Illness and Injury Reporting How-To Information

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This How-To Information will assist you with finding the appropriate forms to use for reporting illnesses and injuries.


HOW TO INFORMATION


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BBP Exposure Report

Who: Staff or Faculty

When: Use this form to document all incidents involving blood or potentially infectious material that may have resulted in personnel exposure.  When in doubt, use this form and report the incident as soon as possible to the immediate supervisor, but no later than the end of the work shift.

How: This form and a copy of the Supervisors Report of Injury should be provided to the attending physician.  The physician should send the completed form to the Office of Human Resources to be filed with the employees’ occupational medical records.

Form: BBP Exposure Report

Related Information:


To find out more, go to: Illness and Injury Prevention Programs

Sharps Injury Log

Who: Staff or Faculty

When: Use this form to report a Sharps injury

How: Complete all sections of the form, make photocopy for your records, and send the original the Office of Human Resources.

Form: Sharps Injury Log

Related Information:


To find out more, go to: Illness and Injury Prevention Programs

Supervisors Report of Injury

Who: Supervisor of injured worker

When: Immediately after the injury is known, the injured worker’s Supervisor should complete this form. 

How: Complete all sections of the form, make photocopy for your records, and send the original the Office of Human Resources.

Form: Supervisors Report of Injury


To find out more, go to: HR's Workers' Compensation

Student and Visitor Injury or Accident Report

Who: Staff or Faculty

When: Use this form whenever a student or visitor is injured or in an accident that does not involve vehicles.

Note:
Students, visitors, and others should report incidents and/or accidents by contacting University Police or Risk Management in non-Emergency situations.  Students should report to the Faculty supervising during the time of the incident if the incident occurs during class or laboratory session.  Risk Management will follow up with the responsible University staff regarding the reported Accident/Incident.

Serious Incidents / Incidents Must Be Reported to University Police Department as soon as possible and will be assigned a UPD case number.

  • Faculty and Staff should complete the California State STD 268 within 48 hours of the accident.
  • Student and visitors should file a campus Incident Report.

How: Complete this form, retain a copy for your department, send a copy to UPD, and route the original to SRM

Form: Student and Visitor Injury or Accident Report


To find out more, go to: Employee and Supervisor Illness and Injury Reporting