Cal OSHA Form 300A - California Department of Indust rial Relations

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What is Cal OSHA Form 300A?

The OSHA form 300A represents the Annual Summary of Work-Related Injuries and Illnesses. This is Appendix B. The form is provided by the Division of Occupational Safety and Health from the California Department of Industrial Relations. According to the law that is used in the territory of California, every establishment has to provide the report, using OSHA 300A form PDF. Even if there were no injuries related to work, employers have to fill out the template. You have to use the Log so all your entries will be verified. Don’t complete the form without it, since it will not count. Each category must be calculated separately. You also need to calculate the total there. If you did not have any work-related injuries, you can put “0” in the section.

While the OSHA 300A form fillable option belongs to employers mainly, employees and even former employees can ask to review the document. It must be available for them. The fillable OSHA 300A form has a deadline. You need to fill it out between February and April 30.

Cal OSHA Form 300A - California Department of Indust rial Relations on PDFLiner

What I need the Cal OSHA Form 300A for?

  • Employers have to use OSHA 300A form printable version to report each injury and illness of an employee that is related to the working procedures. If an employee can’t work due to the injury and is restricted from performing specific actions that must be documented;

  • Employers need OSHA form 300A PDF fillable to file it to the Department, even if there were no related to work injuries or illness. In this case, employer has to mention that there are no such cases in total, but still send the form to the Department;

  • Employees can ask their employer to show OSHA form 300A printable document if their names are mentioned. The employer has to reveal the data in this case.

How to fill out Cal OSHA Form 300A?

You can easily find the template available on the official website of the Department of Industrial Relations in California. You can read it there and even download it on your computer. Yet, if you want form 300A fillable online you need to use an editor for PDF, like PDFLiner. Enter the form there and begin to fill it out. Once you are done, you can print it, save it on your device, and send it to the officials via email or by regular mail. Make sure you calculate the deadline properly since regular mail travels slower than email. You can add the report to the employees who want to see it via email. Here is what you need to include in the printable 300A form:

  1. Provide information on the establishment, including the name, address, description of the industry, information on the employment, and average number of employees during the year;

  2. Provide information on the number of cases related to the work, including the total number of deaths, transfers, and number of days employees spent away from work;

  3. Calculate the number of days each employee received off the work based on the trauma;

  4. Mention the illness and injuries types;

  5. Provide your phone number, date, and signature.

Organizations that work with Cal OSHA Form 300A

  • California Department of Industrial Relations Division of Occupational Safety and Health.
Fillable online Cal OSHA Form 300A - California Department of Indust rial Relations
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