California Personnel Advisor—Forms
Note: Only forms noted as "Printable" may be downloaded
and printed. All other forms will be made available upon your paid subscription.
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ACCIDENT INVESTIGATION REPORT —Document the cause and action taken as the result of an accident
- AFFIDAVIT TO COLLECT COMPENSATION OF DECEASED EMPLOYEE
—Form to
be completed by surviving spouse, registered domestic partner, guardian or
conservator of the estate in order to obtain deceased employee's wages,
up to $5,000 (members only)
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AFFIRMATIVE ACTION PLAN MODEL—Document
Affirmative Action analysis
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- AMERICANS
WITH DISABILITIES —Reasonable
accommodation forms (members only)
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ATTENDANCE
LOG—Track
employee attendance for an entire year.
Record vacation, sick days,
family leave and other absences.
- BACKGROUND CHECK AUTHORIZATION FORM
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- CAL/OSHA—Employer Records of
Occupational Injuries and Illnesses
The following links provide the
required occupational injury and
illness forms
and instructions under Cal/OSHA.
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Appendix
A—Cal/OSHA
Form 300—Log
of Work-Related Injuries and Illnesses
(revised 7/2007)
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Appendix
B—Cal/OSHA
Form 300A—Summary of Work-Related Injuries and
Illnesses (revised 7/2007)
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Appendix
C—Cal/OSHA
Form 301—Injury and Illness Incident Report
(revised 7/2007)
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Appendix D—Instructions
to Complete Cal/OSHA Form 300
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Appendix E—Instructions
to Complete Cal/OSHA Form 300A
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Appendix F—Instructions
to Complete Cal/OSHA Form 301
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Appendix
G (Optional Form)—Worksheet
to Help You Fill Out the Annual Summary
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Exempt
employers (those not
subject to record keeping
requirements)
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CERTIFICATION OF FITNESS FOR DUTY—Fitness
for duty certification by health care
provider regarding employee's ability to
return to work.
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CHECKLIST FOR BARRIERS FOR DISABLED WORKERS—Assess the workplace to accommodate persons with disabilities
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CHECKLIST FOR NEW EMPLOYEES—Orientation of new employees
- COBRA MODEL FORMS—Model "General" Notice and "Election" Notice of
COBRA Continuation Coverage Rights
- DIRECT DEPOSIT AUTHORIZATION FORM—Optional form for
payroll direct deposit authorization and bank information
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EMPLOYEE DEVELOPMENT PLAN—Develop plans to increase skills and knowledge for employers and employees
- EMPLOYEE HANDBOOK—Employers
can use the employee handbook template to create or revise a company
employee policy handbook
- EMPLOYEE HANDBOOK
ACKNOWLEDGMENT FORM—Acknowledges
receipt of employee handbook.
- EMPLOYMENT DECISION TABLE—Decision making during the hiring selection process
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EMPLOYMENT INTERVIEW EVALUATION—Evaluate an applicant during an interview
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EXEMPT JOB DESCRIPTION—Write exempt job descriptions
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EXIT INTERVIEW—Obtain information from an employee about the job, management and the organization
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- FAMILY MEDICAL LEAVE ACT—FMLA Forms
(members only) (Revised January 2009):
- Medical Certificate Forms (two
forms that may be used to obtain medical certificate from healthcare provider):
▪ For Employee's Serious Health
Condition (Form WH-380E)
▪ For Family Member's Serious Health Condition (Form WH-380F)
- Notice of Eligibility and Rights & Responsibilities
(WH-381) (may be used
to respond to employee's request for leave)
- Designation Notice (WH-382) (to approve or deny
employee’s request for leave)
- Military Leave Certification (two forms
that may be used to obtain certification for FMLA military leave):
▪ Certification of Qualifying Exigency for Military
Family Leave (WH-384)
▪ Certification of Serious Injury or Illness of Covered Service Member
(WH-385)
- Employee Request for FMLA Leave Form (sample
form employees may use when requesting family leave)
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INCIDENT RESOLUTION FORM—Document resolutions to workplace incidents
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INTERNET AND COMPUTER USAGE POLICY—Company policy for employee's use of company automation, including all forms of Internet/Intranet access
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LEAVE OF ABSENCE REQUEST FORM—Sample
form employees may use when requesting leave
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NAME/ADDRESS
CHANGE FORM—Record
and document employee name or address
changes
- NEW EMPLOYEE INFORMATION FORM—Emergency and general
contact information for the employee
- NEW HIRE PACKET—Complete packet of forms and required
notices for new employees
- NEW
HIRE REPORTING FORM—New
Hire Reporting forms for California and
multi-state employers
―
California New Hire Reporting (Form DE
34)
―
Multistate Employers
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NON-EXEMPT JOB DESCRIPTION—Write non-exempt job descriptions
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ONE-ON-ONE MEETING GUIDE—Organize and document one-on-one meetings
- OUTLINE FOR JOB OFFER LETTER—Send to an applicant to make a job offer
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PERFORMANCE PLAN AND EVALUATION—Evaluate individual workers or teams of workers
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SAFETY DEPARTMENT MEETING—Document department safety and health meetings
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REPORTING
INDEPENDENT CONTRACTORS—File
reports with the California
Employment Development Department (EDD)—(For employers who use independent
contractors)
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SAFETY INSPECTION CHECKLIST—Assess the safety of the workplace
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STAFFING PLAN GUIDE—Develop a staffing or hiring plan
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TERMINATION CHECKLIST —Assist the employer when planning to terminate an employee
- TIME SHEET —Weekly time sheet record of employee work
hours
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WAGE AND SALARY PLAN—Develop salary plans
- WORKERS COMPENSATION
―California
Workers' Compensation Claim Form
(DWC-1) and "Notice of Potential Eligibility" for employees
―Predesignation
of Personal Physician (DWC-9783) (revised March, 2006)
―Notice of Personal Chiropractor or
Personal Acupuncturist (DWC-9783.1) (revised March, 2006)
—"Facts About Workers' Compensation For Employees" Pamphlet that
employers must distribute to all newly hired employees informing them of their
rights and obligations under California workers' compensation laws
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WORKLOAD ACTIVITY LOG—Assess workloads in order to determine staffing needs
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