Welcome to the APPappReady to begin? Use the form below to create your Accident Prevention Program document:For best results, use the TAB key to move from one field to the next. Review the checklist before you begin, but don't worry if you are missing information. You'll review and complete the document in Word after you download it. When you are done, click Submit my Entries & Get my Document. Organization(Required)Enter the legal or official name or your organization:Address(Required)Your Accident Prevention Program will apply to this location. If you have more than one location, you may need different documents for each one.Email(Required) Safety Orientation ContactWho is responsible for conducting safety orientations?Safety Orientation PhoneEnter their phone number.Safety Orientation EmailEnter their email address. Number of Employees(Required) 1-10 employees 11 or more employeesSafety CommitteeOrganizations with 11 or more employees must have a safety committee that holds regular meetings and keeps minutes. What is your safety committee policy?Safety MeetingsOrganizations with 10 or fewer employees are not required to have a safety committee, but must hold regular safety meetings and keep minutes. What is your safety meeting policy?Reporting an InjuryIf an employee gets injured or becomes ill on the job, who should they report it to?First Aid LocationWhere is the first aid kit located?First Aid/CPR HelpIn the event of an emergency, who is trained in first aid and/or CPR?Emergency Phone LocationWhere is the list of emergency phone numbers located?Evacuation Map LocationIf you have an evacuation map for your facility, where is it located?Fire EmergenciesWhat should employees do in the event of a fire?Fire Extinguisher LocationsWhere are fire extinguishers located?Fire Extinguisher UseWho is knowledgeable about fire procedures and fire extinguisher use and can provide training?Earthquake ResponseWhat should employees do in the event of an earthquake?Earthquake Shutoff ValvesAre there emergency shutoff valves on the premises? Where are they located?Earthquake Gathering PlaceIs there a designated gathering place in the event of an earthquake? Where is it?Earthquake ContactPerson who knows about earthquake procedures and can provide training.Violence/Active Shooter IncidentWhat should employees do in the event of an incident?Violence/Active Shooter ContactPerson who conducts drills and/or briefs employees about what to do.Reporting Hazards and Unsafe PracticesIf an employee sees a hazard or unsafe practice, who should they report it to?Areas of Safety ConcernCheck the box for any items that apply to your location. PPE (Personal Protective Equipment) Food Safety Driving/Vehicle Operation Burns and Scalds Medications and Hazardous Substances Safe Lifting Slips and Falls Electrical Hazards Cut Prevention and Knife Safety Power Tools and Heavy EquipmentHiddenPPE headerHiddenPPE DetailsEnter the details of your PPE policy, including procedures, safety tips, and the name of the person responsible for training and orientation in the correct use of PPE:HiddenFood Safety HeaderHiddenFood Safety DetailsEnter the details of your food safety policy, including procedures, safety tips, and the name of the person responsible for training and orientation on food safety:HiddenDriving HeaderHiddenDriving DetailsEnter the details of your driving/vehicle operation policy, including procedures, safety tips, and the name of the person responsible for training and orientation:HiddenBurn HeaderHiddenBurn DetailsEnter the details of your policy to prevent burns and scalds, including procedures, safety tips, and the name of the person responsible for training and orientation:HiddenMedications HeaderHiddenMedications DetailsEnter the details of your policy for handling hazardous substances, including medications. Include details about PPE, procedures, safety tips, and the name of the person responsible for training and orientation:HiddenSafe Lifting HeaderHiddenSafe Lifting DetailsEnter the details of your safe lifting policy, including procedures, tips for taking care of your back, and the name of the person responsible for training and orientation:HiddenSlips and Falls HeaderHiddenSlips and Falls DetailsEnter the details of your slips and falls policy, including procedures, safety tips, and the name of the person responsible for training and orientation:HiddenElectrical HeaderHiddenElectrical DetailsEnter the details of your policy on electrical hazards, including procedures, safety tips, and the name of the person responsible for training and orientation:HiddenCut HeaderHiddenCut DetailsEnter the details of your policy on cut prevention and knife safety, including procedures, safety tips, and the name of the person responsible for training and orientation:HiddenHeavy Equipment HeaderHiddenHeavy Equipment DetailsEnter the details of your power tool and heavy equipment policy, including procedures, PPE, safety tips, and the name of the person responsible for training and orientation: