made accordingly, especially if a heat wave is expected. This monitoring will take place all summer long.

B. Weather Monitoring Prior To Workday During Times Of Risk Prior to each workday, the supervisor will be responsible for monitoring the weather using www.weather.gov, or with the aid of a simple thermometer at the worksite. This weather information will be taken into consideration to determine when it will be necessary to make modifications to the work schedule (such as stopping work early, rescheduling the job, working at night or during the cooler hours of the day, increasing the number of water and rest breaks).

If schedule modifications are not possible and workers have to work during a heat wave, the supervisor will provide a tailgate meeting to reinforce heat illness prevention with emergency response procedures and review the weather forecast with the workers. In addition, the supervisor will provide workers with an increased number of water and rest breaks. The supervisor will ensure workers stop and take these breaks and closely observe all workers for signs of heat illness.

The supervisor will be responsible for using a thermometer at the jobsite and periodically checking the temperature to monitor for sudden increases. Once the temperature exceeds 80 o
Fahrenheit (F), the shade
structures are opened and accessible to the workers. Once the temperature equals or exceeds 95' F, additional preventive measures such as the high-heat procedures are implemented.

III. Monitoring Employee Acclimatization For Working Outdoors In Heat The supervisor will watch for sudden heat waves early in the season or increases in temperatures to which employees are unaccustomed for several weeks or longer. When necessary, the workday will be cut short or rescheduled for another day. In addition, during the summer months, the work shift may start earlier in the day or later in the evening to reduce exposure. During any heat wave, we will observe all employees closely (or maintain frequent communication via phone or radio) and watch for possible signs of heat illness.

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41 For new employees, the supervisor will try to find ways to lessen the intensity of work during a two-week breakin period. Steps taken to lessen the intensity of the workload for new employees will be documented. The supervisor will:
 Stay alert to the presence of heat-related symptoms
 Assign new employees a buddy or experienced coworker to watch for discomfort or signs of heat illness IV. Providing Clean Drinking Water
The supervisor will provide access to potable drinking water at the beginning of each work shift so each employee can remain hydrated throughout the workday. The supervisor will remind employees to drink sufficient amounts of water, at least one quart (4 cups) per hour, when the work environment is hot, and employees are likely to be sweating more than usual in the course of their duties. Water must be “fresh, pure, and suitably cool” and provided to employees free of charge. The water shall be located as close as practicable to areas where employees are working. Single use, disposable cups will be provided. No one should drink from the water container.

When employees do not have access to plumbed or otherwise continuously supplied water, and we cannot readily replenish the water during the shift, the supervisor will provide enough water at the start of the shift so each employee has access to one quart of water or more per hour.

V. Providing Adequate Shade
When the outdoor temperature in the work area exceeds 80° F, we will provide and maintain one or more areas with shade at all times while employees are present. These areas will either be open to the air or provided with ventilation or cooling. We will also provide shade when an employee specifically requests it, even when the temperature does not exceed 80° F. Employees will be allowed and encouraged to take a preventative cool-down rest in the shade when they feel the need to protect themselves from overheating. Such access to shade shall be permitted at all times. An individual employee who takes a preventative cool-down rest (A) shall be monitored and asked if he or she is experiencing symptoms of heat illness; (B) shall be encouraged to remain in the shade; and (C) shall not be ordered back to work until any signs or symptoms of heat illness have abated, but in no event less than 5 minutes in addition to the time needed to access the shade.

Depending on the worksite, shade may be provided by trees or buildings. When natural shade is not available, we will provide other acceptable means of shade such as umbrellas, tents, canopies, etc., to block the sunlight. In these instances, we will provide chairs, benches, sheets, towels, or any other items to allow employees to sit and rest without contacting the bare ground. We will also relocate the shade structure as the work environment or location changes.

The amount of shade present will be at least enough to accommodate the number of employees on recovery or rest periods, so they can sit in a normal posture, fully in the shade without having to be in physical contact with each other. The shade shall be located as close as practicable to the areas where employees are working. The amount of shade present during meal periods shall be at least enough to accommodate the number of employees on the meal period who remain onsite.

In instances where natural shade is not available, supervisors will:
• Bring sufficient shade structures to the site
• Ensure sufficient shade structures are opened and placed as close as practical to the workers

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42 • Point out the daily location of the shade structures to the workers, as well as allow and encourage employees to take a five-minute cool-down rest in the shade when they feel the need to do so to protect themselves from overheating
• Ensure the shade structures are relocated to follow along with the crew and double-check they are as close as practical to the employees so access to shade is provided at all times If it is infeasible or unsafe to have shade structures, or to have shade present on a continuous basis, we will provide alternative procedures with equivalent protection.

In instances where natural shade such as a tree is available, supervisors will evaluate the thickness and shape of the shaded area in orchards or other areas of vegetation (given the changing angles of the sun during the entire shift), before assuming that sufficient shadow is being cast to protect employees.

In situations where it is not safe to provide shade (example winds of more than 40 mph), we will document how the determination was made and identify what steps will be taken if someone requests shade, or we will identify other cooling measures with equivalent protection. Cooling measures other than shade may be used if they are as effective as shade in allowing employees to cool.

VI. Addressing High-Heat Procedures
When the outdoor temperature equals or exceeds 95 F, supervisors will:
 Conduct a pre-shift meeting to review high heat procedures  Be available so employees at the work site can contact them when necessary; if a cell phone or two-way radio is used, reception must be validated
 Be extra vigilant with observing employees for alertness and signs of heat illness  Remind employees to drink plenty of water and take cool-down breaks throughout the work shift  Designate one or more employees on each worksite as authorized to call for emergency medical services, and allow other employees to call for emergency services when no designated employee is available.  Closely monitor and observe all employees during a heat wave. Any new employee who has been assigned to a high heat area shall be closely observed for the first 14 days of employment, unless the employee indicates at the time of hire that he or she has been doing similar outdoor work for at least 10 of the past 30 days for four or more hours per day.

VII. Handling An Ill Employee And Emergency Procedures
When an employee exhibits possible signs or reports symptoms of heat illness (refer to Types of Heat Illnesses) while taking a preventative cool-down rest or during a preventative cool-down rest period, a supervisor will:
 Immediately call 911
 Move the employee to a cooler/shaded area
 Remove excess layers of clothing
 Fan and mist the worker with water
 Apply ice (ice bags or ice towels)
 Provide cool drinking water, if able to drink
A supervisor will remain with the sick employee until emergency help arrives. If the area is remote, the supervisor will have a map along with clear and precise directions (such as streets or road names, distinguishing features, and distances to major roads) of the site to clearly communicate the location to emergency medical services, the supervisor will designate someone to physically go to the nearest road or highway where emergency responders

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43 can see them. If necessary, the supervisor can transport employees to a place where they can be reached by an emergency medical provider.

Prior to assigning a crew to a particular worksite, the supervisor will:
• Ensure a qualified, appropriately trained, and equipped person will be available at the site to render first aid if necessary
• Ensure responsibility for calling emergency medical service is assigned to the best capable person at the site • Verify all leads and supervisors carry cell phones or other means of communication to ensure emergency medical services can be called
• Ensure all communication devices are functional at the worksite prior to each shift VIII. Providing Supervisor and Employee Training
A. Employees
All employees are required to attend a health and safety training session prior to beginning work that should be reasonably anticipated to result in exposure to the risk of heat illness. See Training Handout. The following information will be provided:
 The environmental and personal risk factors for heat illness, as well as the added burden of heat load on the body caused by exertion, clothing, and personal protective equipment.  Our procedures for complying with the requirements of the heat illness prevention regulation  The importance of frequent consumption of small quantities of water  The importance of acclimatization
 The different types of heat illness and the common signs and symptoms of heat illness  The importance of employees immediately reporting symptoms or signs of heat illness for themselves and co-workers
 Our specific procedures for responding to possible heat illness, including how emergency medical services will be provided should they become necessary
 Our specific procedures for contacting emergency medical services and, if necessary, for transporting employees to a point where they can be reached by an emergency medical service provider  Our procedures for designating a person to be available to ensure emergency procedures are invoked when appropriate
 Our specific procedures for ensuring clear and precise directions to the work site will be provided as needed to emergency responders
B. Supervisors
In addition to obtaining the training required for employees listed above, supervisors will be trained before performing work that could be reasonably anticipated to result in exposure to heat illness. Training will include:
 All information provided during employee training
 Procedures for preventing heat illness, including monitoring weather reports and how to respond to hot weather advisories
 Information about how to identify heat illness
 Steps to take for emergency response to heat illness

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44 IX. Definitions
Acclimatization: Temporary adaptation of the body to work in the heat that occurs gradually as a person is exposed to the heat. Acclimatization peaks in most people within four to fourteen days of regular work for at least two hours per day in the heat.

Heat Illness: A serious medical condition resulting from the body's inability to cope with a particular heat load, and that includes heat cramps, heat exhaustion, heat syncope and heat stroke.

Heat Wave: Any day in which the predicted high temperature is at least 80oFahrenheit and at least 10oFahrenheit higher than the average high daily temperature in the preceding five days.

Environmental Risk Factors for Heat Illness: Working conditions that create the possibility that heat illness could occur, including air temperature, relative humidity, radiant heat from the sun and other sources. Conductive heat sources such as the ground, air movement, workload severity and duration, protective clothing and personal protective equipment worn by employees.

Personal Risk Factors for Heat Illness: Factors such as an individual's age, degree of acclimatization, health, water consumption, alcohol consumption, caffeine consumption, and use of prescription medications that affect the body's water retention or other physiological responses to heat.

Preventative Recovery Period: A period of time to recover from the heat in order to prevent heat illness.

Shade: Blockage of direct sunlight. Canopies, umbrellas and other temporary structures or devices may be used to provide shade as long as it does not expose employees to unsafe or unhealthy conditions and does not deter or discourage access or use. One indicator that a blockage is sufficient is when objects do not cast a shadow in the area of blocked sunlight. Shade is not adequate when heat in the area of shade defeats the purpose of shade, which is to allow the body to cool. For example, a car sitting in the sun does not provide acceptable shade to a person inside it, unless the car is running with air conditioning.

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45 City of Kerman Heat Illness Employee - Training Handout DATE: ____________________ DEPARTMENT: ________________________________________________________ We have developed a training program to increase employee awareness of the occurrence of exposures to heat illnesses when working outdoors and to motivate employees to protect themselves.

Overview of Heat Illness Prevention Regulation
The heat illness prevention regulation is intended to ensure both employers and employees understand the dangers associated with working in heat in outdoor workplaces. The following information is a review of the specific requirements of a heat illness prevention program, including water, shade, high-heat procedures, and training.

Written Heat Illness Prevention Program
We have a written program that outlines how we provide information on and control exposures that can result in heat illness while performing outdoor work in the heat. This program is available to you during our training or during your work shift from the supervisor at your location.

Water
We will provide enough fresh drinking water so you have access to at least one quart of water per hour and actively encourage you to drink it. Refrain from alcoholic beverages or beverages that contain caffeine, such as soft drinks, coffee, and tea.

Shade
Our goal is to provide shade so everyone who needs it has access to it to cool off when the weather is hot. If infeasible or unsafe to provide shade, we will provide other means to help keep you cool.

High-Heat Procedures
When the outside temperature reaches or exceed 95° F, additional precautions, to the extent they are feasible, will be taken to ensure your safety and health. This includes good communication, close supervision if you have not recently worked outdoors in the heat for four or more hours per day, observing you, and reminding you to drink plenty of water.

Training
All employees and supervisors who have potential heat exposures receive the same training so everyone understands our policy and procedures for keeping everyone safe when working outdoors. Training addresses how to acclimate to the heat, how much water to drink, the signs and symptoms of heat illness, the importance or reporting symptoms to your supervisor, and how to get help in an emergency.

You can read the California heat illness prevention regulation for additional information on any specific program element at http://www.dir.ca.gov/dosh/heatillnessinfo.html

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46 Types of Heat Illness
Heat illness is a serious medical condition resulting from the body's inability to cope with a particular heat load and includes heat cramps, heat exhaustion, heat syncope, and heat stroke.

Heat Stroke
The most life-threatening heat-related illness; heat stroke happens when the body can no longer control its temperature.

The body's temperature rises fast. The body cannot sweat and is unable to cool itself. Warning signs include red, hot, dry skin; very high body temperature; dizziness; nausea; confusion; strange behavior or unconsciousness; rapid pulse or throbbing headache. Heat stroke can cause death or disability if treatment is not given.

Heat Exhaustion
Heat exhaustion is a milder illness that happens when the body has lost too much water and salt in sweat. Warning signs include heavy sweating, cramps, headache, nausea or vomiting, paleness, tiredness, weakness, dizziness, and fainting. If heat exhaustion is not treated, it can turn into heat stroke. Get medical assistance if the symptoms are severe or if the victim has heart problems or high blood pressure.

Heat Syncope
Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization.

Symptoms of heat syncope include light-headedness, dizziness, and fainting.

Heat Cramps
Heat cramps are muscle pains and spasms due to heavy activity. They usually involve the stomach muscles or the legs. It is generally thought that the loss of water and salt from heavy sweating causes the cramps. If you have heart problems or are on a low sodium diet, get medical attention for heat cramps.

Heat Rash
Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms include red cluster of pimples or small blisters. Heat rash is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

Sunburn
Sunburn is when skin becomes red, painful, and unusually warm after being in the sun. Sunburn should be avoided because it damages the skin and could lead to more serious illness.

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47 MODULE 5 - FIRE PREVENTION PLAN
I. Scope and Application
This Fire Prevention Plan is in compliance with the California Code of Regulations, Title 8, §3221 and is intended to prevent and minimize the possibility of a fire.

The plan applies to all City employees and all City facilities, whether owned, rented, or otherwise occupied. Plan copies are site-specific. All managers and supervisors are responsible for executing and enforcing the plan.

II. Elements
A. Potential Fire Hazardous
The following is a list of potential workplace fire hazardous:
 Overloaded electrical circuits;
 Incorrectly wired electrical circuits;
 Use of electrical extension cords as permanent wiring;  Inadequate protection of electrical cords from damage;  Accumulation of trash and waste;
 Storage of combustible materials close to water heaters, furnaces, space heaters, hot lamps, hot plates, hot irons, or outside close to buildings;
 Improper storage of flammable liquids to include storing such liquids in unapproved containers, unapproved storage cabinets and in areas where ignition sources reside, such as in rooms with natural gas operated water heaters;
 Lack of preventive maintenance and lubrication of machinery and/or equipment;  Inadequately maintained heating, ventilation, and air conditioning systems;  Smoking in unauthorized facilities and/or near flammable liquid storage or dispensing systems;  Static electricity build-up during dispensing of flammable liquids;  Use of space heaters without tip-over shut off protection;  Lack of explosion-proof electrical apparatus in areas where there can be a buildup of flammable vapors.

B. Personnel Responsible for Maintenance of Fire and Emergency Equipment City facilities work to ensure compliance with International Fire Code (IFC) requirements for emergency equipment. Fire protection systems within City facilities are inspected and tested by authorized service contractors on a schedule established by the Public Services Director or designee. If any system or part of a system is not working properly, action is taken promptly.

C. Personnel Responsible for Control of Flammable/Combustible Materials Supervisors at each City location are responsible for insuring the proper storing of flammable or combustible materials.

III. Housekeeping
The City controls storage of flammable and combustible materials and residues so that they do not contribute to fire ignition. Housekeeping procedures include such activities as:

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48  Daily disposal of trash from waste containers;
 Immediately cleaning up and proper environmental disposal of all spills of flammable liquids;  Maintenance of electrical equipment to include:
o Keeping electrical circuits from becoming overloaded; o Adding additional electrical outlets and power if needed; o Avoiding the use of electrical extension cords except for temporary usage (24 hours maximum); o Identifying problems with electrical wiring and outlets and making the necessary repairs; o Ensuring that flammable vapors are kept away from electrical ignition points; and o Not placing anything on top of electrical cords.
 All use and storage locations (including tanks) of flammable liquids are properly posted, warning people in the area of the fire and explosion dangers;
 Keeping the quantity of flammable liquids to a minimum to reduce the risk and magnitude of fire;  Storing flammable liquids in UL-approved safety cans and/or UL-approved flammable liquid cabinets, and in areas where there are no ignition sources;
 Keeping all containers of flammable liquids closed when not in use to prevent potential release of flammable vapors that could ignite;
 Storing oily rags in UL-approved safety cans and in areas where there are no ignition sources;  Daily emptying of oily-rag containers;
 Not storing any combustible materials within 36" of water heaters, furnaces, space heaters, hot lamps, hot plates, and hot irons;
 Only using space heaters that have automatic "tip-over" devices that shut offthe units in the event they should topple over; and
 Enforcement of "no smoking" rules in areas where flammable liquids are stored or where flammable liquids are dispensed.

IV. Training
Managers and supervisors are responsible for ensuring that documented training is provided to their employees regarding the provisions of this plan and that housekeeping procedures are implemented. Also, managers and supervisors must ensure that their facility is free from improper accumulation of flammable and combustible waste materials and residues so they do not contribute to a fire.

V. Maintenance
The City regularly and properly maintains equipment and systems installed in the workplace to prevent accidental ignition of combustible materials. These maintenance procedures are coordinated by the Public Works Director or designee and include, but are not limited to, the following:
 A regular schedule of on-going preventive maintenance of machinery and/or equipment (including HVAC systems) to ensure inspection, maintenance and proper lubrication;  Maintenance of sufficient electrical power to handle each facility and function's electrical needs - including areas where space heaters are used; and
 Checking electrical outlets and circuits to ensure they are correctly wired.

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49 MODULE 6 - CITY HALL ROBBERY PROCEDURE
The City of Kerman has implemented processes and procedures to handle a “hold-up” situation in the City Hall. There is a hold-up button located at the front desk of The City Hall. The main objective of front office staff is to survive the situation without incident. “Hold-up” policies and procedures will be reviewed by Safety Committee periodically.

In the event of a robbery at City Hall; do the following:
 City Hall staff is to be fully cooperative with any assailant. Give them what they want and allow them to leave the office as unhindered as possible.
 The only appropriate action is to press the “hold-up” button and it should only be done if able to do so without putting yourself in danger.
 Operators at the monitoring station will respond to the “hold-up” alarm report as described by the alarm monitoring system. This would include dispatch of the police, indicating a hold-up situation.  After the assailant has left, front office staff should either verify that the monitoring station operator has dispatched police or they should dial 911 themselves. They should also notify management. Under no circumstances should anyone follow the suspect.

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50 MODULE 7 - ERGONOMIC PROGRAM
I. Purpose
The purpose of the City’s Ergonomic Program is to inform employees that the City is committed to improving our employee’s comfort and well-being by identifying and correcting ergonomic risk factors on the job. City’s goal is to reduce or eliminate hazardous that contribute to the development of musculoskeletal disorders (MSD).

II. Policy
It is the policy of the City of Kerman to maintain an ergonomic program that achieves the following goals:
 Prevent or minimize the occurrence of work-related musculoskeletal disorders such as tendonitis, low back pain, and carpal tunnel syndrome, by controlling employee exposure to the ergonomic risk factors that can cause or aggravate them;
 Ensure that affected employees are informed about work-related musculoskeletal disorders and associated ergonomic risk factors (e.g., repetitive motion, sustained postures, exertions);  Reduce the severity of work-related musculoskeletal disorders through early medical management  Encourage employee involvement in controlling exposure to ergonomic risk factors III. Ergonomic Program Coordinator
The IIPP Administrator will be the Ergonomic Program Coordinator and will lead efforts to identify and resolve ergonomic related problems.

IV. Identifying Workstation Risk Factors
Risk factors are job attributes or exposures that increase the probability of developing MSDS. The Office Evaluation Form can help identify possible risk factors. These risk factors are not necessarily causation factors for MSDS, nor, does the presence of a risk factor mean that an employee performing a job is at excessive risk of injury. Rather, a combination of risk factors, coupled with individual pre-dispositions may contribute to the risk of MSD occurrence.

The following are risk factors for developing MSDS:
 Repetition Rate - The current literature suggests a strong link between repetitive motion and the development of these disorders. This risk factor appears to be even more significant when sufficient recovery periods are not applied.
 Duration - When duration of a task is increased, the risk for MSDS is also increased.  Force - Forceful exertions place loads on joint structures and tissues of the musculoskeletal system.  Contact Stress - Contact stresses are produced when parts of the body come in contact with hard, sharp objects, resulting in forces transmitted through the skin to tendons and nerves. An example includes resting your wrists on a hard surface while using a keyboard.
 Posture - Stress to the body occurs when a body position places undue load on the musculoskeletal system or the nerves and blood vessels.
 Environment - Environmental factors such as vibration, lighting, and cold temperatures can increase the risk of developing MSDS.
 Other Stressors:
o Time pressures, deadlines, and work overload
o Absence of employee involvement in decision making
o Unaccustomed work, especially during training periods or after returning from a long-term leave  Non-Occupational Risks - Many employees have hobbies or other past times not related to work which might present any of the above-mentioned risk factors. If the muscle-tendon groups used during these activities are

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51 the same as those used during work activities, then the individual may not be allowing for adequate recovery periods in between exposures.

V. Hazardous Prevention and Control
Engineering controls are preferred over all other control methods because they involve designing the workstation to fit the individual and not the reverse. Examples of engineering controls most commonly used include the following:
 Work Station Design - Workstations should be easily adjustable and designed for each specific task so that they are comfortable for the employee and are appropriate for the job being performed. Specific attention shall be paid to static loading of muscles, work activity height, reach requirements, force requirements, sharp or hard edges, proper seating, support for the limbs, equipment orientation, and layout of the workstation.  Design of Work Methods - Work methods should be designed to reduce exposure to static, extreme and awkward postures, repetitive motions, excessive forces, inefficient grasps, and vibrations.

Administrative controls reduce the duration, frequency, and severity of exposures to ergonomic hazardous. An example would be to take rest pauses or breaks to relieve fatigued muscle-tendon groups. Administrative controls can be used in combination with other controls, but should not be used as the only control method for an ergonomic hazardous. The following sheet with Helpful Stretches can also alleviate some symptoms.

VI. Medical Management
The major components of a medical management program for the prevention and treatment of MSDS is employee training and education, early reporting of symptoms, appropriate medical care, and accurate recordkeeping. Early Reporting & Symptoms - All employees should report signs and symptoms on the Symptoms Survey Sheet of MSDS as soon as they occur. Pain, numbness and tingling in wrists, arms, elbows, neck, shoulders and back are early symptoms of MSDS.

VII. Training
Ergonomic training is available for all employees. This training will consist of the following:
 Overview of the Ergonomic Management Program
 Recognition of ergonomic hazardous
 Hazardous prevention and control
 Recognition of symptoms and reporting requirements
Definitions
Administrative controls are changes in the way that work in a job is assigned or scheduled that reduce the magnitude, frequency or duration of exposure to ergonomic risk factors. Examples of administrative controls for MSD hazardous include: employee rotation; job task enlargement; alternative tasks; and employer-authorized changes in work pace.

Carpal Tunnel Syndrome: The compression and entrapment of the median nerve where it passes through the wrist into the hand--in the carpal tunnel. The median nerve is the main nerve that extends down the arm to the hand and provides the sense of touch in the thumb, index finger, middle finger, and half of the fourth, or ring, finger.

Engineering controls are physical changes to a job that reduce MSD hazardous. Examples of engineering controls include changing or redesigning workstations, tools, facilities, equipment, materials, or processes.

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52 Musculoskeletal Disorder (MSD) is a disorder of the muscles, nerves, tendons, ligaments, joints, cartilage, blood vessels, or spinal discs. For purposes of this program, this definition only includes MSDS in the following areas of the body that have been associated with exposure to risk factors: neck, shoulder, elbow, forearm, wrist, hand, abdomen (hernia only), back, knee, ankle, and foot. MSDS include muscle strains and tears, ligaments sprains, joint and tendon inflammation, pinched nerves, and spinal disc degeneration.

MSD signs are objective physical findings that an employee may be developing an MSD. Examples of MSD signs are:
decreased range of motion; deformity; decreased grip strength and loss of function.

MSD symptoms are physical indications that an employee may be developing an MSD. For purposes of this standard, MSD symptoms do not include discomfort. Examples of MSD symptoms include: pain; numbness; tingling; burning; cramping; and stiffness.

Risk Factor means, for the purposes of this program: force, awkward posture, repetition, vibration, and contact stress.

Work practice controls are changes in the way an employee performs the physical work activities of a job that reduce or control exposure to MSD hazardous. Work practice controls involve procedures and methods for safe work.

Examples of work practice controls for MSD hazardous include: Use of neutral postures to perform tasks (straight wrists, lifting close to the body); use of two-person lift teams; and observance of micro breaks.

Work Related: means that an exposure in the workplace caused or contributed to an MSD or significantly aggravated a pre-existing MSD.

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53 Ergonomic Symptoms Survey
Name: ________________________________________________________ Date: _____________ Phone: _______________________________ Department: ____________________________________________ Supervisor: ______________________________________ Phone: _________________________________ Job Title: ________________________________________ Time at current work station: ________________ Have you had pain or discomfort during the last year? Yes No (if no STOP here) If Yes, check the item(s) below and state R = Right and L = Left Neck Shoulder Elbow/Forearm Hand/Wrist Fingers
Upper Back Lower Back Thigh/Knee Lower Leg Ankle/Foot
Please put a check by the word(s) that best describe your problem Aching Numbness (asleep) Tingling
Burning Pain Weakness
Cramping Swelling Other: _______________________
Loss of Color Stiffness _____________________________
When did you first notice the problem? _____________ (Month) ________________ (Year) How long does each episode last?
1 hour 1 month
1 day 6 months
1 week
How many separate episodes have you had in the past year? __________________________________________ What do you think caused the problem? ____________________________________________________________ ______________________________________________________________________________________________ Have you had the problem in the last 7 days? Yes No
How would you rate this problem (Mark an "X" on the line) Now - None________________________________________________________________________Unbearable When it is Worst
None________________________________________________________________________Unbearable Have you had any medical treatment for this problem? Yes No If no, why not? _______________________________________________________________________________ If yes, where did you receive treatment?___________________________________________________________ Did the treatment help? Yes No
Please comment on what you thin would improve your symptons? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ This form shall be completed by persons who may be experiencing musculoskeletal disorders as a result of their work environment. Carefully read this form and provide the following information:

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54 Office Ergonomic Evaluation Form
Name: ________________________________________________________ Date: _______________ Phone: _______________________________ Department: ____________________________________________ Supervisor: ______________________________________ Phone: ___________________________________ Job Title: _____________________________________________________________________________________ Average Daily PC Usage: 0-2 Hours 2-4 Hours 4-6 Hours
CTD Symptoms Yes No
CTD = Cumulative Trauma Disorders
Follow-Up Yes No Follow up Date _________________
Comments: ____________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Chair Recommendation
Feet flat on floor? Yes No Footrest
Upper legs parallel to floor? Yes No Raise Chair Lower Chair Lower back supported? Yes No Adjust back rest, seat pan, arm rest Set pan length OK? Yes No Evaluate other chairs
Other ____________________________
Keyboard/Hands Recommendation
Forearms parallel to floor? Yes No Raise keyboard Lower keyboard Wrists straight and level? Yes No Adjust keyboard incline angle Keying/Mouse grip force OK? Yes No Needs adjustable keyboard/mouse platform Mouse location OK? Yes No Needs wrist rest Needs mouse wrist rest Evaluate ergonomic keyboard
Position mouse next to keyboard at same height
Evaluate mouse hardware change
Other ____________________________
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55 Monitor Recommendation
Monitor directly in front of user? Yes No Reposition monitor Viewing distance 16-24 inches? Yes No Lower monitor Raise monitor top of Slightly below seated Refocus on distant objects eye level ? Yes No (30 seconds every 30 minutes)
Screen free of glare, reflection? Yes No Add task lighting Visual control OK? Yes No Reposition entire PC workstation Eyeglass(bifocal) RX OK? Yes No Adjust monitor tilt angle Other ____________________________
Copyholder Recommendation
Copyholder use OK? Yes No Needs copy holder
Position copy holder at same height and
viewing distance as monitor
Other ____________________________
Phone Recommendation
Phone use OK? Needs phone cradle device
Is phone use required while on PC? Needs headset
Average daily phone usage
0-30 minutes 30-90 minutes 90+ minutes
Work Habits Recommendation
Work habits OK? Yes No Mini-breaks
(2-3 minutes every 45 minutes of PC work)
Alternate between typing and non-typing work
PC break software
Other ____________________________
General Office Recommendation
Are awkward postures minimized? Yes No Lower desk work surface height Is back twisting minimized? Yes No Needs adjustable height workstation Can you avoid overhead reaches? Yes No Change office layout Change drawer/shelf location
Reposition notebook, books, etc.

Other ____________________________
Evaluation conducted by ____________________________________ Date: _____________________________

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56 Helpful Stretches

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58 MODULE 8 - OCCUPATIONAL NOISE EXPOSURE PROGRAM
I. Purpose
This policy is designed to create a safe working environment for all the City of Kerman employees with regard to occupational noise exposure and the prevention of hearing loss due to work related tasks. It is the intent of the City that noise exposure levels to employees remain below the action level.  A potential exists for employee noise exposure as outlined in California Code of Regulations, Title 8, Sections 5095-5100 (8CCR5095-5100).
 Exposure dangers can be the result of working in certain areas of the City or the result of performing certain tasks using portable/mobile equipment.
 Occupational noise exposure levels can vary over time due to equipment changes or modifications to workplace tasks, and therefore need periodic review and testing.

II. Requirements
Monitoring will be performed and noise assessed in all areas of Kerman’s facilities that pose a risk. The required level of hearing protection will be posted at the site, including a time exposure limit that the employee cannot exceed. Appropriate Hearing Protection Devices (HPDs) will be issued to employees who work in areas that have been determined to have noise levels at or above the established standards of 90 dBA.

Employees need to stay 50% below the maximum time limit exposure to protect them from hearing loss.

The time-weighted average will be adjusted for the Noise Reduction Rating (NRR) printed on the hearing protection. Employees exposed to noise at or above 90 dBA action level are to participate in annual audiometric examinations (i.e., baseline and annual).

III. Responsibilities
 The Safety Committee will annually review the Occupational Noise Exposure Program (ONPP) and provide suggestions for improvements to the policy, implementation, and testing.  The IIPP Administrator or his/her designee will perform noise monitoring as requested by the Safety Committee.
 Supervisors shall continue to periodically review Job Safety Analysis and other workplace assessments with regards to noise exposure and the required level of hearing protection.  Conduct frequent checks and enforce the proper use of HPDs by employees  Employees will consistently wear and care for any HPDs assigned to them.

IV. Monitoring Limits & Testing Procedure
 Noise level monitoring will be considered whenever employees have the following:
o Difficulty communicating by speech while facing each other in the noise area at a distance of two feet. o Complaints such as headaches and/or ringing in the ears after working in a noise area for extended periods; or
o Temporary loss of hearing that has the effect of muffling speech and other sounds after extended exposure to the noise.
 For steady sound, a 10-15 minute sample will be taken with a Type 1 or 2 Sound Level Meter. Readings shall be taken in the fast response, on the A-weighted scale.

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Section 5, Item E.
59  Subtract 7 decibels from the NRR value of the hearing protection. Subtract the remaining amount from the measured level of the noise source.
 The resulting value is the in-the-ear corrected decibel level.  Check following chart for time restriction based on decibel reading.

Permissible Noise Exposures
Duration per day, hours
Sound level dBA slow
response
8 90
6 92
4 95
3 97
2 100
11/2 102
1 105
1/2 110
1/4 or less 115
Taken from Table G-16A of 29CFR1910.95, Appendix A; Equivalent exposure time limits for sound levels other than 90 decibels; Action level established by OSHA (50% of standard)
 All employees identified by monitoring for inclusion in the ONPP will participate in preliminary (baseline) and subsequent (annual) audiometric tests.

V. Recordkeeping
 The (Name of Department) will maintain the following records:
o Noise exposure measurements
o Audiometric test results (includes audiograms, employee’s name and department, audiogram date, examiner’s name, audiometer calibration date, and employee’s last assessment date) o Audiometric test facility’s background noise level
 Records will be provided upon written request by employees, former employees, or representatives designated by individual employees
VI. Training
All employees will be trained initially upon hire, and as new tasks are introduced. Training on hearing protection will be included with the PPE training, and will identify the types of protection, proper employee usage, and areas/tasks where it is required.

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Section 5, Item E.
60 MODULE 9 - LOCKOUT AND TAGOUT SAFETY PROGRAM
I. Purpose
This procedure establishes the requirements for the lockout of energy isolating devices whenever maintenance or servicing is done on machines or equipment. It shall be used to ensure that the machine or equipment is stopped, isolated from all potentially hazardous energy sources and locked out before employees perform any servicing or maintenance where the unexpected energization or start-up of the machine or equipment or release of stored energy could cause injury.

II. Lockout
Lockout locks shall be used on all occasions when a piece of equipment needs to be isolated from its source. Only standardized locks used specifically for lockout shall be used by all personnel. Some equipment can’t be locked out, but that does not mean it can’t be dangerous if it’s starts or is energized. This is when a Tagout tag shall be used. State law states that a lockout lock has to be:
 Durable enough for the heat, cold, humidity, or corrosiveness in the area where it’s used.  Standardized by color, shape, or size throughout the facility.  Strong so it can’t be removed without heavy force or tools like bolt cutters.  Identified by the name of the employee who installs and removes it III. Tagout (Hazardous Safety Tag)
The Tagout program consists of using a special tag, (Hazardous Safety Tag) that warns people of the danger of activating an energy source. A Tagout tag has a printed warning, (i.e., “Do Not Start”, “Do Not Operate”, etc.) with the name of the person who is tagging out the equipment, the date/time which it was tagged out, and the piece of equipment being worked on. The Tagout tag should only be used if a lockout lock cannot be used.

The Tagout tag has to meet all the same standards that are issued for locks. They have to be durable, strong, standardized, and show the identity of the employee doing the work.

Sequence of Lockout or Tagout System Procedure:
 Notify affected employee that you will be locking or tagging out equipment and why.  If the equipment is operating, shut it down by the normal operating procedure (i.e., depress stop button, throw switch).
 Operate the switch, valve, or other, energy isolating device so that the equipment is isolated from all potential energy source (i.e., breaker in an electrical panel).
 Lockout and/or tagout the energy isolating device with assigned standardized lock and/or tag provided by the City
 Carefully, try turning the equipment on to make certain that the equipment will not operate. This will ensure that you have locked out a piece of equipment.
 CAUTION! Remember to return operating control back to the “off” position.  The equipment is now locked and/or tagged out. Perform any necessary services or maintenance.

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Section 5, Item E.
61 IV. Restoring Equipment (Lockout/Tagout Removal)
After the maintenance and/or servicing are complete and equipment is ready for normal operation, check the area around the equipment to ensure that no one is exposed. Remove all tools from the equipment. Re-install all guards and, after all employees are in the clear, remove all lockout and/or tagout devices. Operate the energyisolating device to restore energy to the machine or equipment.

V. Procedure for More Than One Person
In the preceding steps, if more than one person is required to lockout and/or tagout equipment, each shall place their own lockout and/or tagout device to the energy-isolating device. When an energy-isolating device cannot accept separate multiple locks or tags, then a multi-lock device will need to be purchased. The key to this lock shall be given to a supervisor who will be responsible for removing the lockout device when all the conditions, listed above, for lockout/tag out removal have been met.

VI. Things to Remember
 Always lock or tag equipment energy source before maintenance or repair.  Use lockout whenever possible. Tagout is just a warning, not an active way to prevent accidents.  Follow all lockout/tagout installation and removal steps.  Be sure other workers in the area are aware of your lockout/tagout activities.  Never ignore someone else’s lock or tag.

VII. Documentation
A Lockout and Tagout Program List of Source, which qualifies for this program, will be kept with this written plan.

A copy will also be posted at each workplace in a highly visible location. A sample lockout/tagout sign and equipment tag are also part of this written program.

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Section 5, Item E.
62 VIII. Lockout and Tagout Program List of Source
Location Source
City Hall – 850 S. Madera Avenue
South side of Building Main Breaker
South side of Building 3 Phase Panel
South side of Building 3 Phase Power Panel
5 locations in City Hall Sub Panels
Roof on the AC Electrical Connects
Kerman Police Department – 850 S. Madera Avenue
North end of building Breaker Panel
Roof on the AC Electrical Connects
Public Works Corporation Yard – 15201 W. California Avenue Public Works Breaker Panel
Shop and Warehouse Bld. Breaker Panel
Pump / Storage Breaker Panel
Roof on the AC Electrical Connects
Waste Water Treatment Plant – 15485 West Church Avenue
Inside Control Room Breaker Panel
Control Building Store Room Breaker Panel
Garage Building Breaker Panel
Lock out Electrical disconnects when they are available.

Roof on the AC Electrical Connects
Community Center Power and Communication Room – 15101 W. Kearney Blvd.

South West Corner of Bld. Breaker Panel
Roof on the AC Electrical Connects
Senior Center/Needs Building (Next to Senior Center) – 720 S. Eighth Street Roof on the AC Breaker Panel
Northeast corner of the Senior Center (outside of the building) Breaker Panel City-Owned Building – 942 S. Madera Avenue
Roof on the AC Electrical Connects
Southeast Storage Room Breaker Panel
Plaza Park Restrooms – Madera Avenue and “B” Street
Storeroom Main Breaker Panel
Rotary Park – 702 Vineland Avenue
Southwest Storeroom Main Breaker Panel
Electrical Cage Breaker Panel
Lions Park – 744 Park Avenue
Northwest Storeroom Main Breaker Panel
All Well Sites & Backup Generators
Well 9A - Lions Park-Del Norte/C St. Breaker Panels/Backup Generators Well 10 - Standby Rotary Park-Vineland/E St. Breaker Panels/Backup Generators Well 12 - Industrial Way (Near Zacky Farms) Breaker Panels/Backup Generators Well 14 - Vineland & Highway180 Breaker Panels/Backup Generators Well 15 - City Yard – 15201 W. California Breaker Panels/Backup Generators Well 17 - Goldenrod California – 920 S. Goldenrod Breaker Panels/Backup Generators Well 18 Test Well – Highway 180 Behind Shopping Center Breaker Panels/Backup Generators

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Section 5, Item E.
63 MODULE 10 – PERSONAL PROTECTIVE EQUIPMENT POLICY
(ADOPTED 08-07-2013)

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Section 5, Item E.
64 RETRUN TO TABLE OF CONTENTS
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Section 5, Item E.
65 I. Purpose
The purpose of this Policy is to protect all employees including part-time employees, community service workers and volunteers from the risk of injury by creating a barrier against workplace hazardous in compliance with Cal/OSHA Standards. Personal protective equipment is not a substitute for good engineering or administrative controls or good work practices, but should be used in conjunction with these controls to ensure the safety and health of employees. Personal protective equipment will be provided, used, and maintained when it has been determined that its use is required and that such use will lessen the likelihood of occupational injury/or illness.

II. Applicability
This Policy applies to all City employees.

III. Policy
It is the policy of the City of Kerman that all aspects of CalOSHA's requirements for personal protective equipment, California General Industry Safety Orders, Title 8, Subchapter 7, Group 2, Article 10, shall be met or exceeded. This Policy addresses eye, face, head, foot and body protection. http://www.dir.ca.gov/Title8/sb7g2.html IV. Responsibilities
A. Safety Officer and Risk Management Officer shall:

1. Ensure that the Personal Protective Equipment Policy is implemented. The Safety Officer and Risk Management Officer have the authority to delegate any or all portions of this policy to subordinates, but the Safety Officer and Risk Management Officer will be held responsible for compliance.

2. Annually budget for the department's personal protective equipment

3. Conduct workplace hazardous assessments to determine the presence of hazardous which necessitate the use of personal protective equipment
B. Supervisors shall:

1. Implement the Personal Protective Equipment Policy.

2. Ensure that employees wear personal protective equipment when appropriate.

3. Counsel employees when personal protective equipment is not worn

4. Notify the Safety Officer when new hazardous are introduced or when processes are added or changed.

5. Ensure that employees are trained on the proper use, care, and cleaning of personal protective equipment.

C. Employees shall:

1. Wear personal protective equipment as required.

2. Care for, clean, and maintain all issued personal protective equipment.

3. Inform their supervisor of the need to repair or replace personal protective equipment. 111
Section 5, Item E.
66 D. Safety Officer shall:

1. Update and maintain the Personal Protective Equipment Policy.

2. Assist with and review workplace hazardous assessments to determine the presence of hazards which necessitate the use of personal protective equipment.

3. Maintain records on hazardous assessments.

4. Provide assistance in training supervisors and employees on the proper use, care, and cleaning of approved personal protective equipment.

5. Provide guidance to supervisors for the selection and purchase of approved personal protective equipment.

V. Procedure
A. Hazardous Assessment and Equipment Selection
CalOSHA requires employers to conduct inspections of all workplaces to determine the need for personal protective equipment (PPE) and to help in selecting the proper PPE for each task performed. The Risk Management Officer or their designee in conjunction with the Safety Officer will conduct a walk through survey of each work area initially and whenever new hazardous are introduced into the workplace to identify sources of hazardous including impact, penetration, compression, chemical, heat, dust, electrical sources, material handling, vibration, and light radiation. Each survey will be documented using the Hazardous Assessment Certification form, which indicates the workplace surveyed, the person who conducted the survey, findings of potential hazardous, and the date of the survey.

Once the hazardous of a workplace have been identified, the Risk Management Officer or designee and the Safety Officer will determine the suitability of the PPE presently available; and, as necessary, select new or additional equipment ensuring a level of protection equal to or greater than the minimum required to protect the employees from the hazardous. Care will be taken to recognize the possibility of multiple and simultaneous exposures to a variety of hazardous. Adequate protection against the highest level of each of the hazardous will be provided.

B. Protective Devices
All personal protective clothing and equipment shall be of safe design and construction for the work to be performed and shall be maintained in a sanitary, safe and reliable condition. Only those items that meet NIOSH (National Institute for Occupational Safety and Health) or ANSI (American National Standards Institute), ISEA (International Safety Equipment Association) and the ASTM (American Society for Testing Material) standards will be procured or accepted for use. Newly purchased PPE must conform to the updated ANSI, ISEA and ASTM standards which have been incorporated into the CalOSHA PPE regulations, as follows:
(http://www.safetyequipment.org/c/stdz891-2009.cfm

1. Eye and Face Protection ANSI/ISEA Z87.1-2020

2. Head Protection ANSI/ISEA Z89.l-2014

3. Foot Protection ASTM F2413-18

4. Hand Protection ANSI/ISEA 1341 - 2019

5. Body Protection - Cal/OSHA Standard 3383

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Section 5, Item E.
67 Careful consideration will be given to the comfort and fit of PPE in order to ensure that it will be used. Protective devices are generally available in a variety of sizes. Care should be taken to ensure that the right size is selected.

C. Eye and Face Protection
Prevention of eye injuries requires that all persons, who may be in eye hazard areas, shall wear protective eyewear. This includes employees and other persons visiting the hazardous area.

Suitable eye protectors shall be used when employees are exposed to hazards from flying particles, molten metal, acids or caustic liquids, chemical liquids, gases, vapors, aerosols, or potentially injurious light radiation.

1. Employees who wear contact lenses or prescription glasses must wear appropriate eye and face protection devices in a hazardous environment.

2. Side shields shall be used when there is a hazard from flying objects.

3. Goggles and chemical splash face shields shall be used when there is a hazard from chemical splash.

4. Face shields shall only be worn over primary eye protection (safety glasses or goggles).

D. Voluntary Respirator Use
The City may, upon request from an employee and depending on specific workplace conditions, provide a filtering facepiece-type respirator (dust mask) to the employee for voluntary use. The Safety Officer will provide all employees who voluntarily choose to wear a respirator with a copy of Appendix D of the Cal/OSHA standard http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9784 E. Emergency Eyewash and Safety Shower Facilities
Emergency eyewash (including bottled eye wash) and safety shower facilities meeting the requirements of ANSI Z358. l shall be provided in all areas where the eyes and body of any employee may be exposed to chemicals. All such emergency facilities will be located where they are easily accessible in an emergency. Permanent emergency eyewash and safety shower facilities must be flushed at least monthly and the inspection noted on a laminated "inspection tag" attached to the eyewash or safety shower.

F. Head Protection
Head protection shall be provided to and worn by any employee including part-time employees, community service workers and volunteers that may be exposed to falling, flying, or fixed objects that may fall, or to electrical shock.

G. Hand Protection
Suitable gloves shall be worn when hazards from chemicals, cuts, lacerations, abrasions, punctures, burns, biologicals, and harmful temperature extremes are present. Glove selection shall be based on performance characteristics of the gloves, conditions, duration of use, and hazards present. One type of glove will not work in all situations.

The first consideration in the selection of gloves for use against chemicals is to determine, if possible, the exact nature of the substances to be encountered. Read instructions and warnings on chemical container labels and SDSs before working with any chemical. Recommended glove types are often listed in the section for personal protective equipment.

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Section 5, Item E.
68 All glove materials are eventually permeated by chemicals. However, they can be used safely for limited time periods if specific use and other characteristics (i.e., thickness and permeation rate and time) are known. The Safety Officer can assist in determining the specific type of glove material that should be worn for a particular chemical.

H. Foot Protection (Revised 05-17-17)
All safety footwear shall comply with ASTM F2413-18, "American Society for Testing Materials." Safety shoes or boots with impact protection are required to be worn in work areas when carrying or handling materials such as packages, objects, parts and/or heavy tools, which could be dropped; and for other activities where objects might fall onto the feet. Safety shoes or boots with compression protection are required for work activities in which materials could potentially roll over an employee's feet. Safety shoes or boots with puncture protection are required where sharp objects such as nails, wire, tacks, screws, large staples, scrap metal, etc., could be stepped on by employees causing a foot injury.

It is the responsibility of the employee, either full time or part time status, to purchase and wear safety shoes or boots when required by their position. Procedure to complete the reimbursement for the purchase of safety shoes will be in accordance with the following terms and conditions:
a. Employees are required to wear safety shoes/boots at work. If proper shoes/boots are not worn, the employee will be reassigned to other duties or sent home to don the proper shoes/boots. b. Reimbursement Limit – The City of Kerman will reimburse up to a maximum of $250.00 within a 12-month period for the purchase or replacement of protective footwear for permanent part time and full time employees.
c. Frequency of Reimbursement – Reimbursement for protective footwear will be provided as needed (based on the condition of existing protective footwear) but no more frequently than once in a twelvemonth period of time. If an employee wears out his or her footwear in less than 12 months, he or she will be expected to show their Department Head so that the Department Head can determine if the boots will be replaced and notify Human Resources to notify Red Wing Shoes. d. To qualify for reimbursement, protective footwear must be deemed appropriate by the respective Department Head for the work environment and functions of the respective employee. The basic requirement for protective footwear will be that is must meet or exceed an ASTM F2413-18rating. e. Employees will be trained on the proper cleaning and maintenance procedures for their protective footwear and will be expected to follow those procedures on a regular basis, to ensure safety and to prolong the life of the footwear.
f. Employees will take their personal protective footwear home with them and will wear them to work as appropriate.
g. In the event of an on-the-job incident where an employee damages his or her footwear, the City may reimburse for the replacement of the boots even if it has been less than 12 months since the last purchase.

The decision as to whether or not the City will replace the damaged boots will be made by the respective Department Head and the Finance Director and will depend on the circumstances of the incident and whether or not the employee was following city policies and procedures.

I. Body Protection
Employees will be provided with appropriate body protection whenever their job tasks expose parts of their body (otherwise not protected) to hazardous or flying substances or objects. Loose sleeves, tails, ties, lapels, cuffs, or

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Section 5, Item E.
69 other loose clothing that can be entangled in moving machinery shall not be worn. All clothing saturated or impregnated with flammable liquids, corrosive substances, irritants or oxidizing agents shall be removed and shall not be worn until properly cleaned. Personal protection clothing will protect the body, back (lumbar support) and legs (chain saw chaps).

J. Life Rings and Personal Flotation Devices
At least one U.S. Coast Guard approved 30-inch life ring with not less than 90 feet of 600 pound capacity line attached shall be kept in a conveniently accessible place where employees work exposes them to the hazard of drowning. Each employee shall wear a U.S. Coast Guard approved personal flotation device when using a boat.

K. Cleaning and Maintenance
It is important that all PPE be kept clean and properly maintained. Cleaning is particularly important for eye and face protection where dirty or fogged lenses could impair vision. PPE shall be inspected, cleaned, and maintained at regular intervals by the employee the PPE is assigned to so that the PPE provides the requisite protection.

Personal protective equipment shall not be shared between employees until it has been properly cleaned and sanitized.

PPE will be distributed for individual use whenever possible.

L. Signage
Safety signage shall be posted wherever PPE is required. Signage is not required at temporary job sites; however, the job site hazards and personal protective equipment required shall be discussed at a daily tailgate meeting.

Signage shall have clear and concise wording like "Safety Glasses Required in This Area" or "Head Protection Required." Signs shall be purchased and posted by the respective department.

M. Training
Any employee required to wear PPE shall receive training in the proper use and care of the PPE. Periodic retraining shall be offered by the City to both employees and supervisors, as needed. The training shall include, but not necessarily be limited to, the following subjects:

1. When PPE is necessary to be worn

2. How to properly don, take off, adjust, and wear PPE.

3. The limitations of PPE.

4. The proper care, maintenance, useful life and disposal of the PPE.

N. Recordkeeping
The Safety Officer shall maintain the Hazard Assessment Certification form for each permanent work site evaluated for at least three (3) years or as required by Cal/OSHA. Training records shall be maintained by the respective Department and Safety Officer for a period of three (3) years. 115
Section 5, Item E.
70 VI. PERSONAL PROTECTIVE EQUIPMENT POLICY FORMS

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Section 5, Item E.
71 1. Hazard Assessment Certification Form
Job/operation Title: Department:

Job Site: Job:

Equipment Used:
(See Equipment Code below)
Supervisor:

Task
No. Describe Each Task or Activity Hazard Associated with Task or Activity Control Measures
1 2
3 4
5 6
7 8
9 10
Hazard Assessment: Part of Body and Type of Protection Required (Check all that Apply) Areas of Impact Protective Devices
Body 
Ears 
Eyes 
Face 
Foot 
Hands 
Head 
Body Cut Resistant Chaps  | Lumbar Support  *Hard Hat – Ear Muffs/Plugs 
Face Protection: Face Shield 
Safety Spectacles | Goggles | Welding Shield 
Respirator/Mask 
Safety Shoes: Metatarsal Guards 
Toe Guards 
Protective Device0Gloves:

Chemical Resistant  | Cut Resistant  Leather 
Rubber  | Temperature Resistant 
Other as Required by Product 
Safety-toe shoes 
Cement Boots 
Flotation Device 
Other 
* City Purchases Type 1 Class E, G & C with regular brim and full brim which is equal to a Class B hat.

Equipment Code
Person Certifying Assessment
Print Name Signature Date
1 Axe 7
Compress/Air
Gas Operation 13 Grader 20 Knife 26 Pavement Crack Sealer 32 Scissor Lift 38 Welder 2 Backhoe 8 Drills 14 Hand Hammer 21 Ladder 27 Propane Gas Tank 33 Shovel 39
3 Battery Charger 9 Edger 15 Hand Pruning
Shears 22 Lawn Mower 28 Rake 34 Street Grinder 40
4 Bucket Lift 10 Electrical Tools 16 Hedger 23 Leaf Blower 29 Riding Mower 35 Stump Grinder 41 5 Chainsaw 11 Floor Jack 17 Hoe 24 Lift Jack 30 Sander 36 Trailer 42 6 Clippers 12 Forklift 19 Jack Hammer 25 Paint Sprayer 31 Saw 37 Weed Eater 43

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Section 5, Item E.
72 2. Personal Protective Equipment Issuance Form
(Please Complete for each Employee)
Name: ___________________________________________________ Department: ________________________________________ Classification: ______________________________________________ Date: ____________________________________________ Type of PPE Provided:

Protective Devices Date Provided
Body Cut Resistant Chaps | Lumbar Support 
Ear Muffs/Plugs 
Face Protection – Face Shield  | Safety Spectacles |Goggles | Welding Shield  Protective Device0Gloves –
Chemical Resistant  | Cut Resistant  Leather  | Rubber  | Temperature Resistant  Other as Required by Product 
*Hard Hat 
Respirator/Mask 
Safety Shoes – Metatarsal Guards |Toe Guards  | Safety-toe shoes  Cement Boots 
Flotation Device 
Other:

I acknowledge that while I am working for City of Kerman, I am expected to wear and take proper care of the Personal Protection Equipment issued to me (checked above). I understand that upon termination, I am expected to return all issued equipment.
________________________________________________
______________________________________________
Employee Name (Please Print) Employee Signature
_______________________________________________
______________________________________________
Supervisor Name (Please Print) Supervisor Signature
* City Purchases Type 1 Class E, G & C with regular brim and full brim which is equal to a Class B hard hat.

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Section 5, Item E.
73 EMPLOYEE ACKNOWLEDGEMENT FORM
Injury and Illness Prevention Program (IIPP)
Employee Last Name: _______________________________________________________ Employee First Name: _______________________________________________________ City Department: ___________________________________________________________ Employee Position/Title: _____________________________________________________ Employee Phone Number: ____________________________________________________ I certify that I have received, reviewed, and read a copy of the City of Kerman “Injury and Illness Prevention Program" (IIPP) and fully understand my responsibilities with respect to the policy and procedures as outlined. I further agree to comply with safe work practice information received in this basic safety orientation and IIPP review.

Signature: _____________________________________________ Date: ________________________

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Section 5, Item E.
74 SIGNS FOR POSTING

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Section 5, Item E.
75 Keep Us Safe
If an employee wishes to report a hazard, safety suggestion, Or other safety problem anonymously,
He or she can report it anonymously on the
City of Kerman Safety Tipline
(877) 312-6149
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Section 5, Item E.
76 AFTER CALLING 911

FOR ANY HAZARDOUS

MATERIAL SPILLS PESTICIDE EXPOSURES

OR ACCIDENTS INVOLVING BODILY FLUIDS
PLEASE CALL:

FRESNO COUNTY

EMERGENCY RESPONSE TEAM
AT
559-600-3271
MON – FRI (8:00 AM – 5:00 PM)

AFTER HOURS
559-600-3111
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Section 5, Item E.
77 EMERGENCY
AMBULANCE: 911
FIRE – RESCUE: 911
HOSPITAL: FRESNO COMMUNITY – 559-459-6000
SAINT AGNES MEDICAL CENTER 559-449-
5000PHYSICIAN: WORKER’S COMP

CONCENTRA
• NORTH FRESNO - 7265 N. 1ST STREET, #105; PHONE 431-8181 • SOUTH FRESNO - 2555 S. EAST AVENUE; PHONE 499-2400
• MADERA - 509 S. “I” STREET IN MADERA; PHONE 673-9020
APOLLO
 FRESNO - 6042 N FRESNO ST, STE 104; PHONE 515-6841
POLICE: 911
CAL/OSHA: 559-445-5302
POSTING IS REQUIRED BY TITLE 8 SECTION 1512 (E), CALIFORNIA CODE OF REGULATIONS

STATE OF CALIFORNIA

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SAFETY POLICIES
AND

PROCEDURESINJ

URY AND

ILLNESS

PREVENTION

PROGRAM
20142
024
SUPERCEDES 0205-1712-
176
EFFECTIVE 0511-1713-
2417
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Attachment 'B'
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CITY OF KERMAN SAFETY POLICIES AND PROCEDURES
Table of Contents
CITY OF KERMAN SAFETY POLICIES AND PROCEDURES .........................................................................22 Table of Contents...................................................................................................................................22 INJURY AND ILLNESS PREVENTION PROGRAM .........................................................................................111 I. Policy Statement..............................................................................................................................111 II. Purpose................................................................................................................................................2 III. Responsibility ......................................................................................................................................2 A. IIPP Administrator............................................................................................................................2 B. Safety Coordinator...........................................................................................................................2 C. Department Heads and Supervisors ................................................................................................2 D. Employees........................................................................................................................................2 IV. Compliance......................................................................................................................................333 A. Management Responsibility.........................................................................................................333 B. Employee Responsibility ..............................................................................................................333 C. Performance Evaluations.............................................................................................................333 D. Employee Correction....................................................................................................................333 V. Communication ...............................................................................................................................333 A. Two-Way Communication............................................................................................................333 B. System of Communication ...........................................................................................................333 C. Safety Suggestions and Hazard Reporting ...................................................................................444 VI. Hazard Assessment..........................................................................................................................444 A. Safety Inspections........................................................................................................................444 B. Additional Inspections..................................................................................................................444 VII. Accident/Exposure Investigations...................................................................................................555 A. Investigation.................................................................................................................................555 B. Reporting......................................................................................................................................555 C. Reporting to Cal-OSHA.................................................................................................................555 VIII. Hazard Correction............................................................................................................................555 IX. Training and Instruction ..................................................................................................................666 A. Orientation for Establishment of IIPP and/or Substantial Amendment......................................666 B. New Employee Initial On-The-Job Training..................................................................................666 C. Specific Kerman Training Programs .............................................................................................666 D. Retraining.....................................................................................................................................666 E. Specialized Training......................................................................................................................666 X. Recordkeeping.................................................................................................................................777 Formatted: Left, Tab stops: Not at 6.63"
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Section 5, Item E.

XI. Injury and Illness Prevention Forms................................................................................................888 Hazard Alert Form................................................................................................................................999 Hazard Alert Response Form..........................................................................................................101010 Employee’s Report of Incident.......................................................................................................111111 Supervisor’s Report of Employee Injury.........................................................................................131212 Orientation Safety Check List ........................................................................................................141313 Office Hazard Inspection Checklist/Action Form ...........................................................................151414 MODULE 1 - BLOODBORNE PATHOGEN PROGRAM ...........................................................................171616 I. Purpose......................................................................................................................................171616 II. Scope .........................................................................................................................................171616 III. Definitions .................................................................................................................................171616 IV. Exposure Determination ...........................................................................................................181717 A. Police Department .................................................................................................................181717 B. Public Works Department......................................................................................................191818 C. Parks & Recreation Department............................................................................................191818 V. Methods of Compliance ............................................................................................................191818 A. Universal Precautions.............................................................................................................191818 B. Hand washing and Other General Hygiene Measures...........................................................191818 C. Sharps Management..............................................................................................................211818 D. Personal Protective Equipment .............................................................................................211919 E. Protection for Hands..............................................................................................................211919 F. Protection for Eyes/Nose/Mouth...........................................................................................221919 G. Equipment, Environmental and Working Surfaces................................................................232020 H. Special Sharps Precautions.....................................................................................................232020 VI. Hepatitis B Vaccination..............................................................................................................232020 A. General Statement of Policy ..................................................................................................232020 B. Hepatitis B Vaccination ..........................................................................................................232020 VII. Reporting and Treatment of Exposure Incidents......................................................................242121 A. City's Reporting Responsibility...............................................................................................242121 B. Exposure Treatment...............................................................................................................242121 C. Documentation ......................................................................................................................252222 VIII. Procedures for Evaluation and Follow-Up of Exposure Incidents.............................................252222 IX. Employee Training.....................................................................................................................262323 X. Recordkeeping Procedures .......................................................................................................262323 A. Medical Records.....................................................................................................................262323 B. Training Records.....................................................................................................................272424 XI. Bloodborne Pathogen Forms.....................................................................................................282525 126
Section 5, Item E.

Hepatitis B Vaccine Consent/Declination ...........................................................................................292626 First Aid Incident Report for Bloodborne Pathogens.....................................................................302727 Sharps Injury Log ............................................................................................................................312828 MODULE 2 - HAZARD COMMUNICATION PROGRAM .........................................................................322929 I. General Information..................................................................................................................322929 A. Container Labeling .................................................................................................................322929 B. Material Safety Data Sheets (MSDS) or Safety Data Sheets (SDS).........................................322929 C. Employee Training and Information ......................................................................................332929 II. Hazardous Non-Routine Tasks – Confined Spaces Entry...........................................................343030 III. Informing Contractors...............................................................................................................343030 IV. Emergency Spill Procedures......................................................................................................353131 MODULE 3 - EMERGENCY ACTION PLAN.............................................................................................363232 I. Scope and Application...............................................................................................................363232 II. Emergency Action Plan Information Sheet ...............................................................................373333 III. Definitions .................................................................................................................................383434 IV. Elements....................................................................................................................................383434 A. Emergency Evacuation Procedures & Route Assignments....................................................383434 B. Procedures for Employees Who Remain to Operate Critical Operations Before Evacuation383434 C. Evacuation of Persons with Disabilities..................................................................................393535 D. Employee Accountability Procedures after Evacuations.......................................................393535 E. Rescue and Medical Duties....................................................................................................403636 V. Alarm System.............................................................................................................................403636 VI. Evacuation for Emergencies......................................................................................................403636 A. Fire Emergency.......................................................................................................................403636 (Do not attempt any action that places you or another person at risk or injury).........................403636 B. Earthquake .............................................................................................................................403636 C. Lockdown ...............................................................................................................................413737 D. Other Emergencies.................................................................................................................413737 VII. Training......................................................................................................................................413737 MODULE 4 - HEAT ILLNESS PREVENTION PLAN (Effective 05/01/15).................................................423838 I. Purpose......................................................................................................................................423838 II. Monitoring the Weather...........................................................................................................443939 A. Weather forecast ...................................................................................................................443939 B. Weather Monitoring Prior To Workday During Times Of Risk...............................................443939 III. Monitoring Employee Acclimatization For Working Outdoors In Heat ....................................443939 IV. Providing Clean Drinking Water................................................................................................454040 V. Providing Adequate Shade ........................................................................................................454040 VI. Addressing High-Heat Procedures.............................................................................................464141 Formatted: Font:
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Section 5, Item E.

VII. Handling An Ill Employee And Emergency Procedures.............................................................464141 VIII. Providing Supervisor and Employee Training............................................................................474242 A. Employees..............................................................................................................................474242 B. Supervisors.............................................................................................................................474242 IX. Definitions .................................................................................................................................484343 City of Kerman Heat Illness Employee - Training Handout ............................................................494444 ........................................................................................................................................................494444 Types of Heat Illness.......................................................................................................................504545 MODULE 5 - FIRE PREVENTION PLAN..................................................................................................514646 I. Scope and Application...............................................................................................................514646 II. Elements....................................................................................................................................514646 A. Potential Fire Hazards............................................................................................................514646 B. Personnel Responsible for Maintenance of Fire and Emergency Equipment .......................514646 C. Personnel Responsible for Control of Flammable/Combustible Materials...........................514646 III. Housekeeping............................................................................................................................514646 IV. Training......................................................................................................................................524747 V. Maintenance..............................................................................................................................524747 MODULE 6 - CITY HALL “HOLD-UP”ROBBERY PROCEDURE.................................................................534848 MODULE 7 - ERGONOMIC PROGRAM.................................................................................................544949 I. Purpose......................................................................................................................................544949 II. Policy .........................................................................................................................................544949 III. Ergonomic Program Coordinator ..............................................................................................544949 IV. Identifying Workstation Risk Factors.........................................................................................544949 V. Hazard Prevention and Control.................................................................................................555050 VI. Medical Management ...............................................................................................................555050 VII. Training......................................................................................................................................555050 Ergonomic Symptoms Survey.........................................................................................................575252 Office Ergonomic Evaluation Form.................................................................................................595353 Helpful Stretches ...........................................................................................................................625656 MODULE 8 - OCCUPATIONAL NOISE EXPOSURE PROGRAM...............................................................645858 I. Purpose......................................................................................................................................645858 II. Requirements............................................................................................................................645858 III. Responsibilities..........................................................................................................................645858 IV. Monitoring Limits & Testing Procedure ....................................................................................645858 V. Recordkeeping...........................................................................................................................655959 VI. Training......................................................................................................................................655959 MODULE 9 - LOCKOUT AND TAGOUT SAFETY PROGRAM...................................................................666060 128
Section 5, Item E.

I. Purpose......................................................................................................................................666060 II. Lockout......................................................................................................................................666060 III. Tagout (Hazard Safety Tag) .......................................................................................................666060 IV. Restoring Equipment (Lockout/Tagout Removal).....................................................................676161 V. Procedure for More Than One Person ......................................................................................676161 VI. Things to Remember.................................................................................................................676161 VII. Documentation..........................................................................................................................676161 VIII. Lockout and Tagout Program List of Source..............................................................................686262 MODULE 10 – PERSONAL PROTECTIVE EQUIPMENT POLICY (ADOPTED 08-07-2013) .......................696363 I. I.................................................................................................................................................Purpose 716565
II. Applicability...............................................................................................................................716565 III. Policy .........................................................................................................................................716565 IV. Responsibilities..........................................................................................................................716565 A. Safety Officer and Risk Management Officer Shall .........................................................................64 B. Supervisors Shall..............................................................................................................................64 C. Employee Shall ................................................................................................................................64 D. Safety Officer Shall ..........................................................................................................................65 V. Procedure ..................................................................................................................................726666 A. Hazardous Assessment and Equipment Selection...........................................................................65 B. Protective Devices ...........................................................................................................................65 C. Eye and Face Protection ..................................................................................................................66 D. Voluntary Respirator Use.................................................................................................................66 E. Emergency Eyewash and Safety Shower Facilities..........................................................................66 F. Head Protection...............................................................................................................................66 G. Hand Protection...............................................................................................................................66 H. Foot Protection................................................................................................................................67 I. Body Protection ...............................................................................................................................67 J. Life Rings and Personal Flotation Devices.......................................................................................68 K. Cleaning and Maintenance..............................................................................................................68 L. Signage.............................................................................................................................................68 M. Training ............................................................................................................................................68 N. Recordkeeping .................................................................................................................................68 VI. PERSONAL PROTECTIVE EQUIPMENT POLICY FORMS...............................................................767070 Hazard Assessment Certification Form .............................................................................................70 Formatted: List Paragraph, Indent: Left: 0.13", Space
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Section 5, Item E.

Personal Protective Equipment Issuance Form................................................................................. 71 EMPLOYEE ACKNOWLEDGEMENT FORM............................................................................................827374 INJURY & ILLNESS PREVENTION PROGRAM TRAINING.......................................................................837475 I. Injury and Illness Prevention Program (IIPP) Quiz.........................................................................8880 SIGNS FOR POSTING............................................................................................................................948586 Formatted: Normal, Indent: Left: 0.5", Space After: 5 pt, Tab stops: 0.5", Right,Leader: … + 6.63", Right,Leader: … Formatted: TOC 1
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Section 5, Item E.
1 INJURY AND ILLNESS PREVENTION PROGRAM
I. Policy Statement
It is the policy of the City of Kerman to provide a safe and healthful environment for our employees and general public. We strive to eliminate unnecessary hazards by providing specific safety policies and procedures and creating an atmosphere that promotes safety.

The following Injury and Illness Prevention Program (IIPP) has been developed to provided safety and loss control guidelines to protect people from injury or illness; to reduce the risk of loss to real property and business assets; and to meet the regulatory requirements of federal, state and local governmental agencies.
___________________________________
___________________________________
Luis PatlanJohn Jansons, City Manager Date
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Section 5, Item E.
2 II. Purpose
Every California employer must establish, implement and maintain a written Injury and Illness Prevention (IIPP) Program and a copy must be maintained at each worksite. The requirements for establishing, implementing and maintaining an effective written Injury and Illness Prevention Program are contained in Title 8 of the California Code of Regulations, Section 3203 (T8 CCR 3203). This program complies with the requirements of the California Code of Regulations and consists of the following eight elements:
 Responsibility
 Compliance
 Communication
 Hazard Assessment
 Accident/Exposure Investigation
 Hazardous Correction
 Training and Instruction
 Recordkeeping
III. Responsibility
A. IIPP Administrator
The City’s representative on the Risk Management Authority shall be the IIPP Administrator. The IIPP Administrator is Toni JonesJosefina Alvarez, Finance Director, (559-846-9382550-0714 or; [email protected]@cityofkerman.org) has the authority and the responsibility for ensuring the implementation and maintenance of the City’s Injury and Illness Prevention Program and for answering questions about the Program.

B. Safety Coordinator
The City’s Safety Coordinator will direct the City’s safety programs, conduct hazardous inspections, update the Material Safety Data Sheet binders, and insure that Federal and State regulation updates are added to the IIPP program. The Safety Coordinator will also be the Chair of the Safety Committee and advise the IIPP Administrator of problems, concerns, and corrections. Mark SalvadorAkayla Cheema, 559-846-4809 550-2080 or [email protected]@cityofkerman.org currently holds the position of Safety Coordinator.

C. Department Heads and Supervisors
Department Heads and Supervisors are responsible for training employees to perform their jobs properly and safely and shall teach, demonstrate, observe and enforce compliance with established safety standards.

D. Employees
Each employee is responsible to comply with the IIPP and to perform their work duties in a safe manner at all times. Employees should ask for additional training or assistance when they feel there is a gap in their ability, knowledge or training with respect to safely performing their duties.

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Section 5, Item E.
3 IV. Compliance
A. Management Responsibility
Management is responsible for ensuring that organizational safety and health policies are clearly communicated and understood by employees. Managers and supervisors are also expected to enforce these rules fairly and uniformly.

B. Employee Responsibility
All employees are responsible for using safe work practices, assisting in the maintenance of a safe work environment and for following directives, policies and procedures regarding safety and health.

C. Performance Evaluations
Employee performance evaluations include an evaluation of compliance with safe work practices and procedures.

D. Employee Correction
Employees who fail to follow safe work practices and/or procedures, or who violate safety rules or directives, will be subject to disciplinary action, in accordance with the Personnel Rules & Regulations (Section 4.1/4.2) and/or the applicable memorandum of understanding.

V. Communication
A. Two-Way Communication
Management recognizes that open, two-way communication between management and staff on safety and health issues is essential to maintaining an injury-free, productive workplace.

B. System of Communication
The following system of communication is designed to facilitate a continuous flow of safety and health information between management and staff in a readily understandable manner:

1. An orientation program will be provided to all new employees by the designee appointed by the Department Head (See Orientation Safety Check List) that includes a review of the IIPP and a discussion of safety policies and procedures that the employee is expected to follow.

2. The City will conduct safety meetings where safety is freely and openly discussed at least every quarter.

Employees are expected to attend and are encouraged to participate in such meetings.

3. From time to time, written safety notifications will be distributed or posted on bulletin boards.

4. Other appropriate methods of communicating pertinent safety and health information will be implemented as such methods are identified.

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Section 5, Item E.
4 C. Safety Suggestions and Hazardous Reporting

1. All employees are requested and encouraged to inform their supervisors or other management personnel of any matter which they perceive to be an actual or potential workplace hazardous. Employees are also encouraged to make suggestions for safety improvements to the City. While the City prefers that safety reports and suggestions are made in writing, employees can also make such suggestions and reports orally. All safety reports or suggestions should be made to the reporting employee's supervisor, the IIPP Administrator, or to other management personnel.

2. If an employee wishes to report a hazardous, safety suggestion, or other safety problem anonymously, he or she can complete a "Hazardous Alert Form" which does not require the employee's name or job title.

3. No employee shall be retaliated against for reporting potential or actual hazardouss or for making safety suggestions.

4. Management will review all safety suggestions and hazardous reports.

5. If an employee's name is included with a hazardous report or safety suggestion, the reporting employee will be notified about any non-confidential corrective action that is taken with respect to the hazardous report or safety suggestion.

6. The resolution of safety issues will be communicated to employees through "Hazardous Response Forms" and/or communication at Safety Meetings.

7. A folder on the City's public employee drive may be used for program documents and safety information.

This folder is to be accessible to all employees. The safety folder will consist of the following:
• Blank "Hazardous Alert Forms"
• PDF Program/Plan Documents
• Directions to access Internet based safety training materials VI. Hazard Assessment
Inspection of the workplace is the primary tool used to identify unsafe working conditions and practices. While the City encourages all employees to continuously identify and correct workplace hazards and poor safety practices, certain situations require formal evaluation and documentation on the “Hazardous Inspection Checklist/Action Form”.

A. Safety Inspections
Annual sSafety inspections will be conducted by a manager and/or supervisor and at least one non-supervisory employee. When possible, it is the intent of the City to abate any hazard which gives rise to a risk of imminent harm to any person. Any recommendations for future corrective action will be timely filed with the IIPP Administrator or the assigned safety representative for the specific area.

B. Additional Inspections
Inspections will also be conducted in accordance with the following:

1. Whenever new substances, processes, procedures, or equipment presenting a new safety or health hazard are introduced into the workplace.

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Section 5, Item E.
5 2. Whenever management becomes aware of a new or previously unrecognized hazard, either independently or by receipt of information from an employee.

VII. Accident/Exposure Investigations
A. Investigation
All workplace accidents resulting in injury or property damage, however slight, will be timely investigated to determine the primary and contributing causes. The primary and contributing causes will be documented and analyzed to assist the City in taking corrective action to prevent similar accidents from occurring in the future.

The IIPP Administrator is responsible for ensuring that workplace accidents are reported on the “Employee Report of Incident Form” and properly investigated.

B. Reporting
All facts, findings, and recommendations uncovered during workplace investigations will be documented on the "Supervisor's Report of Employee Injury Form". Management will review all reports with a view towards determining adequacy of corrective action.

C. Reporting to Cal-OSHA
The following incidents must be directly reported to the closest area office of Cal-OSHA within 8 hours of occurrence by the IIPP Administrator or designee:

1. Accidents causing fatalities;

2. Illnesses causing in-patient hospitalization of three or more employees;

3.2.Accidents causing in-patient hospitalization for more than 24-hours other than observation; and

4.3.Amputation of any body part.

The following information must be provided with any such report:
• Establishment name;
• Location of incident;
• Time of the incident;
• Number of fatalities or hospitalized employees;
• Contact person;
• Phone number; and
• Brief description of the incident.

VIII. Hazard Correction
Unsafe or unhealthy working conditions, practices, or procedures shall be corrected in a timely manner depending upon the severity of the hazards. Hazards shall be corrected according to the following procedures:
 When hazards are observed or discovered.
 When an imminent hazard exists that cannot be immediately abated without endangering employees and/or property.
o The City will ensure that all exposed workers are removed from the area except the personnel necessary to correct the hazard; who have been provided with the necessary safeguards and training to correct the hazard.

All corrective actions taken shall be documented on the appropriate City incident forms.

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Section 5, Item E.
6 IX. Training and Instruction
A. Orientation for Establishment of IIPP and/or Substantial Amendment The IIPP Administrator or designee will conduct the initial orientation of the IIPP. Employees will sign acknowledgement forms for all safety materials that they receive during such an orientation. When substantially amended, additional training will be conducted and copies of the amended IIPP provided.

B. New Employee Initial On-The-Job Training
Shortly after an employee begins their employment with the City, a manager or supervisor will provide the employee with access to an electronic copy of the IIPP (hard copies available in each department) and train the employee in all aspects of required safety procedures that are designed to mitigate hazardouss of their job.

This training will be documented on the “Orientation Checklist". The manager or supervisor conducting the training and the new employee will both sign the Checklist when the training is completed. The Checklist will become a permanent part of the employee's personnel file.

C. Specific Kerman Training Programs
The following describes training programs applicable to certain Kerman employees:
 Emergency Action Plan - This training includes a discussion of Kerman's disaster preparedness structure and how the employee fits within the structure (i.e., what the employee is to do under specific circumstances, such as fire, earthquake, medical emergency). Refresher training/evacuation drills will take place annually.
 First Aid, CPR and Bloodborne Pathogens Training - All employees will receive training in First Aid, CPR and/or Bloodborne Pathogens.
 Defensive Driver Training - City Employees required to drive pursuant to their job duties will participate in defensive driver training. Additional safe driving subjects will be covered in safety meetings on an asneeded basis.  Hazardous Communication Program - Employees will receive training on: hazardous chemicals they may be exposed to in their workplace operations; proper labeling requirements for these chemicals; physical and health effects of the hazardous chemicals; ways to lessen or prevent exposure and the steps the City has taken to achieve reduction in exposure; as well as where to obtain and how to read the Material Safety Data Sheets (MSDS).

D. Retraining
Retraining will be conducted by managers, supervisors and/or the IIPP Administrator or designee when an existing employee changes job functions and/or at least annually as refresher training. Retraining shall cover general workplace safety, job-specific hazards, and/or hazardous materials, as applicable.

E. Specialized Training

1. Supervisors will be trained to understand their responsibilities with respect to the safety and health of the employees that they supervise, as well as training in the hazards and risks faced by the employees under their immediate direction. Such training will include both safety management and technical subjects.

2. Managers/Supervisors and/or IIPP Administrator are responsible for:
 Determine safety-training needs;

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Section 5, Item E.
7  Implement new training programs; and
 Evaluate the effectiveness of these programs
In addition, training will be provided whenever:
 New substances, processes, procedures, or equipment pose a new hazardous and there is a lack of adequate skill or knowledge to deal with the new hazardous;  Management and/or the IIPP Administrator become aware of a previously unrecognized hazardous and there is a lack of adequate skill or knowledge to with the hazardous; and  A new facility or a new component part of a facility is opened.

X. Recordkeeping
The City maintains records for the purpose of:
 Tracking and evaluating the City's loss experience and loss exposures.  Tracking and evaluating the safety activities that have been accomplished.  Providing a documentation of the safety activitiesDocumenting Safety Activities.

All such documentation will be maintained in accordance with the City's records retention schedule.

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Section 5, Item E.
8 XI. Injury and Illness Prevention Forms

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Section 5, Item E.
9 Hazard Alert Form
Date: _______________
Department Where Hazard is Located: ____________________________________________ Supervisor or Recipient of Hazardous Alert Form: ___________________________________________________________ Hazards posing an immediate danger to life and health should be reported as soon as possible to your supervisor, the IIPP Administrator or other manager.

Location of Hazard (i.e. building, room area) ___________________________________________________________ ________________________________________________________________________________________________ Description of Hazard (include whether it is chemical, biological, physical etc.) ________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Recommendation for correction: _____________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Has this hazard been reported to your supervisor Yes No OPTIONAL (if employee would like to remain anonymous, leave this area blank):

Employee Name: __________________________________________________________________________________ Department/Location: ______________________________________________________________________________ Telephone Number: ________________________________________________________________________________ NOTE: It is illegal for any employer to take action against employees who exercise their right under the law to report unsafe conditions. Employees are encouraged to report hazards and are commended for their safety awareness.

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Section 5, Item E.
10 Hazard Alert Response Form
To be completed by the Department Manager where the hazard is located, and reviewed by the IIPP Administrator.

Manager description and evaluation of hazard reported: ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ _______________________________________________________________________________________________ Corrective Action:

Corrective Action Taken (describe): ___________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ _______________________________________________________________________________________________ Date corrective action was completed: ________________________________________________________________ Who carried out corrective action? ___________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Discussed at Safety Meeting – Date: __________________________________________________________________ Response provided to Hazard Report: ________________________________________ Date: ___________________ Manager Signature: _______________________________________________________ Date: __________________ IIPP Administrator Signature: ________________________________________________ Date: __________________

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Section 5, Item E.
11 Employee’s Report of Incident
Date: ___________________ Supervisors Name:
______________________________________________________
Employee Name: __________________________________________________________________________________ Date of Incident: ___________________________________________ Time of Incident: ________________________ Address and description of where/how incident occurred: ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Describe symptoms and specific part(s) of body affected: _________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Please check ‘Yes’ or ‘No’ to the following questions relating to the incident being reported:

I lost time from my normal work shift after the day the incident occurred. ☐Yes ☐No
I anticipate losing time from work as a result of symptoms from this incident. ☐Yes ☐No
I need or desire formal medical treatment beyond on-site first aid. ☐Yes ☐No
The incident involved exposure to a hazardous substance. ☐Yes ☐No
If ALL answers to the above questions are ‘No’ an injury, as defined by the Labor Code, has not occurred. A report to Workers’ Compensation is not required at this time. If any answer is ‘Yes’ an injury may have occurred. A DWC-1 Employee’s Claim for Workers’ Compensation Benefits is needed so that a report to Workers’ Compensation can be made.

If, as a result of this incident, you subsequently develop (1) symptoms for which you require, or desire, formal medical care; or (2) symptoms that cause you to be unable to report for work, you must notify your Supervisor or Human Resource Department immediately. You should also contact AMC Call Connect at 844-691-4111 to report the incident/injury. If medical care is requested or required, AMC Call Connect will direct you to appropriate medical care. You will be provided with an Injury Claim Form and we will direct you to appropriate medical care.

Be advised that certain Statute of Limitations apply to Workers’ Compensation benefits. Labor Code 5400 provides that no claim to recover compensation shall be maintained unless within 30 days after the occurrence of the injury which is claimed to have caused disability or death there is served upon the employer notice in writing, signed by the person injured or someone on his behalf.

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Section 5, Item E.
12 Signature of Employee: ______________________________________________________ Date: _______________ Signature of Supervisor: _____________________________________________________ Date: _______________

ONE COPY TO EMPLOYEE ORIGINAL TO HUMAN RESOURCES FILE
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Section 5, Item E.
13 Supervisor’s Report of Employee Injury
Name of Employee: _______________________________________________________________________________ Job Title: ________________________________________________________________________________________ Date of Injury: ______________________________________ Time _____________________________am______pm Date Reported: _____________________________________ Time _____________________________am______pm Accident Location (full address): _____________________________________________________________________ ________________________________________________________________________________________________ Specific Injury/Illness with part of body affected: ________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Time employee began work: _________________am______pm
Did injured leave work? Yes No Date:___________________ Time _____________________am______pm Did injured return to work? Yes No Date:________________ Time _____________________am______pm Did employee seek medical attention? Yes No
Name of medical facility/physician: __________________________________________________________________ Describe activity performing when event/exposure occurred: ______________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Describe how accident occurred and materials used: _____________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Name(s) of witnesses: ______________________________________________________________________________ ________________________________________________________________________________________________ What steps have been taken to prevent similar accidents? ________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Supervisors Name (printed) ________________________________________________ Dept. Head Initials: ________ Supervisors Signature: ____________________________________________________________________________ Employer: City of Kerman, 850 S. Madera Avenue, Kerman, CA 93630

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Section 5, Item E.
14 Orientation Safety Check List
Employee Name (print): _______________________________________________ Date: _____________ Key Points discussed during Orientation:
 Promote a safe & healthy workplace
Line crew –
 Back safety
 Ladder safety
 Power Tool safety
 Personal Protective Equipment Policy
 Compressed air - Gas tank must be chained, even empty ones ($7,500 OSHA fine)  Forklift – If not certified, do not drive. Seatbelts are required at all times Office –
 Ergonomics Factors
 Stair safety - Slow, use handrail, keep handheld items to a minimum  Transporting items – Use stairs; make as many trips as necessary  Holdup - Give them what they want, don’t be a hero
o Remember information/description of incident/people
o If safe to do, push emergency button
OSHA Requirements –
 Report Areas of Safety Hazard Infringements
 Complete Monthly Fire Extinguisher check; review for signatures ($2,500 fine) Vehicle Safety –
 Annual training/meeting on vehicle safety
 Obey all traffic laws
 Seatbelts – Always wear
 Speed limits – Follow all speed limits
Plant Construction –Trenches and Excavation Safety
 Ditches – Do not enter without proper sloping
 Hard hats - Required, especially ground work, as required in the Personal Protective Equipment Policy (PPE) Employee Signature: __________________________________________________________________ Trainer/Department Representative Signature: _______________________________________________

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Section 5, Item E.
15 Office Hazardous Inspection Checklist/Action Form
Date Inspected ___________________________________________________________________ 3-Year Retention after inspection date.

Department: __________________________________________ Location ______________________________________________ OK
1 2
3 4
5 6
7 8
9 10
1 2
3 4
5 1
2 3
4 5
6 1
2 3
4 5
6 7
8 Is the emergency lighting operable
Are combustibles properly stored in work areas
Is the fire suppression system inspected annually
Fire Hazard
Are all work areas equipped with fire extinguishers
Are the monthly and annual inspections of fire extinguishers performed and documented
Are conduit properly attached to all supports and tightly connection to junction and outlet boxes (visual inspection only)
Are the lighting fixtures in good condition and working Are electrical switch cover plates and outlets in good condition Are electric outlets safe and not overloaded
Electrical Hazard
Are all electrical outlets or strips utilized in a neat and safe manner Is the electrical equipment in good condition, properly grounded and turned off when not in use
Are all chemicals and/or liquids stored in a neat and safe manner Is the lounge area in a neat and sanitary condition
Are the restrooms in a neat and sanitary condition and in good working order Housekeeping Hazards
Are all floors, aisles, exits, and fire extinguishers unobstructed Are all floor mats and/or rugs placed in a location or position that does not create an unsafe condition
Deficiency
Noted
Dated
Corrected
Are evacuation signs identifying escape routes and emergency information in place Are there stepstools or stepladders available for use in all buildings and do they have safety treads
Are all scissors, letter openers, or any other sharp objects stored safely with points facing away from user
Are materials stored on top of cabinets or shelves in an orderly fashion or at heights that do not create a potential hazard
Is the ventilation system properly maintained and are vents cleaned regularly Are emergency phone numbers posted
Item to be Checked
( Use the last page to record a brief description of necessary repairs) General Work Area
Are all telephone or power cords covered or routed as to prevent tripping hazards Are all work areas equipped with First Aid Kits
Is an equipped Lockout/Tagout station available for use in all buildings Is the lighting in all work areas in working condition and provide good working light Other -
Other -
Other

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Section 5, Item E.
16 Item
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Office Hazard Inspection Checklist/Action Form
Deficiency Corrective Action Taken

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17 MODULE 1 - BLOODBORNE PATHOGEN PROGRAM
I. Purpose
This exposure control program has been established in order to minimize and to prevent, when possible, the exposure of City of Kerman employees to disease-causing microorganisms transmitted through human blood or other potentially infectious materials. This program identifies employees who are subject to occupational exposure to bloodborne pathogens, establishes information and training standards for those employees, and establishes an immunization program for the Hepatitis B virus. This program will comply with the Bloodborne Pathogens Standard, Title 8, California Code of Regulations, §5193. This program will be reviewed annually.

II. Scope
All City employees who may be exposed to blood and other potentially infectious materials as part of their job duties are identified and included in this program. Those who have been identified by the City as "reasonably anticipating" exposure to bloodborne pathogens will follow an exposure control plan designed to minimize exposure. The term "employees" includes all full-time, part-time, and temporary status personnel who are employed by the City of Kerman. Any employee, who believes that the exposure exists for them, and has not been identified, should bring their concerns to the attention of their supervisor.

III. Definitions
 "Blood" means human blood, human blood components, and products made from human blood.  "Bloodborne Pathogens" means Pathogenic microorganisms that are present in human blood and can cause disease in humans. These Pathogens include, but are not limited to Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).
 "Contaminated" means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
 "Contaminated Laundry" means laundry, which has been soiled with blood or other potentially infectious materials or may contain sharps.
 "Contaminated Sharps" means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.  "Decontamination" means the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.  "Engineering Controls" means controls (e.g., sharps disposal containers, self-sheathing needles) that isolate or remove the bloodborne pathogen hazard from the workplace.  "Exposure Incident" means a specific eye, mouth, or other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that result from the performance of an employee's duties.
 "Hand washing Facilities" means a facility providing an adequate supply of running potable water, soap, and single use towels or hot air drying machines.
 "HBV" means Hepatitis B Virus.
 "HIV" means Human Immunodeficiency Virus.
 "Occupational Exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
 "Other Potentially Infectious Materials" (OPIM) means:

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18 o The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;
o Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and o HIV - containing cell or tissue cultures, organ cultures, and HIV - or HBV containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.  "Parenteral" means piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.
 "Personal Protective Equipment" (PPE) are specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g. uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard is not considered to be personal protective equipment.  "Regulated Waste" means liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infections materials.  "Source Individual" means any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. Examples include, but are not limited to: hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing facilities; human remains; and individuals who donate or sell blood or blood components.
 "Sterilize" means the use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.
 "Universal Precautions" is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.
 "Work Practice Controls" means controls that reduce the likelihood of exposure by altering the manner in which a task is performed.

IV. Exposure Determination
The following tasks and procedures are reasonably anticipated to involve exposure to blood, body fluids, or other potentially infectious materials:
 Performing first aid duties and/or emergency medical treatment;  Performing mouth-to-mouth resuscitation;
 Performing custodial duties in bathrooms, parks, or other public areas where needles may have been disposed of in trash receptacles; or
 Performing work within sewers and/or coming into possible contact with untreated sewage All personnel in the following job classifications are identified as "reasonably anticipated to involve exposure" (determined to have Occupational Exposure or Potential Occupational Exposure):

A. Police Department
 Police Chief
 Lieutenant
 Corporal
 Records Clerk
 Records Manager
 Animal Control Officer

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19  Animal Shelter Attendant
 Police Sergeant
 Police Officer
 Police Officer Reserve
 Community Service Officer
B. Public Works Department
 Fleet Services Supervisor
 Automotive Fleet Mechanic (I, II)
 Public Works Operations Coordinator
 Maintenance Public Works Lead Supervisor
 Maintenance Worker (I, II, III)
 Water Conservation SpecialistAdministrative Analyst
 WWTP Operators (Grade I, II & III)
 Maintenance TechWWTP Maintenance Worker (I, II, III)
 Maintenance Specialist
C. Parks & Recreation Department
 Community Center CoordinatorBuildings & Facilities Supervisor  Recreation Supervisor
 Recreation Coordinator
 Senior Services Coordinator
 Parks Maintenance Worker (I, II)
 Parks Maintenance SpecialistGeneral Maintenance Worker  Public Transit Operator
V. Methods of Compliance
The following methods of compliance are for use for all City employees not falling within the Police Department specific policy/procedures documents.

A. Universal Precautions
All blood or other potentially infectious materials shall be handled as if contaminated by a bloodborne Pathogen. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.

B. Hand washing and Other General Hygiene Measures
Employees will wash hands thoroughly using soap and water whenever hands become contaminated and as soon as possible after removing gloves or other personal protective equipment. When other skin areas or mucous membranes come in contact with blood or other potentially infectious materials, the skin shall be washed with soap and water, and the mucous membranes shall be flushed with water, as soon as possible.

Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious material.

Likewise, employees should not engage in any of these activities until proper washing with soap and water is performed.

Employees shall use practices to minimize splashing, spraying, spattering, and generation of droplets during procedures involving blood or other potentially infectious materials.

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21 C. Sharps Management
It is understood that City employees are not usually required to administer medication with hypodermic needles, which are generally considered sharps. However, employees should also be aware that a nail soaked with blood that has recently been stepped on or even exposed broken glass, qualifies as a contaminated sharp and should be protected and disposed of in accordance with this program.

Contaminated needles or other contaminated sharps shall not be bent, recapped, or removed. Shearing or breaking of contaminated needles is prohibited.

Contaminated disposable sharps shall be discarded, as soon as possible after use, in disposable sharps containers. Contaminated broken glass is also to be placed in disposable sharps containers.

D. Personal Protective Equipment
All personal protective equipment (PPE) will be provided, repaired, cleaned, and disposed of by the employer (each department) at no cost to employees. Each department will provide instructions on appropriate use of personal protective equipment. Employees shall wear personal protective equipment when performing procedures in which exposure to the skin, eyes, mouth, or other mucous membranes are anticipated. The articles to be worn will depend on the expected exposure. Employees who have allergies to regular gloves may obtain hypoallergenic gloves.

All personal protective equipment shall be removed before leaving the work area and placed in an assigned container for storage, washing, decontamination or disposal.

If a garment is penetrated (soaked through) by blood or other potentially infectious material, the garment shall be removed as soon as possible and placed in a designated container for disposal. Garments which only are lightly splashed or dripped on where the blood or other potentially infectious material have not soaked through are to be removed as soon as possible and placed in an appropriate container for cleaning. – See Personal Protective Equipment Policy V- K.

E. Protection for Hands
Gloves shall be worn in the following situations:
 When it can be reasonably anticipated that hands will contact blood or other potentially infectious materials, mucous membranes, and non-intact skin; or
 When handling or touching contaminated items or surfaces.

Disposable Gloves
 Replace as soon as feasible when gloves are contaminated, tom, punctured or when their ability to function as a barrier is compromised.
 Do not wash or decontaminate single use gloves for re-use.

Utility Gloves
 Decontaminate for re-use if the gloves are in good condition.  Discard when gloves are cracked, peeling, torn, punctured or show other signs of deterioration (whenever their ability to act as a barrier is compromised).

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22 Protection for Eyes/Nose/Mouth
F.

Employees shall wear masks in combination with eye protection devices (goggles or glasses with solid side shields) or chin-length face shields whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, mouth contamination can be reasonably anticipated.

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23 F.G.Equipment, Environmental and Working Surfaces
Clean all contaminated work surfaces with appropriate disinfectant after completing procedures, and immediately or as soon as feasible, when overtly contaminated or after any spill of blood or other potentially infectious material.

Regularly inspect/decontaminate all reusable bins, pails, cans, and similar receptacles which may become contaminated with blood or other potentially infectious material. If these articles become visibly contaminated, they should be decontaminated immediately or as soon as feasible.

G.H. Special Sharps Precautions
Clean up broken glass that may be contaminated using mechanical means such as a brush and dustpan, tongs, or forceps. DO NOT pick up directly with the hands. Report any exposure incident on the “Sharps Injury Log”.

Reusable containers are not to be opened, emptied, or cleaned manually or in any other manner which will expose employees to the risk of injury administered or absorbed through the skin. DO NOT reach by hand into a container which stores reusable contaminated sharps. Full containers should be dropped off at the Public Works Office, 15201 W. California Avenue.

VI. Hepatitis B Vaccination
A. General Statement of Policy
The City of Kerman complies with OSHA mandate by providing the Hepatitis B vaccination series to all City employees in a classification identified as "reasonably anticipated" to involve exposure to bloodborne pathogens at no cost to them. In addition, these employees will be offered post-exposure evaluation and follow-up at no cost should they experience an exposure incident on the job. All employees that have been identified as "reasonably anticipated" to involve exposure are encouraged to participate in the program.

Although the City and/or the departments cannot require anyone to receive the immunization, it is strongly recommended.

All medical evaluations and procedures including the Hepatitis B vaccination series, whether prophylactic or post-exposure, will be made available to the employee at a reasonable time and place. This medical care will be performed by or under the supervision of a licensed physician, physician's assistant, or nurse practitioner.

Medical care and vaccination series will be according to the most current recommendations to the U.S. Public Health Service.

B. Hepatitis B Vaccination
The vaccination is a series of three injections. They are as follows:
 Initial injection;
 Second injection - thirty (30) days following the initial injection; and  Third injection - five (5) months following the second injection.

For maximum benefit from the vaccine, the second injection should be given within a seven (7) day period before or after due date (30 days following the first injection). In the event the employee does not take the initiative to have the second injection from 30 to 60 days following their first injection, the series must be restarted and the employee will be required to pay the cost of the injection(s) required to restart the series.

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24 The vaccination will be made available to employees after they have attended training on bloodborne pathogen and within 10 working days of initial assignment to a job category with exposure.

The vaccination series will not be made available to employees who have previously received the complete Hepatitis B vaccination series, or any employee for whom the vaccine is medically contraindicated will need to retake it.

An employee, who is required to have the Hepatitis B vaccine but chooses not to, will be required to sign a “Hepatitis B Vaccine Consent/Declination”. If an employee has declined the Hepatitis B vaccination, but later changes their mind and wishes to have the vaccination, the City will proceed with the vaccination series at no cost to the employee.

VII. Reporting and Treatment of Exposure Incidents
A. City's Reporting Responsibility
The City has a responsibility, under various federal and state laws and regulations to report occupational illness and injuries, existing programs in the National Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services, the Bureau of Labor Statistics, Department of Labor, and the Occupational Safety and Health Administration receive such information for the purposes of surveillance and other objectives. State Health Departments report cases of infectious disease, including HIV, HBV, HCV and TB to the Centers for Disease Control.

All post-exposure testing and treatment will be in accordance with the City's Worker's Compensation Program.

Employees undergoing follow-up for post exposure reasons must attend all medical appointments and will be provided with the necessary time off to attend such appointments. Employees who experience an exposure incident must immediately report their exposure to their immediate supervisor.

B. Exposure Treatment
When an exposure has occurred, the exposed area shall be thoroughly washed immediately using water on all mucosal surfaces, and soap and running water on skin surfaces. If soap and running water are not available, a waterless skin cleaning agent shall be used until soap and running water can be obtained. When there is contamination of personal protective equipment, the personal protective equipment should be disposed of or decontaminated, if appropriate.

The City's Designated Infection Control Officer is the Injury & Illness Prevention Program Administrator.

Following a "significant" exposure, contact the City's Designated Infection Control Officer. "Significant" exposure is defined as: Any situation in which the body fluids of an individual (such as blood or other potentially infectious material including synovial fluid, amniotic fluid, peritoneal fluid, pleural fluid or any fluid that contains visible blood), are suspected of having entered the employee's body through either a body opening (such as your nose, mouth, or eye), or a break in your skin (such as a cut, rash, or abrasion); a needle stick with a contaminated or used needle; intimate respiratory contact (such as CPR without a barrier); or any other situation in which an individual's body fluids may have entered the employee's body.

Did an exposure occur? The following short answer questionnaire can assist in determining if an employee should receive follow-up.

1. Is the fluid or substance with which the employee is in contact with one of the following? • Blood
• Semen
• Vaginal Secretions

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25 • Any body fluid/matter visibly contaminated with blood • Respiratory secretions (droplets, aerosolized particles)

2. Did the fluid or substance (identified above in 1) enter the employee's body through the following? • Needle stick injury
• Laceration by contaminated object
• Open cut wound, non-intact skin
• Splash or contact with eyes, mouth or nose (mucous membrane) • Prolonged respiratory contact
If answers to BOTH 1 and 2 are yes, the employee should be considered to have sustained a "significant" exposure and needs to seek medical treatment.

C. Documentation
When an employee has an exposure to a communicable disease, the incident must be documented as soon as possible and a report submitted within twenty-four hours of the suspected exposure using the “First Aid Incident Report for Bloodborne Pathogens" or "Supervisor Report of Employee Injury". It is the responsibility of the employee to document the exposure.

The infection exposure report will include the details of the task being performed, the means of transmission, the portal of entry, and the type of PPE in use at the lime. The supervisor will review the exposure report and forward originals to the City's Designated Infection Control Officer/City Risk Management along with the applicable Worker's Compensation documentation.

VIII. Procedures for Evaluation and Follow-Up of Exposure Incidents Following a report of an exposure incident, the City shall make immediately available to the exposed employee a confidential medical evaluation and post-exposure follow-up. Post-exposure follow-up medical evaluations will be conducted through the City of Kerman’s designated health facility. The evaluation and follow-up will include the items listed below:
 Documentation of the significant exposure - the routes of exposure and the circumstances under which the exposure incident occurred.
 Identification of the source individual and their transport destination, unless it can be established that identification is infeasible or prohibited by law.
o The source individual's blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV, HCV and HIV infectivity.
o If consent cannot be obtained, the employer shall document that legally required consent cannot be obtained.
o When law does not require the source individual's consent, the source individual's blood shall be tested and the results documented.
 The exposed employee will be informed of the results of the source individual's testing.  The exposed employee will be offered counseling and medical evaluation of any reported illness.  The information listed below will be provided to the healthcare professional evaluating an employee after exposure.
o A description of the exposed employee's duties as they relate to the exposure incident. o Documentation of the route(s) of exposure and circumstances under which the exposure occurred. o Results of the source individual’s blood testing, if available. o All medical records relevant to the appropriate treatment of the employee including vaccination status.

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26 IX. Employee Training
Employees in the classifications identified as "reasonably anticipated" to involve exposure receive training at no cost to the employee, provided during working hours. The department provides training on bloodborne pathogens at the time of initial assignment to tasks where exposure may occur and annually thereafter. Training includes, at a minimum, the following elements:
 A copy of the Bloodborne Pathogens Program and an explanation of the contents;  A general explanation of the epidemiology and symptoms of bloodborne diseases;  An explanation of the modes of transmission of bloodborne pathogens;  An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials;  An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering , administrative or work practice controls, and personal protective equipment;  Information on the types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment;
 An explanation of the basis for selection of personal protective equipment;  Information on Hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination shall be offered free of charge;  Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potential infectious materials;
 An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident, and the medical follow-up that will be made available;  Information on the post-exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident; and
 An opportunity for questions.

X. Recordkeeping Procedures
A. Medical Records
Medical records of all current and former employees or employees being assigned or transferred to work where there will be exposure to toxic substances or harmful physical agents will be retained for the length of employment plus thirty years (in accordance with 29 Code of Federal Regulations CFR 1910.20Title 8, 3204 of CalOSHA regulations). This is necessary because hepatocellular carcinoma, a possible result of Hepatitis B infection. Can take twenty to thirty years to manifest itself. Also, five percent (5%) of those exposed to HIV infected blood do not seroconvert within six (6) months. This time period is consistent with OSHA standards for retention of employee occupational medical records. Exposure records and post-exposure follow-up records will be maintained in the individual's medical file.

The records will be kept confidential. The contents will not be disclosed or reported to any person within or outside the workplace without the employee's express written consent, except as required by law or regulation.
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27 B. Training Records
Training records shall be maintained a minimum of three years from the date of training and in accordance with the City's records retention schedule. The training records will include: the dates of the training sessions; contents or a summary of the training sessions; names and qualifications of trainers; and names and job titles of all persons attending.

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28 XI. Bloodborne Pathogen Forms
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29 Hepatitis B Vaccine Declination
Date:

DECLINATION - RECORD OF HEPATITIS “B” VACCINE DECLINATION (IF you Decline the Vaccine it is MANDATORY for you to complete this section) Date:

I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to me. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If in the future, I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

Print Name: __ Department:

Employee Signature: _____________
Employer Representative:

Please check all that apply:

I decline the hepatitis B vaccination at this time
I have previously received a complete series of the HBV vaccinations Antibody testing has revealed that I am immune
The vaccine is contraindicated for medical reasons

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30 First Aid Incident Report for Bloodborne Pathogens
Date of incident: Time: a.m. p.m.

Date incident reported: Time: a.m. p.m.

Describe the first-aid incident:

Was there blood or other body fluids present? Yes No
Did an exposure incident occur? Yes No
If yes, please describe it.
(Cal/OSHA – “An exposure incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of one’s duties.”) Did the first aid providers use PPE? Yes No
Print names of persons who provided first aid:

If there was an exposure incident as defined by Cal/OSHA, were they immediately referred for post-exposure evaluation and follow-up? Yes No
Was there blood or other body fluids present? Yes No
If unvaccinated, were they offered the hepatitis B vaccination? Yes No Supervisor’s Signature: Date:

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31 Sharps Injury Log
Supervisors: Complete for each employee exposure incident involving a sharp. This form is to be completed with the employee but not by the employee. Fill in the most appropriate boxes. A sharp includes, but is not limited to, needles, needle devices, scalpels, lancets, X-acto blades, and broken glass.

Employee Name _____ Date/Time of Exposure
Incident: ___________________
Job Classification/Title: ________ Department:
_____________________________ ___________________________ Location Where Exposure Occurred: _________________ __ ______ _________ ___
What procedure was being performed when the incident occurred? Check all body parts that were involved:

Finger Hand Arm Face/Head Torso Leg
Other
_______
How did the exposure incident occur:

During use of sharp Disassembling After use and before sharps container While putting sharp into sharps container Sharp left, inappropriate place Other
_______
Identify sharp object involved:

Type: Brand: Model:

Was sharp injury protection device attached? Yes No
Was protective mechanism activated? Yes No

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32 Did the exposure occur: Before During After activation If the sharp had no engineered sharps injury protection, do you feel that such a mechanism could have prevented the injury? Yes No
What other engineering, administrative, or work practice controls could have prevented this injury? Attach this form to the “Supervisor’s Report of Employee Injury Form”. Send both originals to Human Resources within 24 hours of the incident.

MODULE 2 - HAZARD COMMUNICATION PROGRAM
I. General Information
This Hazard Communication Program has been established for the City of Kerman. The written program is available on the City’s General Shared drive (GenShare) or a hard copy can be reviewed by any interested employee by asking their supervisor to view the binder. This program is based upon the requirements of Title 8, California Code of Regulations, Section §5194 of the General Industry Safety Orders and describes how criteria for labels and warnings, Material Safety Data Sheets (MSDS), and employee information and training will be met.

A. Container Labeling
 The Manager or designee will verify that all containers received will:
o Be clearly labeled as to the contents
o Note the appropriate hazard warnings,
o List the name and address of the manufacturer.

No containers will be released for use until the above data is verified.  The Manager or designee will ensure that all secondary containers are labeled with either:
o An extra copy of the original manufacturer's label, or o A generic label which includes the identity and hazard warning.  Exceptions - Labeling standards are not required for the following substances under the Hazardous Communication Program because these substances fall under other regulations:
o Pesticides - when subject to the labeling requirements issued under the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA);
o Foods, food additives, color additives, drugs or cosmetics that come under the Federal Food, Drug and Cosmetic Act labeling requirements (FD&C);
o Any distilled spirits that are subject to the labeling requirements of the Federal Alcohol Administration Act (FAA); and
o Any consumer product or hazardous substance defined by the Consumer Product Safety Act (CPSA) and the Federal Hazardous Substances Act (FHSA) when they are subject to the labeling requirements of those acts.

B. Material Safety Data Sheets (MSDS)
 The Manager or designee will be responsible for maintaining the MSDS/SDS system for the City, and will review incoming MSDS/SDS for new and significant health/safety information. He/she will see that any new information is passed on to the affected employees.

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33  Copies of MSDS/SDS for all hazardous chemicals to which employees of the City may be exposed are available at the City Public Works Corporate Yard and at the Waste Water Treatment Plant or by contacting the Public Works Administrative Assistant.

C. Employee Training and Information
 The IIPP Administrator, Manager or their designee is responsible for the employee training program.

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34  Prior to starting work, each new employee of the City of Kerman will attend a health and safety orientation in their department and will receive information and training on the following:
o An overview of the requirements contained in the Hazardous Communication Program; o Chemicals present in their workplace operations;
o Location and availability of the written hazardous communication program; o Physical and health effects of the hazardous chemicals; o Methods and observation techniques used to determine the presence or release of hazardous chemicals in the work area;
o How to lessen or prevent exposure to these hazardous chemicals through usage of control/work practices and personal protective equipment;
o Steps the City has taken to lessen or prevent exposure to these chemicals; o Emergency procedures to follow if they are exposed to these chemicals; o Location of first aid stations or first aid kit;
o How to read labels and review MSDS to obtain appropriate hazardous information; and o Where the MSDS are located along with the hazardous chemical list.

II. Hazardous Non-Routine Tasks – Confined Spaces Entry On occasions, employees are required to perform tasks in confined spaces. The requirements of Title 8 California code of Regulations §5157, Permit Required Confined Spaces, and §5158, Other Confined Space Operations, will be complied with. Prior to starting work in such a space, each supervisor will:
 Conduct pre-entry atmospheric testing using the oxygen analyzer. This must be done within 15 minutes of potential entry. Insure that oxygen level is in a safe range prior to entry.  Insure all associated electrical equipment is locked out. Any electrical equipment used for working inside the confined space must be properly grounded.
 Insure any steam or liquid entry lines into the confined space are disconnected or the valves of such lines closed and pad locked with Lockout/Tagout System.
 Insure personnel entering confined space is properly trained in all duties to be performed in the confined space.
 Insure entrant is wearing appropriate personal protective equipment including eye/face protection, gloves, safety boots, hearing protection, head protection and self-contained breathing apparatus (SCBA) if necessary.  Confined space attendant should be properly trained in communicating with the entrant and emergency procedure if problems arise.
 Entrant and Entrant Supervisor are both responsible to notify the department supervisor when the confined space project is completed so it can be properly closed out.

III. Informing Contractors
It is the responsibility of the Manager or designee to provide contractors and vendors with the following information:
• A list of hazardous chemicals to which they may be exposed while on City premises; and • Availability of MSDS/SDS for all hazardous chemicals on file, and where a copy may be obtained The Manager or designee will also obtain from the contractor a list of hazardous chemicals, with appropriate MSDS/SDS, that they will bring into City facilities.

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35 IV. Emergency Spill Procedures
All employees who encounter a hazardous material spill will immediately evaluate if the spill requires an emergency signal for immediate evacuation. If the spill is determined to be a major health and safety hazardous, employees should follow procedures outlined in the City of Kerman Emergency Action Plan. Those procedures involve:
 Sounding the emergency signal. Pulling the nearest fire alarm.  Contacting the emergency authorities.
o 911- Police, Ambulance, etc.
o Dial, as soon as safely possible, O.E.S. (Office of Emergency Services 1-800-742-1011424-8802)  Evacuate the premises.

If the hazardous spill does not warrant an emergency signal, then a supervisor will be notified immediately so that assignment of cleanup activities can be determined. If it is necessary to use the emergency spill kit for cleanup, then it is required by law to contact O.E.S. (Office of Emergency Services) at 1-800-742-1011424-8802.

EMERGENCY SPILL KIT
The City of Kerman has strategically placed an emergency cleanup kit (Envirosorb) in our chemical storage area in the main shop at the warehouse – 15275 W. California, (big yellow bucket in the main shop). Most chemical spills can be contained by the contents of this kit. The kit contains:

First Response Equipment Kit
 1 - Apron
 1 - Pair Gloves
 1 - Face Shield
 1 - Respirator
 1 - Accutint Litmus Indicator
 1 - Top Gun Hand Cleaner
First Response Spill Kit
 1 - First Response Equip Kit
 2 – 15 lb. Bags Counteract
 4 – 15 lb. Bags Spill Sorb
 2 – 12 ft. Absorbent Booms
The cleanup kit shall be used as follows:
1) Put on safety equipment
2) Spread Counteract on spill area.
3) Spread SPILL-SORB over entire spill area. Give material sufficient time to absorb. 4) Sweep or shovel up absorbed material.
5) Store in disposable bags until material can be disposed of according to federal, state, and local regulations.

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36 MODULE 3 - EMERGENCY ACTION PLAN
I. Scope and Application
This Emergency Action Plan is in compliance with the California Code of Regulations, Title 8, §3220 and covers actions that must be taken to ensure employee safety from fire and other emergencies.

Emergencies, disasters, accidents, and injuries may occur at any time, usually without warning. The purpose of this plan is to ensure accountability for all employees by providing employees with procedures for handling possible emergencies and disasters. All managers, supervisors, and employees must review the plan and familiarize themselves with the procedures contained in this plan.

The Emergency Action Plan Information Sheet is to be completed by the Supervisor of each department area/location. This information is site-specific to each working environment and will be used as a tool in the event of an emergency.

This plan defines the information and actions needed by each individual department to ensure appropriate response and procedures in the event of an emergency. See Emergency Action Plan Information Sheet.

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37 II. Emergency Action Plan Information Sheet
(To be completed by each Department Head)
BUILDING LOCATION/FLOOR: ________________________________________________________________________ DESIGNATED RESPONSIBLE COORDINATOR/SUPERVISOR FOR __________________________________ DEPARTMENT Name: ___________________________________________________ Phone: _________________________________ ALTERNATE RESPONSIBLE SUPERVISOR:

Name: ___________________________________________________ Phone: _________________________________ CITY EMERGENCY EVACUATION COORDINATOR: _________________________________________________________ PREDETERMINED EMERGENCY MEETING LOCATION: _____________________________________________________ ALTERNATIVE MEETING LOCATION (if initial predetermined location is inaccessible): ____________________________ ________________________________________________________________________________________________ LIST OF INDIVIDUALS ASSIGNED TO ASSIST PHYSICALLY IMPAIRED INDIVIDUALS (if applicable) Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________ Name: ________________________________________________ Phone: ___________________________________

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38 III. Definitions
Accountability: A system to account for all employees within a small geographical area (workplace) during an emergency.

Meeting Location: A predetermined, distinct part or section, as of a building or outdoor area, set aside for a purpose or specific function; a safe location for employees to meet during an emergency.

Alternate Meeting Location: A secondary predetermined location for meeting during an emergency. This location is a necessity in the event the initial meeting location is inaccessible.

Evacuation: An immediate exit, by all employees and visitors in the facility, due to a threat to life and safety during an emergency.

Evacuation Route: A predetermined route designed to evacuate employees and visitors to a safe meeting location.

Evacuation Route Map: A floor plan (diagram) posted in buildings/work areas identifying primary and secondary evacuation routes, building exits, fire extinguisher locations, and predetermined meeting locations.

Lockdown: An emergency protocol, closing/locking a facility/building, keeping employees/visitors within the locked facility/building away from the threat of a dangerous external event.

IV. Elements
A. Emergency Evacuation Procedures & Route Assignments
Evacuation of the building is required when the building's alarm system sounds or when employees are instructed to do so. Emergency evacuation procedures and route assignments are posted in each work area and all employees have been trained in the correct procedures to follow. New employees are trained when assigned to a work area. Evacuation route maps include: exit locations and evacuation routes; fire extinguisher locations; and predetermined meeting locations.

Building evacuation should proceed as follows:
 Determine in advance the nearest exit in your location;  Calmly and quickly exit per the evacuation route OR proceed to the nearest safe exit;  Instruct visitors who are present to exit with you;
 Assist anyone having difficulty exiting the building (be mindful of persons who have impairments and may need assistance in evacuating the building or reaching the meeting location);  In case of fire, do not use the elevator (if applicable);  After exiting the building, follow the evacuation route to the predetermined meeting location;  Once at the meeting location, report to your supervisor or designee;  Remain at the meeting location until the designated responsible coordinator has given the "all clear" notification to re-enter the building.

B. Procedures for Employees Who Remain to Operate Critical Operations Before Evacuation During some emergency situations, it may be necessary for specifically assigned and properly trained employees to remain in work areas that are being evacuated long enough to perform critical operations. These assignments are necessary to ensure proper emergency control. The selected individuals will receive special

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39 instructions and training by their immediate supervisors to ensure their safety in carrying out the designated assignments.

C. Evacuation of Persons with Disabilities
In cases of emergencies, individuals with mobility or sensory impairments (hearing or vision) may need assistance or guidance with evacuating a building. If there is a fire or situation that could affect electricity/power, do not use elevators.
• To Assist Visually-Impaired Persons
o Explain the nature of the emergency. Alarms or confusion may disorient a person, even when normally familiar with an area. Tell the person what needs to be done in order to evacuate. o Guide the person with you. Allow the person to take your arm below the elbow and instruct them to follow you. Remember to move slowly and communicate clearly with the individual. o Advise the individual of any hazardous or obstacles in the path. o When you have reached safety, advise the individual of their location and stay with them if necessary. o Before leaving, make sure the individual does not need any further help. • To Assist Hearing-Impaired Persons
o To get an individual's attention, you can flash room lights, wave your arms, or tap on the individual's shoulder.
o Gesture about what is happening and what to do (i.e. follow me, get down). o Write the nature of the emergency or evacuation route on a board or paper. • To Assist Mobility-Impaired Persons
o Ask the individual if they have medical/health needs or requirements. o Individuals using wheelchairs can be pushed or accompanied to safety. Do not use elevators. If needed, seek help to safely assist the person.
o If located in a building where stairs are to be used as the emergency exit for mobility-impaired persons, take that person to a safe area (Le. stairwell landings, offices, or balconies) and explain to them that you will get help to evacuate them from the building. Do not put yourself in extra danger. o Individuals using canes, crutches, or walkers should evacuate themselves, except in the event that rapid evacuation is deemed essential.
o If in need of assistance, call "911". Do not attempt to transfer a person from a wheelchair unless absolutely necessary.

D. Employee Accountability Procedures after Evacuations • Each supervisor is responsible for accounting for all assigned employees, personally or through a designee, by having all such employees report to a predetermined meeting location and conducting a head count. • During an evacuation, each supervisor will conduct a sweep of all cubicles, rooms, and restrooms in their area to ensure all employees and visitors have evacuated the building. • All supervisors and employees must report to their designated location immediately following an evacuation.
• Each assigned employee must be accounted for by name and is responsible for reporting to his or her designated Emergency Evacuation Coordinator to ensure an accurate head count. • The Emergency Evacuation Coordinator will determine the method to be utilized to locate any missing personnel in each situation.

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40 E. Rescue and Medical Duties
Rescue and medical duties will be performed by the emergency responders.

V. Alarm System
During an emergency evacuation, employees will be notified of the emergency condition by an audible alarm or verbal notification. Emergency responders will be notified when the fire alarm system is activated or by a call placed to "911".

VI. Evacuation for Emergencies
A. Fire Emergency
(Do not attempt any action that places you or another person at risk or injury) • When fire is discovered:
o Activate the nearest fire alarm; and
o Call "911 ".
• Provide the following information:
o Brief description of the type and location of the fire; o Building address; and
o Your name and phone number from which you are calling. • Upon being notified about the fire emergency, all employees/visitors must:
o Leave the building using the identified evacuation routes; o Assemble in the predetermined meeting location; and
o Remain at the meeting location until the designated responsible coordinator has given the "all clear" notification to re-enter the building.
• Designated Coordinator/Supervisor must:
o Coordinate an orderly evacuation of personnel;
o Ensure that all employees and visitors have evacuated the areas/floors; o Perform an accurate head count of personnel reported to the meeting location; o Determine a rescue method to locate missing personnel; and o Provide emergency personnel with any necessary information about the facility. • Assistants to Physically Impaired should:
o Assist all physically impaired individuals in emergency evacuation.

B. Earthquake
In order to minimize panic, confusion and possible injuries, it is important to know how to respond properly during an earthquake.
 During an earthquake, immediately move away from windows, tall file cabinets, bookshelves, and light fixtures. Find shelter under a sturdy desk or table, if possible. Kneel down in a hunched position. Place hands over your head for added protection. Remain there until shaking stops. Be aware of possible power outages that may affect lighting.
 Do not evacuate unless told to do so or if danger of building collapse is imminent. If instructed to leave the building, follow the evacuation route or use the nearest safe exit. o Be aware of the exit nearest to your workstation and the route to that exit. Establish an alternate route should your first choice be blocked or unsafe to use.

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41 o Move away from the building as quickly as possible to an open area away from all buildings. Stay away from power lines, windows, brick walls or any object that could topple. o Due to possible gas leaks, do not light matches or use cigarette lighters.  Once evacuated, do not re-enter the building until the designated responsible coordinator has given the "all clear" notification to reenter.
 After the initial earthquake:
o Be prepared for aftershocks;
o Report damage, fires, electrical shorts, gas and water leaks to the supervisor in charge; o Check for injured individuals and provide assistance - but do not attempt to move a seriously injured person unless they are in immediate danger; and
o If instructed to re-enter a building, open doors carefully and watch for hazardous.

C. Lockdown
 If a situation arises, due to a hostile threat from an intruder or intruders, please conduct the following:
o Call "911 ".
o Quickly check for employees/visitors unaware of the threat and bring them inside. o Lock doors and close any blinds.
o Place employees/visitors in an area that is "out of view" of the possible intruder. o Turn off lights and computers.
o Keep everyone quiet.
o Wait for police to confirm an "all clear".

D. Other Emergencies
For all other emergencies (medical, etc.), report immediately by dialing "911".

VII. Training
Managers and supervisors are responsible for ensuring that documented training is provided to their employees regarding the provisions of this plan. Also, managers and supervisors must ensure that their facility's evacuation route maps are current and posted in conspicuous places, and that all employees are aware of the locations of fire extinguishers and fire pull boxes within their sections.

Evacuation drills will be held at least once per year. All employees will participate in drills. Employees will evacuate the building during the drill and will not re-enter the building until notified to do so.

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42 MODULE 4 - HEAT ILLNESS PREVENTION PLAN (Effective 05/01/15) I. Purpose
This program is in place to protect all employees from heat hazardous posed by working in the outdoor environment, as required by the heat illness prevention regulation (Title 8 CCR 3395), and to serve as a supplement to the City of Kerman’s Injury and Illness Prevention Program (IIPP). This information is intended to be used as part of and in conjunction with the IIPP. The Heat Illness Prevention Plan ensures that City employees are knowledgeable in the prevention and recognition of heat illness to ensure their safety and the safety of others.

All supervisors and employees must review the plan and familiarize themselves with the Heat Illness Prevention principles and procedures contained in this plan.

The City of Kerman is committed to preventing heat-related illnesses (see Definitions and Descriptions of Heat Illness) that can occur to employees working outdoors by implementing the following key steps:
 Identifying outdoor work environments and conditions
 Monitoring weather conditions
 Monitoring employee acclimatization for working outdoors in heat  Providing clean drinking water
 Providing adequate shade
 Addressing high-heat procedures
 Handling an ill employee and initiating emergency procedures  Providing supervisor and employee training; see “Heat Illness Employee Training Handout”.

The following positions have been identified as working in outdoor environments that could potentially expose employees to illnesses associated with high heat.

Police Department
 Patrol Sergeants
 Policeatrol Officers
 Animal Control Officer
 Animal Shelter Attendant
 Community Service Officer
Public Works Department
 Fleet Services Supervisor
 Automotive Fleet Mechanic (I, II)
 Maintenance SupervisorPW Operations Coordinator
 PW Lead Supervisor
 Maintenance Worker (I, II, & III)
 WWTP Water Distribution/Waste Water Manager
 Maintenance TechWWTP Lead Supervisor

 WWTP Maintenance SpecialistWorker (I, II, & III)
 Water Conservation SpecialistAdministrative Analyst
 WWTP Operators (Grade I, II & III)
Parks & Recreation Department
 Building & Facilities Supervisor

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43  Recreation Supervisor
 Community Center Coordinator
 Recreation Coordinator
 Senior Services Coordinator
General Parks Maintenance Worker (I, II)

 Public Transit Operator
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44 Planning Department
 Building Official
 Building InspectorCode Enforcement Official
II. Monitoring the Weather
A. Weather forecast
When environmental risk factors create the possibility for heat illness, the supervisor will monitor the twoweek forecast for the work area. The supervisor will review the forecasted temperature and humidity for the worksite and compare it against the National Weather Service Heat Index to evaluate the risk level for heat illness. It is important to keep in mind that the temperature at which these warnings occur must be lowered as much as 15 degrees if the workers under consideration are in direct sunlight.

Weather information will be obtained by accessing the National Weather Service at www.weather.gov, calling the local National Weather Service office, or watching the Weather Channel TV network. Work schedules will be planned in advance, based on the forecast. Modifications will be made accordingly, especially if a heat wave is expected. This monitoring will take place all summer long.

B. Weather Monitoring Prior To Workday During Times Of Risk Prior to each workday, the supervisor will be responsible for monitoring the weather using www.weather.gov, or with the aid of a simple thermometer at the worksite. This weather information will be taken into consideration to determine when it will be necessary to make modifications to the work schedule (such as stopping work early, rescheduling the job, working at night or during the cooler hours of the day, increasing the number of water and rest breaks).

If schedule modifications are not possible and workers have to work during a heat wave, the supervisor will provide a tailgate meeting to reinforce heat illness prevention with emergency response procedures and review the weather forecast with the workers. In addition, the supervisor will provide workers with an increased number of water and rest breaks. The supervisor will ensure workers stop and take these breaks and closely observe all workers for signs of heat illness.

The supervisor will be responsible for using a thermometer at the jobsite and periodically checking the temperature to monitor for sudden increases. Once the temperature exceeds 80 o
Fahrenheit (F), the shade
structures are opened and accessible to the workers. Once the temperature equals or exceeds 95' F, additional preventive measures such as the high-heat procedures are implemented.

III. Monitoring Employee Acclimatization For Working Outdoors In Heat The supervisor will watch for sudden heat waves early in the season or increases in temperatures to which employees are unaccustomed for several weeks or longer. When necessary, the workday will be cut short or rescheduled for another day. In addition, during the summer months, the work shift may start earlier in the day or later in the evening to reduce exposure. During any heat wave, we will observe all employees closely (or maintain frequent communication via phone or radio) and watch for possible signs of heat illness.

For new employees, the supervisor will try to find ways to lessen the intensity of work during a two-week breakin period. Steps taken to lessen the intensity of the workload for new employees will be documented. The supervisor will:
 Stay alert to the presence of heat-related symptoms

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45  Assign new employees a buddy or experienced coworker to watch for discomfort or signs of heat illness IV. Providing Clean Drinking Water
The supervisor will provide access to potable drinking water at the beginning of each work shift so each employee can remain hydrated throughout the workday. The supervisor will remind employees to drink sufficient amounts of water, at least one quart (4 cups) per hour, when the work environment is hot, and employees are likely to be sweating more than usual in the course of their duties. Water must be “fresh, pure, and suitably cool” and provided to employees free of charge. The water shall be located as close as practicable to areas where employees are working. Single use, disposable cups will be provided. No one should drink from the water container.

When employees do not have access to plumbed or otherwise continuously supplied water, and we cannot readily replenish the water during the shift, the supervisor will provide enough water at the start of the shift so each employee has access to one quart of water or more per hour.

V. Providing Adequate Shade
When the outdoor temperature in the work area exceeds 80° F, we will provide and maintain one or more areas with shade at all times while employees are present. These areas will either be open to the air or provided with ventilation or cooling. We will also provide shade when an employee specifically requests it, even when the temperature does not exceed 80° F. Employees will be allowed and encouraged to take a preventative cool-down rest in the shade when they feel the need to protect themselves from overheating. Such access to shade shall be permitted at all times. An individual employee who takes a preventative cool-down rest (A) shall be monitored and asked if he or she is experiencing symptoms of heat illness; (B) shall be encouraged to remain in the shade; and (C) shall not be ordered back to work until any signs or symptoms of heat illness have abated, but in no event less than 5 minutes in addition to the time needed to access the shade.

Depending on the worksite, shade may be provided by trees or buildings. When natural shade is not available, we will provide other acceptable means of shade such as umbrellas, tents, canopies, etc., to block the sunlight. In these instances, we will provide chairs, benches, sheets, towels, or any other items to allow employees to sit and rest without contacting the bare ground. We will also relocate the shade structure as the work environment or location changes.

The amount of shade present will be at least enough to accommodate the number of employees on recovery or rest periods, so they can sit in a normal posture, fully in the shade without having to be in physical contact with each other. The shade shall be located as close as practicable to the areas where employees are working. The amount of shade present during meal periods shall be at least enough to accommodate the number of employees on the meal period who remain onsite.

In instances where natural shade is not available, supervisors will:
• Bring sufficient shade structures to the site
• Ensure sufficient shade structures are opened and placed as close as practical to the workers • Point out the daily location of the shade structures to the workers, as well as allow and encourage employees to take a five-minute cool-down rest in the shade when they feel the need to do so to protect themselves from overheating
• Ensure the shade structures are relocated to follow along with the crew and double-check they are as close as practical to the employees so access to shade is provided at all times If it is infeasible or unsafe to have shade structures, or to have shade present on a continuous basis, we will provide alternative procedures with equivalent protection.

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46 In instances where natural shade such as a tree is available, supervisors will evaluate the thickness and shape of the shaded area in orchards or other areas of vegetation (given the changing angles of the sun during the entire shift), before assuming that sufficient shadow is being cast to protect employees.

In situations where it is not safe to provide shade (example winds of more than 40 mph), we will document how the determination was made and identify what steps will be taken if someone requests shade, or we will identify other cooling measures with equivalent protection. Cooling measures other than shade may be used if they are as effective as shade in allowing employees to cool.

VI. Addressing High-Heat Procedures
When the outdoor temperature equals or exceeds 95 F, supervisors will:
 Conduct a pre-shift meeting to review high heat procedures  Be available so employees at the work site can contact them when necessary; if a cell phone or two-way radio is used, reception must be validated
 Be extra vigilant with observing employees for alertness and signs of heat illness  Remind employees to drink plenty of water and take cool-down breaks throughout the work shift  Designate one or more employees on each worksite as authorized to call for emergency medical services, and allow other employees to call for emergency services when no designated employee is available.  Closely monitor and observe all employees during a heat wave. Any new employee who has been assigned to a high heat area shall be closely observed for the first 14 days of employment, unless the employee indicates at the time of hire that he or she has been doing similar outdoor work for at least 10 of the past 30 days for four or more hours per day.

VII. Handling An Ill Employee And Emergency Procedures
When an employee exhibits possible signs or reports symptoms of heat illness (refer to Types of Heat Illnesses) while taking a preventative cool-down rest or during a preventative cool-down rest period, a supervisor will:
 Immediately call 911
 Move the employee to a cooler/shaded area
 Remove excess layers of clothing
 Fan and mist the worker with water
 Apply ice (ice bags or ice towels)
 Provide cool drinking water, if able to drink
A supervisor will remain with the sick employee until emergency help arrives. If the area is remote, the supervisor will have a map along with clear and precise directions (such as streets or road names, distinguishing features, and distances to major roads) of the site to clearly communicate the location to emergency medical services, the supervisor will designate someone to physically go to the nearest road or highway where emergency responders can see them. If necessary, the supervisor can transport employees to a place where they can be reached by an emergency medical provider.

Prior to assigning a crew to a particular worksite, the supervisor will:
• Ensure a qualified, appropriately trained, and equipped person will be available at the site to render first aid if necessary

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47 • Ensure responsibility for calling emergency medical service is assigned to an English-speaking worker the best capable person at the site
• Verify all foremen leads and supervisors carry cell phones or other means of communication to ensure emergency medical services can be called
• Ensure all communication devices are functional at the worksite prior to each shift VIII. Providing Supervisor and Employee Training
A. Employees
All employees are required to attend a health and safety training session prior to beginning work that should be reasonably anticipated to result in exposure to the risk of heat illness. See Training Handout. The following information will be provided:
 The environmental and personal risk factors for heat illness, as well as the added burden of heat load on the body caused by exertion, clothing, and personal protective equipment.  Our procedures for complying with the requirements of the heat illness prevention regulation  The importance of frequent consumption of small quantities of water  The importance of acclimatization
 The different types of heat illness and the common signs and symptoms of heat illness  The importance of employees immediately reporting symptoms or signs of heat illness for themselves and co-workers
 Our specific procedures for responding to possible heat illness, including how emergency medical services will be provided should they become necessary
 Our specific procedures for contacting emergency medical services and, if necessary, for transporting employees to a point where they can be reached by an emergency medical service provider  Our procedures for designating a person to be available to ensure emergency procedures are invoked when appropriate
 Our specific procedures for ensuring clear and precise directions to the work site will be provided as needed to emergency responders
B. Supervisors
In addition to obtaining the training required for employees listed above, supervisors will be trained before performing work that could be reasonably anticipated to result in exposure to heat illness. Training will include:
 All information provided during employee training
 Procedures for preventing heat illness, including monitoring weather reports and how to respond to hot weather advisories
 Information about how to identify heat illness
 Steps to take for emergency response to heat illness

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48 IX. Definitions
Acclimatization: Temporary adaptation of the body to work in the heat that occurs gradually as a person is exposed to the heat. Acclimatization peaks in most people within four to fourteen days of regular work for at least two hours per day in the heat.

Heat Illness: A serious medical condition resulting from the body's inability to cope with a particular heat load, and that includes heat cramps, heat exhaustion, heat syncope and heat stroke.

Heat Wave: Any day in which the predicted high temperature is at least 80oFahrenheit and at least 10oFahrenheit higher than the average high daily temperature in the preceding five days.

Environmental Risk Factors for Heat Illness: Working conditions that create the possibility that heat illness could occur, including air temperature, relative humidity, radiant heat from the sun and other sources. Conductive heat sources such as the ground, air movement, workload severity and duration, protective clothing and personal protective equipment worn by employees.

Personal Risk Factors for Heat Illness: Factors such as an individual's age, degree of acclimatization, health, water consumption, alcohol consumption, caffeine consumption, and use of prescription medications that affect the body's water retention or other physiological responses to heat.

Preventative Recovery Period: A period of time to recover from the heat in order to prevent heat illness.

Shade: Blockage of direct sunlight. Canopies, umbrellas and other temporary structures or devices may be used to provide shade as long as it does not expose employees to unsafe or unhealthy conditions and does not deter or discourage access or use. One indicator that a blockage is sufficient is when objects do not cast a shadow in the area of blocked sunlight. Shade is not adequate when heat in the area of shade defeats the purpose of shade, which is to allow the body to cool. For example, a car sitting in the sun does not provide acceptable shade to a person inside it, unless the car is running with air conditioning.

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49 City of Kerman Heat Illness Employee - Training Handout DATE: ____________________ DEPARTMENT: ________________________________________________________ We have developed a training program to increase employee awareness of the occurrence of exposures to heat illnesses when working outdoors and to motivate employees to protect themselves.

Overview of Heat Illness Prevention Regulation
The heat illness prevention regulation is intended to ensure both employers and employees understand the dangers associated with working in heat in outdoor workplaces. The following information is a review of the specific requirements of a heat illness prevention program, including water, shade, high-heat procedures, and training.

Written Heat Illness Prevention Program
We have a written program that outlines how we provide information on and control exposures that can result in heat illness while performing outdoor work in the heat. This program is available to you during our training or during your work shift from the supervisor at your location.

Water
We will provide enough fresh drinking water so you have access to at least one quart of water per hour and actively encourage you to drink it. Refrain from alcoholic beverages or beverages that contain caffeine, such as soft drinks, coffee, and tea.

Shade
Our goal is to provide shade so everyone who needs it has access to it to cool off when the weather is hot. If infeasible or unsafe to provide shade, we will provide other means to help keep you cool.

High-Heat Procedures
When the outside temperature reaches or exceed 95° F, additional precautions, to the extent they are feasible, will be taken to ensure your safety and health. This includes good communication, close supervision if you have not recently worked outdoors in the heat for four or more hours per day, observing you, and reminding you to drink plenty of water.

Training
All employees and supervisors who have potential heat exposures receive the same training so everyone understands our policy and procedures for keeping everyone safe when working outdoors. Training addresses how to acclimate to the heat, how much water to drink, the signs and symptoms of heat illness, the importance or reporting symptoms to your supervisor, and how to get help in an emergency.

You can read the California heat illness prevention regulation for additional information on any specific program element at http://www.dir.ca.gov/dosh/heatillnessinfo.html

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50 Types of Heat Illness
Heat illness is a serious medical condition resulting from the body's inability to cope with a particular heat load and includes heat cramps, heat exhaustion, heat syncope, and heat stroke.

Heat Stroke
The most life-threatening heat-related illness; heat stroke happens when the body can no longer control its temperature.

The body's temperature rises fast. The body cannot sweat and is unable to cool itself. Warning signs include red, hot, dry skin; very high body temperature; dizziness; nausea; confusion; strange behavior or unconsciousness; rapid pulse or throbbing headache. Heat stroke can cause death or disability if treatment is not given.

Heat Exhaustion
Heat exhaustion is a milder illness that happens when the body has lost too much water and salt in sweat. Warning signs include heavy sweating, cramps, headache, nausea or vomiting, paleness, tiredness, weakness, dizziness, and fainting. If heat exhaustion is not treated, it can turn into heat stroke. Get medical assistance if the symptoms are severe or if the victim has heart problems or high blood pressure.

Heat Syncope
Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization.

Symptoms of heat syncope include light-headedness, dizziness, and fainting.

Heat Cramps
Heat cramps are muscle pains and spasms due to heavy activity. They usually involve the stomach muscles or the legs. It is generally thought that the loss of water and salt from heavy sweating causes the cramps. If you have heart problems or are on a low sodium diet, get medical attention for heat cramps.

Heat Rash
Heat rash is a skin irritation caused by excessive sweating during hot, humid weather. Symptoms include red cluster of pimples or small blisters. Heat rash is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

Sunburn
Sunburn is when skin becomes red, painful, and unusually warm after being in the sun. Sunburn should be avoided because it damages the skin and could lead to more serious illness.

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51 MODULE 5 - FIRE PREVENTION PLAN
I. Scope and Application
This Fire Prevention Plan is in compliance with the California Code of Regulations, Title 8, §3221 and is intended to prevent and minimize the possibility of a fire.

The plan applies to all City employees and all City facilities, whether owned, rented, or otherwise occupied. Plan copies are site-specific. All managers and supervisors are responsible for executing and enforcing the plan.

II. Elements
A. Potential Fire Hazardous
The following is a list of potential workplace fire hazardous:
 Overloaded electrical circuits;
 Incorrectly wired electrical circuits;
 Use of electrical extension cords as permanent wiring;  Inadequate protection of electrical cords from damage;  Accumulation of trash and waste;
 Storage of combustible materials close to water heaters, furnaces, space heaters, hot lamps, hot plates, hot irons, or outside close to buildings;
 Improper storage of flammable liquids to include storing such liquids in unapproved containers, unapproved storage cabinets and in areas where ignition sources reside, such as in rooms with natural gas operated water heaters;
 Lack of preventive maintenance and lubrication of machinery and/or equipment;  Inadequately maintained heating, ventilation, and air conditioning systems;  Smoking in unauthorized facilities and/or near flammable liquid storage or dispensing systems;  Static electricity build-up during dispensing of flammable liquids;  Use of space heaters without tip-over shut off protection;  Lack of explosion-proof electrical apparatus in areas where there can be a buildup of flammable vapors.

B. Personnel Responsible for Maintenance of Fire and Emergency Equipment City facilities comply work to ensure compliance with International Fire Code (IFC) requirements for emergency equipment. Fire protection systems within City facilities are inspected and tested by authorized service contractors on a schedule established by the Public Services Director or designee. If any system or part of a system is not working properly, action is taken immedatelypromptly.

C. Personnel Responsible for Control of Flammable/Combustible Materials Supervisors at each City location are responsible for insuring the proper storing of flammable or combustible materials.

III. Housekeeping
The City controls storage of flammable and combustible materials and residues so that they do not contribute to fire ignition. Housekeeping procedures include such activities as:
 Daily disposal of trash from waste containers;

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52  Immediately cleaning up and proper environmental disposal of all spills of flammable liquids;  Maintenance of electrical equipment to include:
o Keeping electrical circuits from becoming overloaded; o Adding additional electrical outlets and power if needed; o Avoiding the use of electrical extension cords except for temporary usage (24 hours maximum); o Identifying problems with electrical wiring and outlets and making the necessary repairs; o Ensuring that flammable vapors are kept away from electrical ignition points; and o Not placing anything on top of electrical cords.
 All use and storage locations (including tanks) of flammable liquids are properly posted, warning people in the area of the fire and explosion dangers;
 Keeping the quantity of flammable liquids to a minimum to reduce the risk and magnitude of fire;  Storing flammable liquids in UL-approved safety cans and/or UL-approved flammable liquid cabinets, and in areas where there are no ignition sources;
 Keeping all containers of flammable liquids closed when not in use to prevent potential release of flammable vapors that could ignite;
 Storing oily rags in UL-approved safety cans and in areas where there are no ignition sources;  Daily emptying of oily-rag containers;
 Not storing any combustible materials within 36" of water heaters, furnaces, space heaters, hot lamps, hot plates, and hot irons;
 Only using space heaters that have automatic "tip-over" devices that shut off the units in the event they should topple over; and
 Enforcement of "no smoking" rules in areas where flammable liquids are stored or where flammable liquids are dispensed.

IV. Training
Managers and supervisors are responsible for ensuring that documented training is provided to their employees regarding the provisions of this plan and that housekeeping procedures are implemented. Also, managers and supervisors must ensure that their facility is free from improper accumulation of flammable and combustible waste materials and residues so they do not contribute to a fire.

V. Maintenance
The City regularly and properly maintains equipment and systems installed in the workplace to prevent accidental ignition of combustible materials. These maintenance procedures are coordinated by the Public Works Director or designee and include, but are not limited to, the following:
 A regular schedule of on-going preventive maintenance of machinery and/or equipment (including HVAC systems) to ensure inspection, maintenance and proper lubrication;  Maintenance of sufficient electrical power to handle each facility and function's electrical needs - including areas where space heaters are used; and
 Checking electrical outlets and circuits to ensure they are correctly wired.

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53 MODULE 6 - CITY HALL “HOLD-UP”ROBBERY PROCEDURE
The City of Kerman has implemented processes and procedures to handle a “hold-up” situation in the City Hall. There is a hold-up button located at the front desk of The City Hall. The main objective of front office staff is to survive the situation without incident. “Hold-up” policies and procedures will be reviewed by Safety Committee periodically.

In the event of a “hold-up” inrobbery at the City Hall; do the following:
 City Hall staff is to be fully cooperative with any assailant (no hero’s). Give them what they want and allow them to leave the office as unhindered as possible.
 The only appropriate action is to press the “hold-up” button and it should only be done if able to do so without putting yourself in danger.
 Operators at the monitoring station will respond to the “hold-up” alarm report as described by the alarm monitoring system. This would include dispatch of the police, indicating a hold-up situation.  After the assailant has left, front office staff should either verify that the monitoring station operator has dispatched police or they should dial 911 themselves. They should also notify management. Under no circumstances should anyone follow the suspect.

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54 MODULE 7 - ERGONOMIC PROGRAM
I. Purpose
The purpose of the City’s Ergonomic Program is to inform employees that the City is committed to improving our employee’s comfort and well-being by identifying and correcting ergonomic risk factors on the job. City’s goal is to reduce or eliminate hazardous that contribute to the development of musculoskeletal disorders (MSD).

II. Policy
It is the policy of the City of Kerman to maintain an ergonomic program that achieves the following goals:
 Prevent or minimize the occurrence of work-related musculoskeletal disorders such as tendonitis, low back pain, and carpal tunnel syndrome, by controlling employee exposure to the ergonomic risk factors that can cause or aggravate them;
 Ensure that affected employees are informed about work-related musculoskeletal disorders and associated ergonomic risk factors (e.g., repetitive motion, sustained postures, exertions);  Reduce the severity of work-related musculoskeletal disorders through early medical management  Encourage employee involvement in controlling exposure to ergonomic risk factors III. Ergonomic Program Coordinator
The IIPP Administrator will be the Ergonomic Program Coordinator and will lead efforts to identify and resolve ergonomic related problems.

IV. Identifying Workstation Risk Factors
Risk factors are job attributes or exposures that increase the probability of developing MSDS. The Office Evaluation Form can help identify possible risk factors. These risk factors are not necessarily causation factors for MSDS, nor, does the presence of a risk factor mean that an employee performing a job is at excessive risk of injury. Rather, a combination of risk factors, coupled with individual pre-dispositions may contribute to the risk of MSD occurrence.

The following are risk factors for developing MSDS:
 Repetition Rate - The current literature suggests a strong link between repetitious repetitive motion and the development of these disorders. This risk factor appears to be even more significant when sufficient recovery periods are not applied.
 Duration - When duration of a task is increased, the risk for MSDS is also increased.  Force - Forceful exertions place loads on joint structures and tissues of the musculoskeletal system.  Contact Stress - Contact stresses are produced when parts of the body come in contact with hard, sharp objects, resulting in forces transmitted through the skin to tendons and nerves. An example includes resting your wrists on a hard surface while using a keyboard.
 Posture - Stress to the body occurs when a body position places undue load on the musculoskeletal system or the nerves and blood vessels.
 Environment - Environmental factors such as vibration, lighting, and cold temperatures can increase the risk of developing MSDS.
 Other Stressors:
o Time pressures, deadlines, and work overload
o Absence of employee involvement in decision making
o Unaccustomed work, especially during training periods or after returning from a long-term leave  Non-Occupational Risks - Many employees have hobbies or other past times not related to work which might present any of the above-mentioned risk factors. If the muscle-tendon groups used during these activities are

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55 the same as those used during work activities, then the individual may not be allowing for adequate recovery periods in between exposures.

V. Hazardous Prevention and Control
Engineering controls are preferred over all other control methods because they involve designing the workstation to fit the individual and not the reverse. Examples of engineering controls most commonly used include the following:
 Work Station Design - Workstations should be easily adjustable and designed for each specific task so that they are comfortable for the employee and are appropriate for the job being performed. Specific attention shall be paid to static loading of muscles, work activity height, reach requirements, force requirements, sharp or hard edges, proper seating, support for the limbs, equipment orientation, and layout of the workstation.  Design of Work Methods - Work methods should be designed to reduce exposure to static, extreme and awkward postures, repetitive motions, excessive forces, inefficient grasps, and vibrations.

Administrative controls reduce the duration, frequency, and severity of exposures to ergonomic hazardous. An example would be to take rest pauses or breaks to relieve fatigued muscle-tendon groups. Administrative controls can be used in combination with other controls, but should not be used as the only control method for an ergonomic hazardous. The following sheet with Helpful Stretches can also alleviate some symptoms.

VI. Medical Management
The major components of a medical management program for the prevention and treatment of MSDS is employee training and education, early reporting of symptoms, appropriate medical care, and accurate recordkeeping. Early Reporting & Symptoms - All employees should report signs and symptoms on the Symptoms Survey Sheet of MSDS as soon as they occur. Pain, numbness and tingling in wrists, arms, elbows, neck, shoulders and back are early symptoms of MSDS.

VII. Training
Ergonomic training is available for all employees. This training will consist of the following:
 Overview of the Ergonomic Management Program
 Recognition of ergonomic hazardous
 Hazardous prevention and control
 Recognition of symptoms and reporting requirements
Definitions
Administrative controls are changes in the way that work in a job is assigned or scheduled that reduce the magnitude, frequency or duration of exposure to ergonomic risk factors. Examples of administrative controls for MSD hazardous include: employee rotation; job task enlargement; alternative tasks; and employer-authorized changes in work pace.

Carpal Tunnel Syndrome: The compression and entrapment of the median nerve where it passes through the wrist into the hand--in the carpal tunnel. The median nerve is the main nerve that extends down the arm to the hand and provides the sense of touch in the thumb, index finger, middle finger, and half of the fourth, or ring, finger.

Engineering controls are physical changes to a job that reduce MSD hazardous. Examples of engineering controls include changing or redesigning workstations, tools, facilities, equipment, materials, or processes.

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56 Musculoskeletal Disorder (MSD) is a disorder of the muscles, nerves, tendons, ligaments, joints, cartilage, blood vessels, or spinal discs. For purposes of this program, this definition only includes MSDS in the following areas of the body that have been associated with exposure to risk factors: neck, shoulder, elbow, forearm, wrist, hand, abdomen (hernia only), back, knee, ankle, and foot. MSDS include muscle strains and tears, ligaments sprains, joint and tendon inflammation, pinched nerves, and spinal disc degeneration.

MSD signs are objective physical findings that an employee may be developing an MSD. Examples of MSD signs are:
decreased range of motion; deformity; decreased grip strength and loss of function.

MSD symptoms are physical indications that an employee may be developing an MSD. For purposes of this standard, MSD symptoms do not include discomfort. Examples of MSD symptoms include: pain; numbness; tingling; burning; cramping; and stiffness.

Risk Factor means, for the purposes of this program: force, awkward posture, repetition, vibration, and contact stress.

Work practice controls are changes in the way an employee performs the physical work activities of a job that reduce or control exposure to MSD hazardous. Work practice controls involve procedures and methods for safe work.

Examples of work practice controls for MSD hazardous include: Use of neutral postures to perform tasks (straight wrists, lifting close to the body); use of two-person lift teams; and observance of micro breaks.

Work Related: means that an exposure in the workplace caused or contributed to an MSD or significantly aggravated a pre-existing MSD.

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57 Ergonomic Symptoms Survey

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58 Name: ________________________________________________________ Date: _____________ Phone: _______________________________ Department: ____________________________________________ Supervisor: ______________________________________ Phone: _________________________________ Job Title: ________________________________________ Time at current work station: ________________ Have you had pain or discomfort during the last year? Yes No (if no STOP here) If Yes, check the item(s) below and state R = Right and L = Left Neck Shoulder Elbow/Forearm Hand/Wrist Fingers
Upper Back Lower Back Thigh/Knee Lower Leg Ankle/Foot
Please put a check by the word(s) that best describe your problem Aching Numbness (asleep) Tingling
Burning Pain Weakness
Cramping Swelling Other: _______________________
Loss of Color Stiffness _____________________________
When did you first notice the problem? _____________ (Month) ________________ (Year) How long does each episode last?
1 hour 1 month
1 day 6 months
1 week
How many separate episodes have you had in the past year? __________________________________________ What do you think caused the problem? ____________________________________________________________ ______________________________________________________________________________________________ Have you had the problem in the last 7 days? Yes No
How would you rate this problem (Mark an "X" on the line) Now - None________________________________________________________________________Unbearable When it is Worst
None________________________________________________________________________Unbearable Have you had any medical treatment for this problem? Yes No If no, why not? _______________________________________________________________________________ If yes, where did you receive treatment?___________________________________________________________ Did the treatment help? Yes No
Please comment on what you thin would improve your symptons? ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ This form shall be completed by persons who may be experiencing musculoskeletal disorders as a result of their work environment. Carefully read this form and provide the following information:
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59 Office Ergonomic Evaluation Form
Name: ________________________________________________________ Date: _______________ Phone: _______________________________ Department: ____________________________________________ Supervisor: ______________________________________ Phone: ___________________________________ Job Title: _____________________________________________________________________________________ Average Daily PC Usage: 0-2 Hours 2-4 Hours 4-6 Hours
CTD Symptoms Yes No
CTD = Cumulative Trauma Disorders
Follow-Up Yes No Follow up Date _________________
Comments: ____________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Chair Recommendation
Feet flat on floor? Yes No Footrest
Upper legs parallel to floor? Yes No Raise Chair Lower Chair Lower back supported? Yes No Adjust back rest, seat pan, arm rest Set pan length OK? Yes No Evaluate other chairs
Other ____________________________
Keyboard/Hands Recommendation
Forearms parallel to floor? Yes No Raise keyboard Lower keyboard Wrists straight and level? Yes No Adjust keyboard incline angle Keying/Mouse grip force OK? Yes No Needs adjustable keyboard/mouse platform Mouse location OK? Yes No Needs wrist rest Needs mouse wrist rest Evaluate ergonomic keyboard
Position mouse next to keyboard at same height
Evaluate mouse hardware change
Other ____________________________
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60 Name: ________________________________________________________ Date: _______________ Phone: _______________________________ Department: ____________________________________________ Supervisor: ______________________________________ Phone: ___________________________________ Job Title: _____________________________________________________________________________________ Average Daily PC Usage: 0-2 Hours 2-4 Hours 4-6 Hours
CTD Symptoms Yes No
CTD = Cumulative Trauma Disorders
Follow-Up Yes No Follow up Date _________________
Comments: ____________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Chair Recommendation
Feet flat on floor? Yes No Footrest
Upper legs parallel to floor? Yes No Raise Chair Lower Chair Lower back supported? Yes No Adjust back rest, seat pan, arm rest Set pan length OK? Yes No Evaluate other chairs
Other ____________________________
Keyboard/Hands Recommendation
Forearms parallel to floor? Yes No Raise keyboard Lower keyboard Wrists straight and level? Yes No Adjust keyboard incline angle Keying/Mouse grip force OK? Yes No Needs adjustable keyboard/mouse platform Mouse location OK? Yes No Needs wrist rest Needs mouse wrist rest Evaluate ergonomic keyboard
Position mouse next to keyboard at same height
Evaluate mouse hardware change
Other ____________________________

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61 Monitor Recommendation
Monitor directly in front of user? Yes No Reposition monitor Viewing distance 16-24 inches? Yes No Lower monitor Raise monitor top of Slightly below seated Refocus on distant objects eye level ? Yes No (30 seconds every 30 minutes)
Screen free of glare, reflection? Yes No Add task lighting Visual control OK? Yes No Reposition entire PC workstation Eyeglass(bifocal) RX OK? Yes No Adjust monitor tilt angle Other ____________________________
Copyholder Recommendation
Copyholder use OK? Yes No Needs copy holder
Position copy holder at same height and
viewing distance as monitor
Other ____________________________
Phone Recommendation
Phone use OK? Needs phone cradle device
Is phone use required while on PC? Needs headset
Average daily phone usage
0-30 minutes 30-90 minutes 90+ minutes
Work Habits Recommendation
Work habits OK? Yes No Mini-breaks
(2-3 minutes every 45 minutes of PC work)
Alternate between typing and non-typing work
PC break software
Other ____________________________
General Office Recommendation
Are awkward postures minimized? Yes No Lower desk work surface height Is back twisting minimized? Yes No Needs adjustable height workstation Can you avoid overhead reaches? Yes No Change office layout Change drawer/shelf location
Reposition notebook, books, etc.

Other ____________________________
Evaluation conducted by ____________________________________ Date: _____________________________

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62 Helpful Stretches

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64 MODULE 8 - OCCUPATIONAL NOISE EXPOSURE PROGRAM
I. Purpose
This policy is designed to create a safe working environment for all the City of Kerman employees with regard to occupational noise exposure and the prevention of hearing loss due to work related tasks. It is the intent of the City that noise exposure levels to employees remain below the action level.  A potential exists for employee noise exposure as outlined in OSHA 29 CFR 1910.95 and California Code of Regulations, Title 8, Sections 5095-5100 (8CCR5095-5100).  Exposure dangers can be the result of working in certain areas of the City or the result of performing certain tasks using portable/mobile equipment.
 Occupational noise exposure levels can vary over time due to equipment changes or modifications to workplace tasks, and therefore need periodic review and testing.

II. Requirements
Monitoring will be performed and noise assessed in all areas of Kerman’s facilities that pose a risk. The required level of hearing protection will be posted at the site, including a time exposure limit that the employee cannot exceed. Appropriate Hearing Protective Protection Devices (HPDs) will be issued to employees who work in areas that have been determined to have noise levels at or above the established standards of 90 dBA.

Employees need to stay 50% below the maximum time limit exposure to protect them from hearing loss.

All employees are required to stay 50% below the maximum time limit exposure to protect them from hearing loss. The time-weighted average will be adjusted for the Noise Reduction Rating (NRR) printed on the hearing protection. Employees exposed to noise at or above 90 dBA action level are to participate in annual audiometric examinations (i.e., baseline and annual).

III. Responsibilities
 The Safety Committee will annually review the Occupational Noise Exposure Program (ONPP) and provide suggestions for improvements to the policy, implementation, and testing.  The IIPP Administrator or his/her designee will perform noise monitoring as requested by the Safety Committee.
 Supervisors shall continue to periodically review Job Safety Analysis and other workplace assessments with regards to noise exposure and the required level of hearing protection.  Conduct frequent checks and enforce the proper use of HPDs by employees  Employees will consistently wear and care for any HPDs assigned to them.

IV. Monitoring Limits & Testing Procedure
 Noise level monitoring will be considered whenever employees have the following:
o Difficulty communicating by speech while facing each other in the noise area at a distance of two feet. o Complaints such as headaches and/or ringing in the ears after working in a noise area for extended periods; or
o Temporary loss of hearing that has the effect of muffling speech and other sounds after extended exposure to the noise.
 For steady sound, a 10-15 minute sample will be taken with a Type 1 or 2 Sound Level Meter. Readings shall be taken in the fast response, on the A-weighted scale.

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65  Subtract 7 decibels from the NRR value of the hearing protection. Subtract the remaining amount from the measured level of the noise source.
 The resulting value is the in-the-ear corrected decibel level.  Check following chart for time restriction based on decibel reading.

Permissible Noise Exposures
Duration per day, hours
Sound level dBA slow
response
8 90
6 92
4 95
3 97
2 100
11/2 102
1 105
1/2 110
1/4 or less 115
Taken from Table G-16A of 29CFR1910.95, Appendix A; Equivalent exposure time limits for sound levels other than 90 decibels; Action level established by OSHA (50% of standard)
 All employees identified by monitoring for inclusion in the ONPP will participate in preliminary (baseline) and subsequent (annual) audiometric tests.

V. Recordkeeping
 The (Name of Department) will maintain the following records:
o Noise exposure measurements
o Audiometric test results (includes audiograms, employee’s name and department, audiogram date, examiner’s name, audiometer calibration date, and employee’s last assessment date) o Audiometric test facility’s background noise level
 Records will be provided upon written request by employees, former employees, or representatives designated by individual employees
VI. Training
All employees will be trained initially upon hire, and as new tasks are introduced. Training on hearing protection will be included with the PPE training, and will identify the types of protection, proper employee usage, and areas/tasks where it is required.

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66 MODULE 9 - LOCKOUT AND TAGOUT SAFETY PROGRAM
I. Purpose
This procedure establishes the requirements for the lockout of energy isolating devices whenever maintenance or servicing is done on machines or equipment. It shall be used to ensure that the machine or equipment is stopped, isolated from all potentially hazardous energy sources and locked out before employees perform any servicing or maintenance where the unexpected energization or start-up of the machine or equipment or release of stored energy could cause injury.

II. Lockout
Lockout locks shall be used on all occasions when a piece of equipment needs to be isolated from its source. Only standardized locks used specifically for lockout shall be used by all personnel. Some equipment can’t be locked out, but that does not mean it can’t be dangerous if it’s starts or is energized. This is when a Tagout tag shall be used. State law states that a lockout lock has to be:
 Durable enough for the heat, cold, humidity, or corrosiveness in the area where it’s used.  Standardized by color, shape, or size throughout the facility.  Strong so it can’t be removed without heavy force or tools like bolt cutters.  Identified by the name of the employee who installs and removes it III. Tagout (Hazardous Safety Tag)
The Tagout program consists of using a special tag, (Hazardous Safety Tag) that warns people of the danger of activating an energy source. A Tagout tag has a printed warning, (i.e., “Do Not Start”, “Do Not Operate”, etc.) with the name of the person who is tagging out the equipment, the date/time which it was tagged out, and the piece of equipment being worked on. The Tagout tag should only be used if a lockout lock cannot be used.

The Tagout tag has to meet all the same standards that are issued for locks. They have to be durable, strong, standardized, and show the identity of the employee doing the work.

Sequence of Lockout or Tagout System Procedure:
 Notify affected employee that you will be locking or tagging out equipment and why.  If the equipment is operating, shut it down by the normal operating procedure (i.e., depress stop button, throw switch).
 Operate the switch, valve, or other, energy isolating device so that the equipment is isolated from all potential energy source (i.e., breaker in an electrical panel).
 Lockout and/or tagout the energy isolating device with assigned standardized lock and/or tag provided by the City
 Carefully, try turning the equipment on to make certain that the equipment will not operate. This will ensure that you have locked out a piece of equipment.
 CAUTION! Remember to return operating control back to the “off” position.  The equipment is now locked and/or tagged out. Perform any necessary services or maintenance.

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67 IV. Restoring Equipment (Lockout/Tagout Removal)
After the maintenance and/or servicing are complete and equipment is ready for normal operation, check the area around the equipment to ensure that no one is exposed. Remove all tools from the equipment. Re-install all guards and, after all employees are in the clear, remove all lockout and/or tagout devices. Operate the energyisolating device to restore energy to the machine or equipment.

V. Procedure for More Than One Person
In the preceding steps, if more than one person is required to lockout and/or tagout equipment, each shall place their own lockout and/or tagout device to the energy-isolating device. When an energy-isolating device cannot accept separate multiple locks or tags, then a multi-lock device will need to be purchasedsingle lock and/or tag shall be used. The key to this lock shall be given to a supervisor who will be responsible for removing the lockout device when all the conditions, listed above, for lockout/tag out removal have been met.

VI. Things to Remember
 Always lock or tag equipment energy source before maintenance or repair.  Use lockout whenever possible. Tagout is just a warning, not an active way to prevent accidents.  Follow all lockout/tagout installation and removal steps.  Be sure other workers in the area are aware of your lockout/tagout activities.  Never ignore someone else’s lock or tag.

VII. Documentation
A Lockout and Tagout Program List of Source, which qualifies for this program, will be kept with this written plan.

A copy will also be posted at each workplace in a highly visible location. A sample lockout/tagout sign and equipment tag are also part of this written program.

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68 VIII. Lockout and Tagout Program List of Source
Location Source
City Hall – 850 S. Madera Avenue
South side of Building Main Breaker
South side of Building 3 Phase Panel
South side of Building 3 Phase Power Panel
5 locations in City Hall Sub Panels
Roof on the AC Electrical Connects
Kerman Police Department – 850 S. Madera Avenue
North end of building Breaker Panel
Roof on the AC Electrical Connects
Public Works Corporation Yard – 15201 W. California Avenue Public Works Breaker Panel
Shop and Warehouse Bld. Breaker Panel
Pump / Storage Breaker Panel
Roof on the AC Electrical Connects
Waste Water Treatment Plant – 15485 West Church Avenue
Inside Control Room Breaker Panel
Control Building Store Room Breaker Panel
Garage Building Breaker Panel
Lock out Electrical disconnects when they are available.

Roof on the AC Electrical Connects
Community Center Power and Communication Room – 15101 W. Kearney Blvd.

South West Corner of Bld. Breaker Panel
Roof on the AC Electrical Connects
Senior Center/Needs Building (Next to Senior Center) – 720 S. Eighth Street Roof on the AC Breaker Panel
Northeast corner of the Senior Center (outside of the building) Breaker Panel City-Owned Building – 942 S. Madera Avenue
Roof on the AC Electrical Connects
Southeast Storage Room Breaker Panel
Plaza Park Restrooms – Madera Avenue and “B” Street
Storeroom Main Breaker Panel
Rotary Park – 702 Vineland Avenue
Southwest Storeroom Main Breaker Panel
Electrical Cage Breaker Panel
Lions Park – 744 Park Avenue
Northwest Storeroom Main Breaker Panel
All Well Sites & Backup Generators
Well 9A - Lions Park-Del Norte/C St. Breaker Panels/Backup Generators Well 10 - Standby Rotary Park-Vineland/E St. Breaker Panels/Backup Generators Well 12 - Industrial Way (Near Zacky Farms) Breaker Panels/Backup Generators Well 14 - Vineland & Highway180 Breaker Panels/Backup Generators Well 15 - City Yard – 15201 W. California Breaker Panels/Backup Generators Well 17 - Goldenrod California – 920 S. Goldenrod Breaker Panels/Backup Generators Well 18 Test Well – Highway 180 Behind Shopping Center Breaker Panels/Backup Generators

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69 MODULE 10 – PERSONAL PROTECTIVE EQUIPMENT POLICY
(ADOPTED 08-07-2013)

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71 I. Purpose
The purpose of this Policy is to protect all employees including part-time employees, community service workers and volunteers from the risk of injury by creating a barrier against workplace hazardous in compliance with Cal/OSHA Standards. Personal protective equipment is not a substitute for good engineering or administrative controls or good work practices, but should be used in conjunction with these controls to ensure the safety and health of employees. Personal protective equipment will be provided, used, and maintained when it has been determined that its use is required and that such use will lessen the likelihood of occupational injury/or illness.

II. Applicability
This Policy applies to all City employees.

III. Policy
It is the policy of the City of Kerman that all aspects of CalOSHA's requirements for personal protective equipment, California General Industry Safety Orders, Title 8, Subchapter 7, Group 2, Article 10, shall be met or exceeded. This Policy addresses eye, face, head, foot and body protection. http://www.dir.ca.gov/Title8/sb7g2.html IV. Responsibilities
A. Safety Officer and Risk Management Officer shall:

1. Ensure that the Personal Protective Equipment Policy is implemented. The Safety Officer and Risk Management Officer have the authority to delegate any or all portions of this policy to subordinates, but the Safety Officer and Risk Management Officer will be held responsible for compliance.

2. Annually budget for the department's personal protective equipment

3. Conduct workplace hazardous assessments to determine the presence of hazardous which necessitate the use of personal protective equipment
B. Supervisors shall:

1. Implement the Personal Protective Equipment Policy.

2. Ensure that employees wear personal protective equipment when appropriate.

3. Counsel employees when personal protective equipment is not worn

4. Notify the Safety Officer when new hazardous are introduced or when processes are added or changed.

5. Ensure that employees are trained on the proper use, care, and cleaning of personal protective equipment.

C. Employees shall:

1. Wear personal protective equipment as required.

2. Care for, clean, and maintain all issued personal protective equipment.

3. Inform their supervisor of the need to repair or replace personal protective equipment.

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72 D. Safety Officer shall:

1. Update and maintain the Personal Protective Equipment Policy.

2. Assist with and review workplace hazardous assessments to determine the presence of hazards which necessitate the use of personal protective equipment.

3. Maintain records on hazardous assessments.

4. Provide assistance in training supervisors and employees on the proper use, care, and cleaning of approved personal protective equipment.

5. Provide guidance to supervisors for the selection and purchase of approved personal protective equipment.

V. Procedure
A. Hazardous Assessment and Equipment Selection
CalOSHA requires employers to conduct inspections of all workplaces to determine the need for personal protective equipment (PPE) and to help in selecting the proper PPE for each task performed. The Risk Management Officer or their designee in conjunction with the Safety Officer will conduct a walk through survey of each work area initially and whenever new hazardous are introduced into the workplace to identify sources of hazardous including impact, penetration, compression, chemical, heat, dust, electrical sources, material handling, vibration, and light radiation. Each survey will be documented using the Hazardous Assessment Certification form, which indicates the workplace surveyed, the person who conducted the survey, findings of potential hazardous, and the date of the survey.

Once the hazardous of a workplace have been identified, the Risk Management Officer or designee and the Safety Officer will determine the suitability of the PPE presently available; and, as necessary, select new or additional equipment ensuring a level of protection equal to or greater than the minimum required to protect the employees from the hazardous. Care will be taken to recognize the possibility of multiple and simultaneous exposures to a variety of hazardous. Adequate protection against the highest level of each of the hazardous will be provided.

B. Protective Devices
All personal protective clothing and equipment shall be of safe design and construction for the work to be performed and shall be maintained in a sanitary, safe and reliable condition. Only those items that meet NIOSH (National Institute for Occupational Safety and Health) or ANSI (American National Standards Institute), ISEA (International Safety Equipment Association) and the ASTM (American Society for Testing Material) standards will be procured or accepted for use. Newly purchased PPE must conform to the updated ANSI, ISEA and ASTM standards which have been incorporated into the CalOSHA PPE regulations, as follows:
(http://www.safetyequipment.org/c/stdz891-2009.cfm

1. Eye and Face Protection ANSI/ISEA Z87.1-2020

2. Head Protection ANSI/ISEA Z89.l-2014

3. Foot Protection ANSI Z41.1ASTM F2413-18

4. Hand Protection -There are no ANSI standards for gloves. Selection must be based on the performance characteristics of the glove in relation to the tasks performed.ANSI/ISEA 1341 - 2019

5. Body Protection - Cal/OSHA Standard 3383

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Section 5, Item E.
73 Careful consideration will be given to the comfort and fit of PPE in order to ensure that it will be used. Protective devices are generally available in a variety of sizes. Care should be taken to ensure that the right size is selected.

C. Eye and Face Protection
Prevention of eye injuries requires that all persons, who may be in eye hazard areas, shall wear protective eyewear. This includes employees and other persons visiting the hazardous area.

Suitable eye protectors shall be used when employees are exposed to hazards from flying particles, molten metal, acids or caustic liquids, chemical liquids, gases, vapors, aerosols, or potentially injurious light radiation.

1. Employees who wear contact lenses or prescription glasses must wear appropriate eye and face protection devices in a hazardous environment.

2. Side shields shall be used when there is a hazard from flying objects.

3. Goggles and chemical splash face shields shall be used when there is a hazard from chemical splash.

4. Face shields shall only be worn over primary eye protection (safety glasses or goggles).

D. Voluntary Respirator Use
The City may, upon request from an employee and depending on specific workplace conditions, provide a filtering facepiece-type respirator (dust mask) to the employee for voluntary use. The Safety Officer will provide all employees who voluntarily choose to wear a respirator with a copy of Appendix D of the Cal/OSHA standard http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9784 E. Emergency Eyewash and Safety Shower Facilities
Emergency eyewash (including bottled eye wash) and safety shower facilities meeting the requirements of ANSI Z358. l shall be provided in all areas where the eyes and body of any employee may be exposed to chemicals. All such emergency facilities will be located where they are easily accessible in an emergency. Permanent emergency eyewash and safety shower facilities must be flushed at least monthly and the inspection noted on a laminated "inspection tag" attached to the eyewash or safety shower.

F. Head Protection
Head protection shall be provided to and worn by any employee including part-time employees, community service workers and volunteers that may be exposed to falling, flying, or fixed objects that may fall, or to electrical shock.

G. Hand Protection
Suitable gloves shall be worn when hazards from chemicals, cuts, lacerations, abrasions, punctures, burns, biologicals, and harmful temperature extremes are present. Glove selection shall be based on performance characteristics of the gloves, conditions, duration of use, and hazards present. One type of glove will not work in all situations.

The first consideration in the selection of gloves for use against chemicals is to determine, if possible, the exact nature of the substances to be encountered. Read instructions and warnings on chemical container labels and MSDSs before working with any chemical. Recommended glove types are often listed in the section for personal protective equipment.

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Section 5, Item E.
74 All glove materials are eventually permeated by chemicals. However, they can be used safely for limited time periods if specific use and other characteristics (i.e., thickness and permeation rate and time) are known. The Safety Officer can assist in determining the specific type of glove material that should be worn for a particular chemical.

H. Foot Protection (Revised 05-17-17)
All safety footwear shall comply with ANSI Z41-l991ASTM F2413-18, "American National Standard for Personal Protection -Protective FootwearSociety for Testing Materials." Safety shoes or boots with impact protection are required to be worn in work areas when carrying or handling materials such as packages, objects, parts and/or heavy tools, which could be dropped; and for other activities where objects might fall onto the feet. Safety shoes or boots with compression protection are required for work activities in which materials could potentially roll over an employee's feet. Safety shoes or boots with puncture protection are required where sharp objects such as nails, wire, tacks, screws, large staples, scrap metal, etc., could be stepped on by employees causing a foot injury.

It is the responsibility of the employee, either full time or part time status, to purchase and wear safety shoes or boots when required by their position. Procedure to complete the reimbursement for the purchase of safety shoes will be in accordance with the following terms and conditions:
a. Employees are required to wear safety shoes/boots at work. If proper shoes/boots are not worn, the employee will be reassigned to other duties or sent home to don the proper shoes/boots. b. Reimbursement Limit – The City of Kerman will reimburse up to a maximum of $100 250.00 within a 12- month period for the purchase or replacement of protective footwear for permanent part time and full time employees.
c. Frequency of Reimbursement – Reimbursement for protective footwear will be provided as needed (based on the condition of existing protective footwear) but no more frequently than once in a twelvemonth period of time. If an employee wears out his or her footwear in less than 12 months, he or she will be expected to provide appropriate footwear at the employee’s costshow their Department Head so that the Department Head can determine if the boots will be replaced and notify Human Resources to notify Red Wing Shoes. Reimbursement for that cost will be provided after 12 months from the date of the prior reimbursement, but limited to once every 12 months.
d. To qualify for reimbursement, protective footwear must be deemed appropriate by the respective Department Head for the work environment and functions of the respective employee. The basic requirement for protective footwear will be that is must meet or exceed an ASTM F2413-18ANSI Z41.1 rating.
e. Employees will be trained on the proper cleaning and maintenance procedures for their protective footwear and will be expected to follow those procedures on a regular basis, to ensure safety and to prolong the life of the footwear.
f. Employees will take their personal protective footwear home with them and will wear them to work as appropriate.
g. In the event of an on-the-job incident where an employee damages his or her footwear, the City may reimburse for the replacement of the boots even if it has been less than 12 months since the last purchase.

The decision as to whether or not the City will replace the damaged boots will be made by the respective Department Head and the Finance Director and will depend on the circumstances of the incident and whether or not the employee was following city policies and procedures.

I. Body Protection

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Section 5, Item E.
75 Employees will be provided with appropriate body protection whenever their job tasks expose parts of their body (otherwise not protected) to hazardous or flying substances or objects. Loose sleeves, tails, ties, lapels, cuffs, or other loose clothing that can be entangled in moving machinery shall not be worn. All clothing saturated or impregnated with flammable liquids, corrosive substances, irritants or oxidizing agents shall be removed and shall not be worn until properly cleaned. Personal protection clothing will protect the body, back (lumbar support) and legs (chain saw chaps).

J. Life Rings and Personal Flotation Devices
At least one U.S. Coast Guard approved 30-inch life ring with not less than 90 feet of 600 pound capacity line attached shall be kept in a conveniently accessible place where employees work exposes them to the hazard of drowning. Each employee shall wear a U.S. Coast Guard approved personal flotation device when using a boat.

K. Cleaning and Maintenance
It is important that all PPE be kept clean and properly maintained. Cleaning is particularly important for eye and face protection where dirty or fogged lenses could impair vision. PPE shall be inspected, cleaned, and maintained at regular intervals by the employee the PPE is assigned to so that the PPE provides the requisite protection.

Personal protective equipment shall not be shared between employees until it has been properly cleaned and sanitized.

PPE will be distributed for individual use whenever possible.

L. Signage
Safety signage shall be posted wherever PPE is required. Signage is not required at temporary job sites; however, the job site hazards and personal protective equipment required shall be discussed at a daily tailgate meeting.

Signage shall have clear and concise wording like "Safety Glasses Required in This Area" or "Head Protection Required." Signs shall be purchased and posted by the respective department.

M. Training
Any employee required to wear PPE shall receive training in the proper use and care of the PPE. Periodic retraining shall be offered by the City to both employees and supervisors, as needed. The training shall include, but not necessarily be limited to, the following subjects:

1. When PPE is necessary to be worn

2. How to properly don, take off, adjust, and wear PPE.

3. The limitations of PPE.

4. The proper care, maintenance, useful life and disposal of the PPE.

N. Recordkeeping
The Safety Officer shall maintain the Hazard Assessment Certification form for each permanent work site evaluated for at least three (3) years or as required by Cal/OSHA. Training records shall be maintained by the respective Department and Safety Officer for a period of three (3) years.

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Section 5, Item E.
76 VI. PERSONAL PROTECTIVE EQUIPMENT POLICY FORMS

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Section 5, Item E.
77 1. Hazard Assessment Certification Form
Job/operation Title: Department:

Job Site: Job:

Equipment Used:
(See Equipment Code below)
Supervisor:

Task
No. Describe Each Task or Activity Hazard Associated with Task or Activity Control Measures
1 2
3 4
5 6
7 8
9 10
Hazard Assessment: Part of Body and Type of Protection Required (Check all that Apply) Areas of Impact Protective Devices
Body 
Ears 
Eyes 
Face 
Foot 
Hands 
Head 
Body Cut Resistant Chaps  | Lumbar Support  *Hard Hat – Ear Muffs/Plugs 
Face Protection: Face Shield 
Safety Spectacles | Goggles | Welding Shield

Respirator/Mask 
Safety Shoes: Metatarsal Guards 
Toe Guards 
Protective Device0Gloves:

Chemical Resistant  | Cut Resistant  Leather
 Rubber  | Temperature Resistant 
Other as Required by Product 
Safety-toe shoes 
Cement Boots 
Flotation Device 
Other 
* City Purchases Type 1 Class E, G & C with regular brim and full brim which is equal to a Class B hat.

Equipment Code
Person Certifying Assessment
Print Name Signature Date
1 Axe 7
Compress/Air
Gas Operation 13 Grader 20 Knife 26 Pavement Crack Sealer 32 Scissor Lift 38 Welder 2 Backhoe 8 Drills 14 Hand Hammer 21 Ladder 27 Propane Gas Tank 33 Shovel 39
3 Battery Charger 9 Edger 15 Hand Pruning
Shears 22 Lawn Mower 28 Rake 34 Street Grinder 40
4 Bucket Lift 10 Electrical Tools 16 Hedger 23 Leaf Blower 29 Riding Mower 35 Stump Grinder 41 5 Chainsaw 11 Floor Jack 17 Hoe 24 Lift Jack 30 Sander 36 Trailer 42 6 Clippers 12 Forklift 19 Jack Hammer 25 Paint Sprayer 31 Saw 37 Weed Eater 43

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Section 5, Item E.
78 209
Section 5, Item E.
79 2. Personal Protective Equipment Issuance Form
(Please Complete for each Employee)
Name: ___________________________________________________ Department: ________________________________________ Classification: ______________________________________________ Date: ____________________________________________ Type of PPE Provided:

Protective Devices Date Provided
Body Cut Resistant Chaps | Lumbar Support 
Ear Muffs/Plugs 
Face Protection – Face Shield  | Safety Spectacles |Goggles | Welding Shield  Protective Device0Gloves –
Chemical Resistant  | Cut Resistant  Leather  | Rubber  | Temperature Resistant  Other as Required by Product 
*Hard Hat 
Respirator/Mask 
Safety Shoes – Metatarsal Guards |Toe Guards  | Safety-toe shoes  Cement Boots 
Flotation Device 
Other:

I acknowledge that while I am working for City of Kerman, I am expected to wear and take proper care of the Personal Protection Equipment issued to me (checked above). I understand that upon termination, I am expected to return all issued equipment.
________________________________________________
______________________________________________
Employee Name (Please Print) Employee Signature
_______________________________________________
______________________________________________
Supervisor Name (Please Print) Supervisor Signature
* City Purchases Type 1 Class E, G & C with regular brim and full brim which is equal to a Class B hard hat.

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Section 5, Item E.
80 3. Safety Toe Shoes Reimbursement Form
Name: ___________________________________________________ Department:
________________________________________
Classification: ______________________________________________ I request reimbursement for the purchase of safety toe shoes required for use on my job with the City of Kerman. I have attached the original receipt for the purchase of my shoes as proof of purchase. I understand it is my responsibility to properly maintain and care for my shoes and all other Personal Protection Equipment issued to me by the City of Kerman. I understand that reimbursement for safety toe shoes is limited to a maximum of$100.00 in any 12 month period, except in the case of unavoidable on the job destruction of the shoes.

Date of Purchase ______________________________________ Purchase Price _________________________________________ Employee Signature: _________________________________________________ Date of Request:
___________________________
___________________________________________________________________________________________________________ I certify that these safety shoes conform to the American national Standards Institute (ANSI Z41.1)

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211
Section 5, Item E.
81 Supervisor: ________________________________________________________ Date of Request:
____________________________
Risk Management Officer: ________________________________________________ Date:
_________________________________
Next Eligible date for Safety Shoe Purchase: ______________________________________________ 212
Section 5, Item E.
82 EMPLOYEE ACKNOWLEDGEMENT FORM
Injury and Illness Prevention Program (IIPP)
Employee Last Name: _______________________________________________________ Employee First Name: _______________________________________________________ City Department: ___________________________________________________________ Employee Position/Title: _____________________________________________________ Employee Phone Number: ____________________________________________________ I certify that I have received, reviewed, and read a copy of the City of Kerman “Injury and Illness Prevention Program" (IIPP) and fully understand my responsibilities with respect to the policy and procedures as outlined. I further agree to comply with safe work practice information received in this basic safety orientation and IIPP review.

Signature: _____________________________________________ Date: ________________________

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Section 5, Item E.
83 INJURY & ILLNESS PREVENTION PROGRAM TRAINING
A. What is the Injury & Illness Prevention Program (IIPP)? The IIPP is a requirement of Title 8, California Code of Regulations (CCR) Subchapter 7 General Safety Orders. It is a general safety program that applies to all employees. The IIPP includes:
 Employee safety training;
 Safety meetings;
o Supervisor safety meetings
o Department safety meetings
 Safety inspections and audits;
 Accident investigations; and
 Communication of safety information.

B. How is safety information communicated?
 Employee training;
 Safety meetings;
o Department meetings
o Supervisor safety meetings
 Newsletters and publications, if available.

C. How often do I need to be trained?
 When you are a new employee and/or given a new job assignment;  Whenever new substances, processes, procedures, or equipment are introduced to the workplace and represent a new hazard; and
 Whenever the City becomes aware of a new or previously unrecognized hazard.

D. Does the IIPP include training information on general safe work practices? Yes and every employee must observe the following rules:
 Know the safety rules and procedures that apply to the work that is being done.  Determine the potential hazards (e.g. physical, chemical, biological) and appropriate safety precautions before beginning any new operation.
 Be alert to unsafe conditions and actions and call attention to them so that corrections can be made as soon as possible.
 Know the location of, the emergency equipment in your area, as well as how to obtain additional help in an emergency. Be familiar with emergency procedures by:
o Reviewing emergency procedures posted in your department and common areas; and o Becoming familiar with how to safely exit the building you work in and knowing where to go once outside the building.

E. What does housekeeping have to do with safety?
There is a definite relationship between safety and orderliness in the work area or shop. When housekeeping standards fall, safety inevitably deteriorates. The work area must be kept clean and orderly.

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Section 5, Item E.
84  Work areas must be kept clean and free from obstructions. Clean up should follow the completion of any operation or at the end of each day.
 Trash should be deposited in appropriate receptacles.  Stairs and hallways should not to be used as storage areas.  Access to exits, emergency equipment, controls, and fire extinguishers must never be blocked.  Chemicals must be stored and labeled properly. Consult manufacturer's guidelines and the Material Safety Data Sheets (MSDS)/Safety Data Sheet (SDS) for appropriate storage requirements.

F. What are my rights as an employee?
 You have the right to a safe work environment.
 You have the right to register anonymous safety concerns with the IIPP Administrator and/or with Cal-OSHA.  You have the right to be informed of any operation in your work area where hazardoussubstances or industrial hazardous are present.
 You have the right to be informed of the location and availability of hazardous materials use information (MSDS) and/or any other safety procedure or information necessary to perform your work assignment safely.  You have the right to receive training on the proper use of hazardous equipment or hazardous materials prior to their use.
 You have the right to review the written IIPP in your department or from the IIPP Administrator.

G. What are my supervisor’s responsibilities?
 To ensure that you receive training on the specific hazards of your job assignment prior to beginning the assignment;
 To provide you (when beginning an assignment which poses a new hazardous) with training on the specific hazard of the equipment or process prior to beginning the assignment;  To determine the specific training required for any employee under his/her supervision; and  To ensure that you have access to any written and/or online copies of the IIPP.

H. What are my responsibilities as an employee?
 To perform your specific job assignment in the safest manner possible;  To operate all equipment as instructed by your supervisor or as outlined in the manufacturer's operational procedures; and
 To operate heavy equipment or perform hazardous processes only after receiving specific supervised training.

I. What are the training documentation requirements?
 All employees shall read the IIPP and sign the Employee Acknowledgement Form  Training documentation will be maintained in accordance with the City's Retention Schedule J. What are the systems in place for identifying, evaluating and preventing occupational safety and health hazards?  The IIPP Administrator is responsible for developing, implementing, and monitoring the effectiveness of safety and health programs.
 The IIPP Administrator conducts the Auditing and Inspection Program.  All occupational accidents, injuries and illnesses are investigated.  All reported employee safety concerns are evaluated.

K. What systems are in place for correcting unsafe or unhealthy conditions and work practices in a timely manner?

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Section 5, Item E.
85  Unsafe conditions that require repair work are reported (Hazard Alert Forms - IIPP – Page 7).  Audits are conducted by the IIPP Administrator or Departments on an annual basis and focus on identifying and correcting unsafe work conditions and practices (Hazard Inspection Checklist-Page 12) Bloodborne Pathogen Program
A. What is the Bloodborne Pathogen (BBP) Program?
The Bloodborne Pathogen Program complies with OSHA, 29 Code of Federal Regulations (CFR) 1910.1030 & California Code of Regulations (CCR) Title 8 §5193 and includes a written Exposure Control Plan covering employees who have the potential to be exposed to human blood or certain body fluids. The handling, cleaning, and transporting of human blood and certain body fluids is regulated by this program.

B. What are Bloodborne Pathogen?
Bloodborne Pathogen are microorganisms such as viruses or bacteria that are carried in blood and certain body fluids with the potential to cause disease in people. Human blood may contain the Hepatitis B Virus or Human Immunodeficiency Virus (HIV).

C. What are Universal Precautions?
Universal Precautions are an approach to infection control, treating all human blood and certain human body fluids as if known to be infectious for HIV or other bloodborne pathogen. Disposable gloves, masks, eye protection and face shields can greatly reduce the potential exposure to all bloodborne pathogen.

D. How do I know if I need training?
If you are required to work with blood or certain body fluids, or are a first aid provider, you will need training. The IIPP Administrator has identified employees needing training in the BBP Exposure Determination section of the BBP program
E. If I am required to have training, how often must I be trained? Initially, and annually thereafter.

F. Where can I obtain a copy of the BBP program?
You may obtain a copy from your supervisor or access on the City’s shared drive.

Hazardous Communication Program - Your "Right-To-Know"
A. What is the purpose of this program?
The purpose of the Hazardous Communication Program is to inform and educate employees about hazardous substances that may be encountered in the workplace.

B. What should I know about the chemicals that I work with?  Be certain that you understand the hazards of chemicals you work with. If you are not certain of the potential hazard, consult your supervisor and the Material Safety Data Sheets (MSDS)/Safety Data sheets (SDS). Any

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Section 5, Item E.
86 questions should be referred to your supervisor or the IIPP Administrator. Do not work with a hazardous material until you have reviewed the MSDS/SDS.
 If a chemical spill occurs, immediately contact your supervisor, the IIPP Administrator, or call 911. Do not attempt to clean up a hazardous material spill unless you have been appropriately trained.  Use personal protective equipment, including eye protection, gloves, coveralls, respirators, and other equipment, as the job requires.
 Warning signs are posted when hazardous, such as radiation, lasers, flammable materials, biological hazardous, mechanical hazardous, or other special hazardous exist.

C. What type of information is found in the MSDS/SDS?
The MSDS contains product name, physical and health hazardous, measures to protect yourself, first aid and emergency procedures, etc.

D. Where can I find the MSDS/SDS?
Copies of the MSDS/SDS are available at each building or by contacting the Public Works Administrative Assistant or Recreation/Community Center Coordinator.

E. When do I have to be trained regarding working with hazardous substances? You are to be trained initially and whenever a new hazard is introduced to your work area.

F. Does the City have a written Hazardous Communication Program? Yes, copies of the program are kept in the IIPP Administrator's office and within each department.

G. What do I need to know about container labels?
All containers (even portable containers) of hazardous substances must be labeled, tagged or marked with the identity and appropriate warning hazardous. Do not remove existing labels.

H. Can I get information regarding hazardous substances to which I may be exposed? You may get information regarding hazardous substances to which you may be exposed from the MSDS. This information may also be shared with your physician.

Emergency Action Plan
A. What is the purpose of the Emergency Action Plan?
The purpose of the Emergency Action Plan is to inform and educate employees about the actions that must be taken to ensure employee safety during fire and other emergencies. 217
Section 5, Item E.
87 B. What type of information is found on the Evacuation Route Map? The Evacuation Route Map includes:
 Emergency exits & escape routes;
 Fire extinguisher locations; and
 Predetermined meeting locations.

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Section 5, Item E.
88 I. Injury and Illness Prevention Program (IIPP) Quiz Name: ____________________________________________________ Date: ___________________ Circle THE CORRECT ANSWER - TRUE OR FALSE
1 In addition to the IIPP, I may be required to complete Hazardous Communication training. T F 2 The IIPP is designed to inform me of general safe work practices and instructions for hazardous related to my job
T F
3 I need to know the potential hazards and appropriate safety precautions prior to starting a new operation.

T F
4 I need to know how to use the emergency equipment in my area, how to obtain additional help, and should be familiar with emergency procedures.

T F
5 If I see an unsafe condition, I should keep it to myself. T F 6 Chemicals must be properly labeled and stored. T F
7 It is okay to occasionally block exits. T F
8 I do not need special training prior to working with hazardous chemicals. T F 9 Anonymous safety concerns may be called in to the IIPP Administrator's Office. T F 10 It is my responsibility to perform my job in the safest manner possible. T F 11 Workplace safety is only the responsibility of the person(s) wearing the risk management hat. T F 12 Any injury at work-no matter how small-must be reported immediately to the person's supervisor and must receive first-aid attention.

T F
13 Safety glasses, gloves, helmets, and safety shoes, must be worn on the job if policy requires them.

T F
14 People have different work styles. Staff members who work best with piles of materials about their areas are just as safe from accident and injury as staff members with neat areas.

T F
15 Safety is just common sense. The City doesn't need to waste time training people not to put their hands in a shredder.

T F
16 People will automatically walk around spilled liquid on the floor. When you see spilled liquid on the floor, wait for the maintenance staff to find it and clean it up.

T F
17 All we can afford is the furniture we've been given. If the chairs don't adjust and we use tables instead of fancy desks, it won't hurt anyone.

T F
18 Chairs or stools can be substituted for a ladder to get items out-of-reach as long as an employee "spots' the person using the chair or stool.

T F
19 Reporting and replacing burned out light bulbs is an inexpensive and effective crime deterrent.

T F
20 A sloppy worker is only a danger to himself. T F
21 Where needed, special procedures for helping physically impaired employees should be incorporated into the entity's emergency plans.

T F
22 In a fire drill or fire, do not use the elevator to exit the building. T F 23 No one needs instructions on how to use a ladder. T F 24 Anyone can safely pick up a fire extinguisher and use it to put out a fire. T F 25 Injuries in office settings often come about because the "housekeeping' of the office has become slack.

T F
26 The most common safety hazards in the office are falls, noise, inadequate pathways, and placement of furniture/equipment.

T F
27 Heavy objects can cause serious injuries. Employees need to be trained to lift heavy objects. T F 28 Chemical and cleaning supplies should be stored in a locked cabinet or storage room. T F 29 It is unfriendly to require sign-in sheets or badges for visitors or vendors. T F

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Section 5, Item E.
89 30 Only those entities that have commercial kitchens need to worry about kitchen wiring, sanitation, temperature control, and maintenance.

T F
31 Workplace violence is a growing concern for employers and employees nationwide. T F 32 Chain and padlock exterior doors with push bars to make sure employees won't prop them open.

T F
33 Only public entity employees working in the medical field need to worry about infections that can be transmitted through contact with blood and body fluids.

T F
34 Employees should be trained to check vehicles before driving. T F 35 HIV is the most common bloodborne infection in the United States. T F 36 OSHA is just a regulatory agency; safety training and information must be obtained elsewhere.

T F
37 A City is only responsible for ensuring that operators of vehicles used in the course of the City's operations are properly licensed.

T F
38 A drug-free workplace policy with enforceable consequences for disregarding the policy contributes to a safe workplace.

T F
39 Reassignment to light or modified duty can help reduce the overall costs and length of disability for a work-related accident.

T F
40 Stress affects morale, productivity, and safety. T F 41 Employees need to discern an "empty threat" from one that is serious. T F 42 Sometimes the least expensive warning device can be the most effective. T F

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Section 5, Item E.
90 Injury and Illness Prevention Program Quiz - Answers

1. In addition to the IIPP, I may be required to complete Hazardous Communication training.

TRUE

2. This IIPP is designed to inform me of general safe work practices & instructions for hazardous related to my job.

TRUE

3. I need to know the potential hazards and appropriate safety precautions prior to starting a new operation.

TRUE

4. I need to know how to use the emergency equipment in my area, how to obtain additional help, and should be familiar with emergency procedures.

TRUE

5. If I see an unsafe condition, I should keep it to myself.

FALSE

6. Chemicals must be properly labeled and stored.

TRUE

7. It is okay to occasionally block exits.

FALSE

8. I do not need special training prior to working with hazardous chemicals.

FALSE

9. Anonymous safety concerns may be called in to IIPP Administrator's Office.

TRUE

10. It is my responsibility to perform my job in the safest manner possible.

TRUE

11. Workplace safety is only the responsibility of the person(s) wearing the risk management hat.

FALSE -Workplace safety is everyone's responsibility. It is best to establish a safety culture through policies, procedures, training, and supervision.

12. Any injury at work-no matter how small--must be reported immediately to the person's supervisor and receive first-aid attention.

TRUE - Serious conditions often arise from small injuries if they are not cared for at once

13. Safety glasses, gloves, helmets, and safety shoes, must be worn on the job if policy requires them.

TRUE - Personal protective equipment (PPE) is meant to protect workers from specific hazardous associated with their job responsibilities. Policies, procedures, training, and supervision all contribute to the safe use of PPEs.

14. People have different work styles. Staff members who work best with plies of materials about their areas are just as safe from accident and injury as staff members with neat areas.

FALSE - Slips, trips, and falls are the most frequent cause of accident and injury in the workplace. Staff should be encouraged to maintain a neat work area for safety reasons.

15. Safety is just common sense. The City doesn't need to waste time training people not to put their hands in a shredder.

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91 FALSE- One person's common sense is not necessarily the same as another's. The City should identify its expectations for safe workplace procedures through policies, checklists, training, and supervision.

16. People will automatically walk around spilled liquid on the floor. When you see spilled liquid on the floor, wait for the maintenance staff to find it and clean it up.

FALSE - Slips, trips, and falls cause the most workplace accidents. Encourage everyone to clean up spills or alert maintenance right away,

17. All we can afford is the furniture we've been given. If the chairs don't adjust and we use tables instead of fancy desks, it won't hurt anyone.

FALSE - Repetitive motion injuries lower back pain, neck and shoulder aches, headaches, and eyestrain can all afflict computer users with non-ergonomic work stations.

18. Chairs or stools can be substituted for a ladder to get items out-of-reach as long as an employee 'spots' the person using the chair or stool.

FALSE - Standing on chairs or stools, especially ones with castors, is a great contributor to slip and fall injuries in the workplace. Instruct staff to only use appropriate step-stools or ladders and to follow ladderuse safety protocol.

19. Reporting and replacing burned out light bulbs is an inexpensive and effective crime deterrent.

TRUE - Burned out bulbs create places to hide that aren't there when the area is well lighted.

20. A sloppy worker is only a danger to himself.

FALSE - Co-workers' housekeeping habits affect the safety of fellow workers.

21. Where needed, special procedures for helping physically impaired employees should be incorporated into the entity's emergency plans.

TRUE

22. In a fire drill or fire, do not use the elevator to exit the building.

TRUE - Always use the stairs. Most stairways are fire resistant and present barriers to smoke if the doors are kept closed. Unsealed elevator shafts can act as a chimney drawing the smoke into them.

23. No one needs instructions on how to use a ladder.

FALSE - Load, height, angle, maintenance, and repair all need to be considered before safely stepping on a ladder.

24. Anyone can safely pick up a fire extinguisher and use it to put out a fire.

FALSE - Only those trained to use the particular type of fire extinguisher should attempt to use it to put out a fire. There are specific types used for grease, electrical, wood, and chemical fires –to name a few.

25. Injuries in office settings often come about because the "housekeeping" of the office has become slack.

TRUE - Cleanliness and good housekeeping can also reduce allergic reactions to dust and mold, and prevent illness such as the flu and conjunctivitis (pink eye).

26. The most common safety hazards in the office are falls, noise, inadequate pathways, and placement of furniture/equipment.

TRUE - The most common hazards are the least expensive to solve. Safety education, a safety culture, and supervision can reduce or eliminate most causes of these common hazardous.

27. Employees need to be trained to lift heavy objects, which can cause serious injuries.

TRUE - Heavy objects include people lifted by police officers and fire fighters. Failing to lift objects of any weight properly can result in injury. Small, light loads (I.e., stacks of files, boxes of computer paper, books) can wreak havoc on backs, necks, and shoulders if bodies are used incorrectly when lifting them.

28. Chemical and cleaning supplies should be stored in a locked cabinet or storage room.

TRUE - In addition, chemicals should be stored in a separate closet or cabinet from cleaning supplies to keep them from interacting.

29. It is unfriendly to require sign-in sheets or badges for visitors or vendors.

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92 FALSE - It all depends on how the request is made. Provide training for the front-desk staff. Teach them some phrases to use to encourage compliance with signing the guest register and wearing visitor badges, as well as what to do if the person is unwilling to comply.

30. Only those entities that have commercial kitchens need to worry about kitchen wiring, sanitation, temperature control, and maintenance.

FALSE - Even if your kitchen is simply a staff break room with refrigerator. Microwave oven, sink, and dishwasher, it is important to ensure that equipment is appropriate for the setting, and is installed and maintained properly.

31. Workplace violence is a growing concern for employers and employees nationwide.

TRUE Approximately two million American workers are victims of workplace violence each year. It can occur at or outside the workplace and can range from threats and verbal abuse to physical assaults and homicide:
one of the leading causes of job-related deaths.

32. Chain and padlock exterior doors with push bars to make sure employees won't prop them open.

FALSE Exit doors must be accessible at all times. Never store items in front of the doors or otherwise block them. Never chain and padlock these doors. To keep staff from using these exits for a short-cut, a smoke break, or other non-emergency use, alarm the doors and post a warning that the alarm will go off when the doors are opened

33. Only public entity employees working in the medical field need to worry about infections that can be transmitted through contact with blood and body fluids.

FALSE - Anyone who comes into contact with blood or body fluids needs to take proper precautions. This would include first-aid for an injured co-worker or client, and maintenance staff called upon to clean up after an ill person. The greatest risks are from HIV and Hepatitis Band C. But other infections, such as Strep, pneumonia, and TB, can also be transmitted.

34. Employees should be trained to check vehicles before driving.

TRUE - Whether it's their own or the City's vehicle, workers should make certain key safety equipment is working as intended before driving off (the headlights and brake lights work, the wiper blades clean and do not smear, the horn honks, the brakes slow and stop the vehicle, the tires have treads, all the seatbelts function properly, and that the gas tank is full).

35. HIV is the most common bloodborne infection in the United States.

FALSE - OSHA reports that Hepatitis C infection is the most common chronic bloodborne infection in the United States, affecting approximately 4 million people. It is caused most commonly by needlestick injuries.

36. OSHA is just a regulatory agency; safety training and information must be obtained elsewhere.

FALSE - OSHA provides many e-Tools on various construction topics. These tools allow the user to get training and in some cases customize policies for their entities. Booklets, fact sheets, checklists, and alerts are available through the OSHA Web site.

37. A City is only responsible for ensuring that operators of vehicles used in the course of the City's operations are properly licensed.

FALSE - A City must ensure that operators of vehicles used in the course of its business are properly licensed, follow safety precautions, and are adequately trained to drive the kind of vehicle used on its behalf. This can be done by screening drivers, establishing driving policies, maximizing vehicular safety, and providing for vehicular inspection and maintenance.

38. A drug-free workplace policy with enforceable consequences for disregarding the policy contributes to a safe workplace.

TRUE - A drug-free workplace contributes to a safe workplace, because others' behavior affects the safety of fellow workers.

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93 39. Reassignment to light or modified duty can help reduce the overall costs and length of disability for a work-related accident.

TRUE - Light or modified duty is offered to an injured employee for a limited time. The program may start with less work and fewer hours than regular job requirements and is gradually increased as abilities return, until the person is able to fully function in the job.

40. Stress affects morale, productivity, and safety.

TRUE - Workplace stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the employee. Job design, relaxation techniques, individual levels of tolerance all enter into reducing the effects of stress on the job.

41. Employees need to discern an "empty threat" from one that is serious.

TRUE - Policies, procedures, and training will help workers identify a real threat to safety from an empty threat from a person on the phone or onsite.

42. Sometimes the least expensive warning device can be the most effective.

TRUE - Smoke alarms and fire extinguishers are the first lines of defense in the event of a fire in a building.

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94 SIGNS FOR POSTING

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95 Keep Us Safe
If an employee wishes to report a hazard, safety suggestion, Or other safety problem anonymously,
He or she can report it anonymously on the
City of Kerman Safety Tipline
(877) 312-6149
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96 AFTER CALLING 911

FOR ANY HAZARDOUS

MATERIAL SPILLS PESTICIDE EXPOSURES

OR ACCIDENTS INVOLVING BODILY FLUIDS
PLEASE CALL:

FRESNO COUNTY

EMERGENCY RESPONSE TEAM
AT
559-600-3271
MON – FRI (8:00 AM – 5:00 PM)

AFTER HOURS
559-600-3111
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97 County of Fresno
Adult Worker Offender Program
Employer Name City of Kerman
Employer’s Product/Service City Government
Mailing Address 850 S. Madera Ave
Work Site 15201 W. A Street
Public Works Secretary Denise Isaak
Phone Number (559) 846-9343, Opt 1
Email Address [email protected]
Federal Tax ID Number 94-6000351
State ID Number 74-900309
Worker’s Comp Carrier AIMS (self-insured-no Policy #)
If an AWOP person believes they have sustained a work related injury, they are to:

1.Immediately notify their Supervisor so the injury can be reported in a timely manner.

2.A call will be placed to the AMC Call Connect @ 1-844-691-4111.

3.If medical treatment is needed, the Supervisor will direct them to Concentra, or the nearest emergency room if immediate medical attention is needed. The City will provide them with the necessary paperwork.

4.The injured worker will update the Supervisor on the outcome of any medical appointments and turn in all notes issued by medical office.

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99 EMERGENCY
AMBULANCE: 911
FIRE – RESCUE: 911
HOSPITAL: FRESNO COMMUNITY – 559-459-6000
SAINT AGNES MEDICAL CENTER 559-449-5000
PHYSICIAN: WORKMAN’S WORKER’S COMP –

CONCENTRA
• NORTH FRESNO - 7265 N. 1ST STREET, #105; PHONE 431-8181 • SOUTH FRESNO - 2555 S. EAST AVENUE; PHONE 499-2400
• MADERA - 509 S. “I” STREET IN MADERA; PHONE 673-9020
APOLLO
 FRESNO - 6042 N FRESNO ST, STE 104; PHONE 515-6841
POLICE: 911
CAL/OSHA: 559-445-5302
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STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: Jesus A. Gonzalez, City Engineer
SUBJECT: Public Hearing and Authorization of Submission of Application for CDBG Funds for Fiscal Year 2025-2026 (JG)
RECOMMENDATION: Council conduct a public hearing and adopt the resolution authorizing the submission of an application for Community Development Block Grant (CDBG) funds for Fiscal Year 2025-2026 for the Kerckhoff Park Improvements.

EXECUTIVE SUMMARY:

The City of Kerman receives an annual allocation of Federal CDBG funds from the U.S.

Department of Housing and Urban Development (HUD) through an agreement with the County of Fresno (County). The City’s funding allocation for FY 2025-2026 is $226,250. Staff submitted to the County an application for restoration of the restrooms and baseball field grandstand at Kerckhoff Park. The County has determined that the proposed project is eligible for CDBG funding.

The proposed project is the interior restoration of the existing restrooms and baseball field grandstand at Kerckhoff Park. The project is located within an area, with over 54 percent of the area being low to moderate income households. A preliminary application for the proposed project was submitted to the County for verification of project eligibility and the County has determined the project to be eligible for funding.

A public hearing is required to be held to allow interested citizens the opportunity to comment on projects or activities submitted for CDBG funding. The Notice of Public Hearing was published in the Kerman News on October 30, 2024 and posted at City Hall.

FISCAL IMPACT:

The total estimated cost of the project is $241,250. The City’s FY 2025-2026 CDBG funding allocation is $226,250. The project overage in the amount of $15,000 will be through a local match funding source to be identified in the Fiscal Year 25-26 budget.

ATTACHMENTS:

A. Resolution
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Attachment ‘A’
RESOLUTION NO. 24-___

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF KERMAN

AUTHORIZING SUBMISSION OF APPLICATION FOR

COMMUNITY DEVELOPMENT BLOCK GRANT FUNDING
FOR FISCAL YEAR 2025-2026
WHEREAS, a Notice of Public Hearing was published in the Kerman News on October 30, 2024; and;
WHEREAS, the City Council held a Public Hearing to discuss an application for Community Development Block Grant (CDBG) Funds for Fiscal Year 2025-2026 on November 13, 2024; and WHEREAS, the City Council received a report from the City Engineer identifying the need for the restrooms restoration and baseball field grandstand at Kerckhoff Park.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF KERMAN RESOLVES AS FOLLOWS:

1. Submission of an application for CDBG Funds for 2025-2026 to the County of Fresno for restrooms and baseball field grandstand restoration at Kerckhoff Park is hereby authorized.

2. The City Manager is authorized to sign all application documents and funding agreements pertaining to said project.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regularly scheduled meeting held on the 13
th day of November 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:

The foregoing resolution is hereby approved.

Maria Pacheco
Mayor
ATTEST:

Josie Camacho
City Clerk
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STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: John Jansons, City Manager
SUBJECT: Discussion-Study Session on West Fresno County Solar Projects (JAJ) RECOMMENDATION: That Council hear a brief presentation regarding solar development in West Fresno County, including that of Westlands Water District, to become informed about current development proposals and any impacts to Kerman, with possible direction to staff.

BACKGROUND:

In March of 2024, the City was introduced to Keith Bergthold of Community Energy California advocating that community benefit provisions be imbedded in proposed large scale solar array developments in western Fresno County to the benefit of local cities. Much emphasis was placed on the creation of a Non-Profit Organization that would have a Board of Directors comprised of local Mayors to direct and control community benefits exacted from solar development projects.

It is staff’s understanding that local Mayors of West Fresno County cities, including Kerman, had been introduced to this issue and had meetings with Mr. Bergthold and his team (Rural Communities Rising) to discuss opportunities and effects of large-scale solar developments.

Peeked with interest, and in an attempt to better understand a burgeoning advocacy and organizing effort by Mr. Bergthold and others, Kerman hosted a meeting of West Fresno County City Managers in April to gain greater understanding of this subject area.

In June, Mr. Bergthold and his group were invited to brief City Council and describe their advocacy work, but did not accept the City’s offer indicating they would be busy throughout the summer doing community outreach activities for their newly rebranded organization, “Regenerate California Initiative” in conjunction with Rural Communities Rising.

In August, a follow-up meeting of Westside Mayors and representatives of Assembly Member Esmerelda Soria discussed Soria’s proposed legislation, AB 2661, which would condition development of large-scale solar development on Westlands Water District fallowed properties.

On September 26, 2024 Esmerelda Soria’s AB 2661 (Attachment ‘A’) was signed into law by Governor Newsom thereby setting conditions on solar development and energy generation, transmission, sale, storage, maintenance and community benefit programs, into law. 233
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Official Summary/Bill Text:

The California Water District Law provides for the establishment of water districts and authorizes a district to construct, maintain, and operate plants for the generation of hydroelectric energy and transmission lines for the conveyance of the hydroelectric energy. Existing law merged the former West Plains Water Storage District into the Westlands Water District, and provides for the operation of the Westlands Water District.

This bill would authorize the Westlands Water District to provide, generate, and deliver solar photovoltaic electricity and to construct, operate, and maintain works, facilities, improvements, and property necessary or convenient for generating and delivering that electricity. The bill would require the district to use the electricity for the district's own purposes, and the bill would authorize the district to sell surplus electricity to a public or private entity engaged in the distribution or sale of electricity. The bill would also authorize the district to construct, operate, and maintain energy storage systems and electric transmission lines, and to construct, operate, and maintain works, facilities, improvements, and property necessary or convenient for the operation of the energy storage systems and electric transmission lines, within the boundaries of the district, as specified. The bill would require the district to report the amount of income, and the purposes for expenditure of that income, from electricity facilities constructed pursuant to these provisions in a specified report. The bill would require the district to establish a community benefits agreement plan for a specified electrical infrastructure development plan and related transmission and other electrical projects, as provided. The bill makes legislative findings and declarations as to the necessity of a special statute for the Westlands Water District.

On October 10, 2024, Mayor Pacheco and City Manager Jansons accepted an invitation to tour the West County communities with other west Fresno County city representatives to describe their respective communities to Intersect Power solar developers (Attachment ‘B’) and provide a better understanding of West County communities, including Kerman, and the assets, opportunities, and challenges of each city. The narrated tour also featured a review of Kerman’s infrastructure and commercial businesses that could serve, support, or subcontract with the solar firms looking to develop nearby.

On October 16, 2024, the California Energy Commission (CEC) conducted and in-person “environmental scoping and informational meeting” at Harris Ranch to review the Darden (Intersect Power) Clean Energy Project. Materials associated with that CEC Hearing are included as Attachment ‘C’.

On October 23, 2024, Staff provided City Council with the project description materials from the Intersect Power sponsored tour along with a short briefing on the tour, and Council directed staff to return to Council with a report and presentation so as to discuss the matter in more depth.

Representatives of Assembly Member Soria’s office, a representative of Westlands Water District, representatives of Workforce Development Board, and a local solar engineering 234
Section 7, Item A.
consultant are scheduled to attend and support the discussion and be available for Council questions. Representatives of Intersect Power were not available due to a scheduling conflict, but offered to attend at a later date if requested.

FISCAL IMPACT:

There is no fiscal impact associated with receiving this presentation.

ATTACHMENTS:

A. AB 2661
B. Intersect Power Materials
C. CEC Notes
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Section 7, Item A.

Attachment 'A'

SENATE COMMITTEE ON ENERGY, UTILITIES AND

COMMUNICATIONS
Bill No:

Author:

Version:

Urgency:

Consultant:

Senator Steven Bradford, Chair
2023 - 2024 Regular
AB 2661
Soria
5/16/2024 Amended
No
Nidia Bautista
Hearing Date:

Fiscal:

SUBJECT: Electricity: Westlands Water District
7/2/2024
No
DIGEST: This bill authorizes the Westlands Water District (Westlands) to own electric generation, storage, and transmission facilities within the district and sell the output to public or investor-owned utilities (IOUs) for sale to retail customers.

ANALYSIS:

Existing law:
1) Establishes and vests the California Public Utilities Commission (CPUC) with regulatory authority over public utilities, including electric IOUs and transmission owners providing intrastate transmission services. (Article XII of the California Constitution)
2) Authorizes the CPUC to supervise and regulate every public utility, including electrical corporations, and to do all things that are necessary and convenient in the exercise of that power and jurisdiction. (Public Utilities Code §201 et seq. and §701)
3) Requires retail sellers and publicly owned utilities (POUs) to increase purchases of renewable energy such that at least 60 percent of retail sales are procured from eligible renewable energy resources by December 31, 2030. This is known as the Renewables Portfolio Standard (RPS). (Public Utilities Code §399.11 et seq.) 4) Establishes it is the policy of the state that eligible renewable energy resources and zero-carbon resources supply 100 percent of all retail sales of electricity to California end-use customers by December 31, 2045. (Public Utilities Code §454.53)
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1. Welcome
Attachment 'C'
AGENDA
Wednesday, October 16, 2024
Environmental Scoping and Informational Meeting
Darden Clean Energy Project (23-OPT-02)
The meeting begins at 2:00 p.m. and will conclude at 6:30 p.m.

All start and end times are estimates

2. Presentation by CEC staff on the opt-in certification process

3. Presentation by the CEC Office of the Public Advisor, Energy Equity, and Tribal Affairs on public and tribal participation opportunities

4. Initial Comment Period to accommodate participants who will not be able to stay the duration of the event for the closing comment period

5. Presentation by the applicant on the project as currently proposed, including information on project features which address mandatory requirements of the opt-in certification process ( e.g., labor agreements/prevailing wage, economic benefits, community benefits)

6. CEC staff presentation on analysis and issues identified (Break)

7. Comments from California Native American Tribes, responsible and trustee agencies, elected officials, other government agencies
(Break)

8. Comments from interested members of the public, neighboring communities, and other individuals and entities

9. Adjourn
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STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: Jesus A. Gonzalez, City Engineer
SUBJECT: Award of Contract for the Hart Ranch Community Park Project to Avison Construction, Inc. (JG)
RECOMMENDATION: Council by motion adopt the resolution:

1. Awarding the Hart Ranch Community Park Project contract to Avison Construction, Inc. in the amount of $12,453,125.00; and

2. Authorizing a 5% construction contingency in the amount of $622,700.00; and

3. Authorizing the City Manager to sign the construction contract on behalf of the City; and

4. Authorizing the City Manager to sign change orders, up to the additional contingency amount, on behalf of the City.

EXECUTIVE SUMMARY:

The Hart Ranch Community Park (Project) is the development of a 15-acre portion of land located in the southeast quadrant of the City, at California and Goldenrod Avenues. Its history dates back to the 2008 receipt of a 15-acre land donation by the Giacolini family. Lack of funding at the time prevented the immediate development of the Project; however, it did allow for holding community outreach activities. Design of the Project began in 2019, and took into consideration the community’s input, resulting in amenities such as a lake feature, community garden, multiple play areas including a splash pad, multi-use fields, a nature trail and exercise equipment.

On June 26, 2024, the City advertised the Project for construction services with four contractors submitting by the August 7, 2024, 2:00 PM deadline. The process ultimately resulted in a September 25, 2024 rejection of bids due to a lack of clarity in the bid documents as to licensure, qualifications, the “allowance” aspect of the lake portion of the Project, and requirements that may have limited competition.

On October 9, 2024, following revisions to the construction documents, the City once again advertised the Project for construction services with four contractors submitting by the November 6, 2024, 2:00 PM deadline. The results are as follows:
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Contractor Name Base Bid
Avison Construction, Inc. (Avison) $12,453,125.00
Caliber Contracting Services $12,869,000.00
Cal Valley Construction, Inc. $12,915,764.74
American Paving Co. $13,495,842.20
Staff has reviewed the bid submitted by Avison, along with information regarding their previous work experience. Based on review, Staff has determined the bid received to be responsive and Avison to be a responsible contractor. Avison’s bid is above the Engineer’s Estimate of $12,300,00.00.

FISCAL IMPACT:

The estimated total Project cost is $14,200,000 for design, construction, construction contingency, construction engineering and materials testing. The City has budgeted $12,830,408.00 from various funding sources including the American Rescue Plan Act (ARPA), Measure M, Land and Water Conservation grant funding, California Natural Resources Agency Proposition 68 grant funding, and State Budget earmarked funds. Staff recommends that the short fall of $1,369,952.00 be funded from Measure M.

ATTACHMENTS:

A. Resolution
297
Section 7, Item B.

Attachment ‘A’
RESOLUTION NO. 24-___

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF KERMAN

AWARDING CONTRACT FOR THE HART RANCH COMMUNITY PARK PROJECT TO AVISON CONSTRUCTION, INC.

WHEREAS, the Invitation to Bid for the Hart Ranch Community Park Project was published in the Kerman News on October 16, 2024 and was sent electronically and mailed to all construction trade journals specified for the City by the California Uniform Construction Cost Accounting Commission in accordance with the City’s Formal Contract Procedures and California Public Contract Code Section 22037; and
WHEREAS, the Project will construct a 15-acre park at the northeast corner of the California and Goldenrod Avenues intersection, within the City of Kerman; and WHEREAS, the following bids for the Project were publicly opened and read aloud at the Kerman City Hall on November 6, 2024 at 2:00 p.m.:

Contractor Name Base Bid
Avison Construction, Inc. (Avison) $12,453,125.00
Caliber Contracting Services $12,869,000.00
Cal Valley Construction, Inc. $12,915,764.74
American Paving Co. $13,495,842.20
WHEREAS, the City Engineer’s Estimate was $12,300,000.00.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF KERMAN RESOLVES AS FOLLOWS:

1. The foregoing recitals are true and correct and incorporated by reference.

2. Upon the recommendation of the City Engineer, the Council awards Hart Ranch Community Park Project to Avison Construction, Inc., 40434 Brickyard Drive, Madera, CA 93636 in the amount of Twelve Million and Four Hundred and FiftyThree Thousand and One Hundred and Twenty-Five Dollars and Zero Cents ($12,453,125.00) which is incorporated by reference.

3. The City Manager is authorized to sign the City's standard form of agreement for construction projects, as contained in the bid package on behalf of the City of Kerman.
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4. Upon the recommendation of the City Engineer, the Council authorizes a contingency amount of Six Hundred and Twenty-Two Thousand and Seven Hundred Dollars and Zero Cents ($622,700.00) as contingency for use on unforeseen construction needs.

5. The City Manager is authorized to sign change orders up to the additional contingency amount.

6. This resolution is effective upon adoption.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regularly scheduled meeting held on the 13th day of November 2024, by the following vote:

AYES:

NOES:

ABSTAIN:

ABSENT:

The foregoing resolution is hereby approved.

Maria Pacheco
Mayor
ATTEST:

Josie Camacho
City Clerk
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STAFF REPORT
MEETING DATE: November 13, 2024
PRESENTER: Hilda Cantú Montoy, City Attorney
SUBJECT: Third Amendment to Employment Agreement with City Manager (HCM) RECOMMENDATION: Council is asked to consider and determine whether to adopt a resolution approving a third amendment to Employment Agreement with City Manager.

EXECUTIVE SUMMARY:

The City and City Manager John Jansons entered into an Employment Agreement (“Agreement”) effective December 1, 2019, and amended on October 1, 2021, and August 9, 2023. Subsequent to the recent completion of the City Manager’s performance evaluation, the City Council, through an Ad Hoc Committee comprised of the Mayor and Council Member Yep, conducted contract negotiations with the City Manager. The parties wish to amend the Employment Agreement as set forth in the Third Amendment to Employment Agreement attached to the proposed resolution regarding this matter.

DISCUSSION:

The Brown Act Requires that prior to taking final action, the legislative body shall orally report a summary of a recommendation for a final action on the salaries, salary schedules, or compensation paid in the form of fringe benefits of a local agency executive during the open meeting in which the final action is to be taken. See Government Code § 54953 (c) (3). A summary of the amended Agreement is described in this staff report per the text that is required to be read aloud by the Mayor at the Council Meeting.

Announcement by Mayor –
As required by the Brown Act (Government Code § 54953 (c) (3)), prior to taking action on this item, the Council must publicly announce a summary of the action being considered. If adopted, the proposed resolution will approve the Third Amendment to Employment Agreement with City Manager John Jansons as follows:
 The current term of the Employment Agreement ends in three years on November 30, 2027. This amendment extends it for an additional two years to November 30, 2029.
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 Effective July 1, 2024, as per the last performance evaluation, the City Manager will be paid an annual base salary of $191,448.00 ($15,954.00 monthly) per year paid in accordance with the City’s payroll procedures.

ATTACHMENTS:

A. Resolution w/Exhibit
301
Section 7, Item C.

Attachment ‘A’
RESOLUTION NO. 24-__

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF KERMAN APPROVING A

THIRD AMENDMENT TO EMPLOYMENT AGREEMENT WITH CITY MANAGER WHEREAS, On December 1, 2019, the City and City Manager entered into an At-Will Employment Agreement; and
WHEREAS, the Agreement has been modified twice; and
WHEREAS, the City Council and City Manager desire to amend the Agreement to extend the term of the Agreement and to add a base salary increase.

NOW, THEREFORE, the City Council of the City of Kerman hereby resolves as follows:

1. The above recitals are true and correct.

2. The City Council approves the Third Amendment to Employment Agreement with City Manager John Jansons attached hereto as Exhibit ‘A’ and incorporated by reference.

3. This resolution is effective immediately upon adoption.

The foregoing resolution was adopted by the City Council of the City of Kerman at a regularly scheduled meeting held on the 13th day of November 2024, by the following vote.

AYES:

NOES:

ABSTAIN:

ABSENT:

The foregoing resolution is hereby approved.
_______________________
Maria Pacheco
Mayor
ATTEST:
_________________________
Josie Camacho
City Clerk
302
Section 7, Item C.

Exhibit ‘A’

THIRD AMENDMENT TO CITY OF KERMAN

AGREEMENT FOR EMPLOYMENT OF CITY MANAGER
This Third Amendment to Employment Agreement (“Third Amendment”) is made and entered on November 14, 2024, by and between the City of Kerman (“City”) and John Jansons (“Employee”).

RECITALS
WHEREAS, City and Employee entered an Employment Agreement (“Agreement”) effective December 1, 2019; and
WHEREAS, the Agreement has been modified twice by the parties; and WHEREAS, City and Employee desire to continue the employment relationship and to make certain modifications to the Agreement.

AGREEMENT
NOW THEREFORE, in consideration of the foregoing recitals and the mutual promises and covenants herein contained, the parties agree as follows:

SECTION 1. Section 3 of the Employment Agreement is amended to read as follows and to repeal prior text in Section 3:

3. Term of Agreement.

The current Agreement expires on November 30, 2027. The term of the Agreement is extended to November 30, 2029. The term of this Agreement shall be at the will of either party.

SECTION 2. Section 4 of the Employment Agreement is amended to read as follows:

4. Salary.

Based on the salary increase received effective July 1, 2024, Employee shall be paid an annual base salary of $191,448.00 ($15,954.00 monthly) per year paid in accordance with the City’s payroll procedures.

SECTION 3. Except as amended by this Third Amendment to Agreement, all other terms in the Employment Agreement shall continue in full force and effect. 303
Section 7, Item C.

IN WITNESS WHEREOF, the City of Kerman has caused this Third Agreement to Employment Agreement to be executed on its behalf by its Mayor and duly attested by its City Clerk, and John Jansons has signed and executed this Agreement on the day and year written below.

CITY OF KERMAN EMPLOYEE
______________________________ ____________________________ Maria Pacheco, Mayor John Jansons
Date: _________________________ Date: _______________________ ATTEST:
____________________________________
Josie Camacho, City Clerk
APPROVED AS TO FORM:
______________________________________
Hilda Cantú Montoy, City Attorney
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Section 7, Item C.

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