Embedded within the intricacies of workplace safety protocols and health management strategies, the Ohio DFSP-5 form, operating under the aegis of the Drug-Free Safety Program (DFSP), serves as a comprehensive action plan designed to guide employers through the systematic improvement of their safety and health processes. This form not only sets out to review and evaluate the results from the Safety Management Self-Assessment but also embarks on detailing a structured plan that identifies, prioritizes, and outlines steps to manage actionable items aimed at enhancing workplace safety. Employers are encouraged to delineate specific actions, the responsible individuals, completion timelines, and the anticipated improvement outcomes for key areas such as management commitment, accountability, employee participation, safety culture, hazard prevention, safety education, accident analysis, workers' compensation claims management, return-to-work practices, and employee wellness programs. Offering a channel for accessing personalized assistance via a dedicated BWC representative, this document underscores the importance of a collaborative, participatory approach towards fostering a safer, more health-conscious work environment. Furthermore, the form embodies a systematic approach to reinforcing the organizational values related to safety and health, ensuring that the journey towards achieving an optimal safety and health process is well documented, carefully planned and responsibly managed.
| Question | Answer |
|---|---|
| Form Name | Ohio Form Dfsp 5 |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | state of ohio bwc website, form safety action, dfsp enrolled, ohio dfsp 5 |
Company name
Policy number
The purpose of an action plan is to help employers improve their safety and health processes. Review the results from the Safety Management
For each section determine:
1.What actions (if any) you will take and how they will be accomplished?
2.Who will be responsible for ensuring the completion of each action item?
3.When will each planned action item be completed?
4.What is the expected improvement to your safety and health process once the action item is completed?
1.Management commitment
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
2.Accountability
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
3.Employee participation
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
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4.Safety culture
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
5.Hazard prevention and control
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
6.Safety and health training and education – The process of ensuring safety education and training is provided to people at all levels, and that skills are assessed to ensure understanding
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
7.Accident analysis – The method of gathering and analyzing accident information; determining root causes and identifying safety improvements to prevent future accidents
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
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8.Workers’ compensation claims management
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
9.
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
10.Employee health promotion (wellness) – The organization’s efforts to encourage personal health improvement and health maintenance among its employees
Planned activity (attach separate sheet if needed)
Person responsible
Target date
Describe how this completed activity will improve your safety and health process
X
Signature of company official responsible for this action plan |
Date submitted |
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