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Flashcards in 121s Deck (15)
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1
Q

Employee must notify a supervisor of an injury or illness:

A

as soon as possible.

2
Q

Employee must complete a 121B and 121C:

A

within 24 hours.

3
Q

Employee must sign Field Injury File copy of the CHP 121 and CHP 121A:

A

within 24 hours.

4
Q

Supervisor must provide employee with CHP 600 and CHP 601:

A

within 24 hours.

5
Q

Supervisor must complete and sign CHP 121 and CHP 121A within 24 hours. Where does the original CHP 121 go?

A

Original is retained and placed in the employee’s Field Injury File. However, if Nondisabling Injury or Illness, original is sent to SCIF. Also, initiate and sign a SCIF 3301 (if Nondisabling Injury or Illness) and provide to employee.

6
Q

Supervisor must update CHP 442:

A

within 3 days.

7
Q

Commander or designee must review and sign CHP 121 and CHP 121A:

A

within 3 days.

8
Q

If illness, Commander or designee must ensure OSHA No. 200 Log is completed:

A

within 6 workdays. One copy of the CHP 121 is placed in the OSHA 200 Log File.

9
Q

Employee’s CHP 442 is located:

A

in the employee’s Field Folder.

10
Q

What copies does Division receive and how long do you have to forward?

A
· CHP 121
· CHP 121A
· CHP 121B
· CHP 121C
· CHP 270, Page 7 (if
applicable)
· CHP 442

Forward within 5 days of injury.

11
Q

What must a employee prepare if there is a status change to a first-aid injury or illness?

A

A CHP 51, Memorandum, with any medical documentation attached. Must be within 24 hours of the change.

12
Q

When is SCIF notified for a Status Change to First-Aid Injury or Illness?

A

When medical expenses are incurred. Remove original CHP 121 from Field Folder and forward it with a copy of the CHP 51 to SCIF within 5 days of the change.

13
Q

What must a supervisor prepare for a Status Change to a Nondisabling Injury or Illness?

A

Initiate SCIF 3301 and provide to employee within 24 hours and prepare a Status Change Comm-Net message.

14
Q

A Comm-Net Message shall be transmitted to Disability and Retirement Unit (DRU) within 24 hours of notification of a:

A

nondisabling (other than record only or first aid) or disabling occupational injury or illness.

15
Q

The commander or designee shall review the commander’s memorandum and attachment with the employee within:

A

24 hours of notification of an injury or illness

other than record only or first aid.