MEMORANDUM
DATE:
October 26, 2016
TO:
MPP’s and Leads
FROM:
Kellie Garcia, Associate Vice President
Human Resources & Administrative Services
SUBJECT:
Risk Management Procedures and Campus Contacts
In order to be responsive to circumstances that may arise on campus, it is important to
review periodically the risk management procedures to help you handle the following
situations: a worker’s compensation or liability claim; an injury to a student or member of
the public; subpoenas; or vehicle accident and reporting measures. These procedures
apply to State and Auxiliary operations, facilities and equipment.
Tim Ridley, CSP ARM-P, Director of Safety & Risk Management, Administration West
Building, Room 101, will provide assistance with Environmental, Health & Safety
procedures. Please call 661-654-6320 to pick up forms or ask questions regarding the
following:
Workers’ Compensation
Any time an employee reports an injury, it is important to notify Human Resources (HR)
immediately at 661-654-2266. HR staff will assure that all other appropriate parties are
informed of the incident. Management personnel are responsible for completing the
Supervisor’s First Report of Injury (SFR) form. Send the SFR to HR within 24 hours
following your first knowledge of the injury. All other reports and official submissions for
the campus will be coordinated and sent by the Worker’s Compensation Administrator
in HR. It is important to report all injuries to HR, not just those you consider important.
The SFR form is available on the HR website:
https://www.csub.edu/bas/hr/_files/_Workers_Comp_Files/WCCSUB_Supervisor_Injury_Report_Form.pdf
The document is also located at the Student Health Center.
Memorandum: Risk Management Procedures and Campus Contacts
October 26, 2016
Page 2
When filling out the SFR form, document everything possible and include pictures,
documents, and witness statements. It is important to document the events surrounding
an injury as early as possible. The actual workers’ compensation disposition date could
be months after the date of injury and specific details of incidents fade over time. Be
attentive in making statements regarding responsibility for the injury or who was “at
fault” or who was “to blame”. Be cautious with statements regarding the injury that can
be misconstrued or misinterpreted. The Workers’ Compensation Board has
responsibility for conducting an investigation into the matter.
Liability Claims
Whenever there is a possibility that someone may make a claim for wrong doing, the
campus is faced with a liability exposure. Any potential liability case that you are aware
of should be immediately reported to Tim Ridley. Individuals are not allowed to bring suit
against the State until they have exhausted the State’s Victim’s Compensation and
Claims process.
Do not talk to, or provide information to any off-campus personnel, including attorneys,
without prior approval from Safety & Risk Management. Often we must forward the case
to the CSU General Counsel or the Attorney General’s Office and are advised to say
nothing without legal counsel present. Even in the presence of counsel, it is important to
answer only the questions asked and not volunteer any additional information. Be
honest in all cases, but never speculate or offer opinions. Report only the facts of the
case. Do not discuss who was “at fault” with anyone at the scene. Do not draw any
“conclusions” in any written reports. Avoid the “I told you so” syndrome.
Public Injury Reports
University Police should be immediately called to the scene of all accidents with injuries
to students or members of the public. To contact University Police by campus phone,
dial 911 or extension 2111. If using a non-campus phone call 661-654-2111. If the
accident is severe, Public Safety Dispatch will notify the Office of Safety & Risk
Management immediately. Safety & Risk Management will coordinate a file for each
situation. This process helps the campus to better respond to the general public or legal
counsel. Follow the same communication guidelines discussed above under liability
claims.
Vehicle Accidents
Standard Forms 269, 270, and 274 may be obtained from Safety and Risk Management
Office. A copy of Standard Form 269, Accident Identification, shall be carried in all State
vehicles. This form should also be carried when operating a privately owned car
or rental vehicle on state business. In the event of a vehicle accident, complete as
much of the form as possible, tear off the perforated part and give it to the other driver.
This will provide them with contact information for the campus.
Memorandum: Risk Management Procedures and Campus Contacts
October 26, 2016
Page 3
Use Standard Form 270 to report all vehicle accidents. The completed report must be
signed by the vehicle operator and their supervisor and delivered to the Office of Safety
& Risk Management within 48 hours. Accidents resulting in injury to persons or involving
serious property damage must also be reported immediately. Accidents occurring
during the weekend should be reported directly to the California Office of Risk
and Insurance Management (ORIM) at 1-800-900-3634. On weekends, the driver of
the vehicle should fax Standard Form 270 to ORIM at 1-916-376-5277. Safety &
Risk Management should be notified on the first workday following a weekend accident.
Do not discuss the accident with anyone except investigating traffic officers, your
supervisor, authorized state officers, or the State’s insurance adjusters.
Supervisor’s Review and Police Reports
The supervisor of an employee involved in an accident must investigate the accident
and complete the State Driver Accident Review Standard Form 274. The supervisor
should take appropriate corrective action and forward Standard Form 274 to the Office
of Safety & Risk Management. If a California Highway Patrol or other police accident
report is needed, a copy of the report can be obtained from the law enforcement agency
at no cost. An accident that involves a privately owned car or commercial automobile
rental being driven on State business will also be reported on Standard Form 270.
Follow the instructions stated above, but clearly mark the form “Privately Owned Vehicle
Involved”.
Subpoenas
The office of the Vice President for Business and Administrative Services, located in
Administrative Building, Room 103, will continue to coordinate receipt of campus
subpoenas to ensure proper documentation. For assistance, please call 661-654-2287.
If you accept subpoena service, please forward the documents within 24 hours. Do not
provide any information or answer any questions until the subpoena has been reviewed
to determine appropriate action.
This information is provided in order to help increase your awareness of the risk
management processes. Your cooperation and assistance with implementation of the
Risk Management Program is greatly appreciated.
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