IIPP/ Safety
Forms

Injury and Illness Prevention Program: This program is for  all SIPE districts to use

Forms:

Mobile Elevating Work Platforms Pre-Use Inspection Checklist

Vehicle Inspection Form

Employee Safety and Health Record (SIPE Form 1-588) for Santa Barbara County school employees. File this form with employee's safety record maintained by supervisor.

Employee and Supervisor's Incident Report (SIPE Form 6-588)

Workplace Violence Incident Report (SIPE Form 7-333)

Safety Hazard/Suggestion Report Form (SIPE Form 2-588)

Hepatitis B Immunization Consent/Waiver Form (SIPE Form 93-1003)

Safety Incentive Funding Request Form (SIPE form 93-1000)

DPR Pesticide Use Reporting Form (State of California Form DPR-HSA-118)

These forms are in PDF format. In order to fill out and save the "filled out" version, you must have Adobe Acrobat Professional 7.0.

You will be able to fill out the form online and print the completed form if you have the latest version of Adobe Reader, which is available for free. Otherwise, you can print the form and fill it out by hand.

Injury and Illness Prevention Program 

Injury and Illness Prevention Program: The Santa Barbara County Schools Joint Powers Self-Insurance Program for Employees (SIPE) has developed an injury and illness prevention program to enhance our employee's health and safety in the workplace. This program applies to all schools enrolled under SIPE.

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