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Durham Catholic District School Board The Board Title: Accident/Personal Injury Procedure #: AP414-2 Administrative Area: Policy Reference: Operations Emergency Preparedness (PO414) Date Approved: September 20, 1999 Dates of Amendment: 1.0 Purpose This Occupational Health and Safety Act, the Workplace Safety and Insurance Act and the Ontario School Boards Insurance Exchange (OSBIE) procedures stipulate specific requirements that must be adhered to in the event of an accident resulting in personal injury of staff and/or students. The following procedure is designed to assist Principals and Site Supervisors in carrying out those established requirements. 2.0 Definitions First Aid provided by a certified first aid provider when an injury occurs that requires no further treatment. Joint Health and Safety Committee (JHSC) A joint health and safety committee (JHSC) is composed of worker and employer representatives. Together, they should be mutually committed to improving health and safety conditions in the workplace. Committees identify potential health and safety issues and bring them to the employer's attention and must be kept informed of health and safety developments in the workplace by the employer. As well, a designated worker member of the committee inspects the workplace at least once a month. The committee is an advisory body that helps to stimulate or raise awareness of health and safety issues in the workplace, recognizes and identifies workplace risks and develops recommendations for the employer to address these risks. To achieve its goal, the committee holds regular meetings and conducts regular workplace inspections and makes written recommendations to the employer for the improvement of the health and safety of workers. Lost Time Injury the injured worker is off work due to the workplace injury beyond the day of the injury. Durham Catholic District School Board Page 1 of 4

Title: Accident/Personal Injury (AP414-2) Administrative Area: Operations 2.0 Definitions (Cont d) Medical Aid provided by a certified medial practitioner such as a doctor, registered nurse, or other medical professional when an injury requires medical attention beyond first aid. No Lost Time Injury this injured worker did not lose time from work beyond that day of the injury after seeking first aid. Ontario School Board Insurance Exchange (OSBIE) is a school board owned, nonprofit insurance program representing 78 school boards and 28 Joint Ventures in Ontario. The primary goals of the Exchange are to insure member school boards against losses, and to promote safe school practices. 3.0 Procedures 3.1 When a serious accident/injury occurs it is essential that the injured person immediately receive care. If possible, someone should remain with the injured person and send a messenger for immediate assistance. Only injuries to parties specified in sections 3.3 and 3.4 are to be reported to the Ontario School Boards Insurance Exchange (OSBIE). 3.2 In the Case of a Staff Member 3.2.1 A person at the scene shall immediately inform the Principal/Site Supervisor that someone has been injured or there has been an accident. 3.2.2 A first aid certified staff member should ensure the injured employee is appropriately attended to with the utmost care 3.2.3 A (911) emergency call should be made immediately if necessary. 3.2.4 The Board s Disability Management Officer is to be notified immediately. 3.2.5 In the case of a critical injury as defined by O.Reg. 834, the Health, Safety and Wellness Coordinator must be notified immediately. In their absence, the Management Co-chair of the JHSC must be notified. 3.3 In the Case of a Student 3.3.1 The supervising staff member shall immediately inform the Principal or designate of the injury an immediately seek medical attention if they cannot be contacted (call 911 if necessary). First aid should be administered as needed by the certified first aid staff representative where an injury occurs that requires no further treatment. 3.3.2 Parents/Legal Guardians shall be immediately contacted with relevant information including but not limited to the nature of the injury and location of hospital or medical facility where the student has been transported to. 3.3.3 Where it is impossible to contact the student s parent or legal guardian, the following must take place immediately: 3.3.3.1 The Principal (or designate) must obtain medical attention for the pupil; 3.3.3.2 The Principal must make it clear to the physician that he/she is acting for the parent/legal guardian; Durham Catholic District School Board Page 2 of 4

Title: Accident/Personal Injury (AP414-2) Administrative Area: Operations 3.0 Procedures (Cont d) 3.3 In the Case of a Student (Cont d) 3.3.3 (Cont d) 3.3.3.3 continued efforts should be made to communicate with the parent/legal guardian; 3.3.3.4 the principal/supervisor (or designate) must communicate promptly with parent, legal guardian or next of kin; 3.3.3.5 the appropriate Family of Schools Superintendent or designate must be notified immediately of any injury; 3.3.3.6 an up-to-date record of the information (3.3.3.6.1 to 3.3.3.6.4 shall be available in each school office and all school personnel need to be aware of the exact location of this data. The information should accompany the student to the hospital and the person accompanying the student should remain at the hospital until the parent/legal guardian arrives: 3.3.3.6.1 name and telephone number of the parent or legal guardian both for home and for the place of business; 3.3.3.6.2 alternate/emergency contact and telephone number in case parent/legal guardian cannot be reached; 3.3.3.6.3 name and telephone number of family physician; 3.3.3.6.4 Ontario Health Card number. 3.3.3.7 The incident should be submitted to OSBIE via the on-line IR report. 3.4 In the Case of a Volunteer, Parent/Guardian, Visitor or any other Non-Employee, the Principal/Site Supervisor or designate shall: 3.4.1 obtain medical attention for the individual including calling 911 if necessary; 3.4.2 notify Emergency Services that they are not the legal guardian of the individual; 3.4.3 attempt to communicate with the injured party to obtain health information and next of kin information; 3.4.4 if applicable, and requested by the injured party, to contact next of kin to provide information about the location of the hospital or medical facility where the individual is being transported to. 3.4.5 The incident should be submitted to OSBIE via the on-line IR report. 3.5 It is recommended that, to avoid unnecessary delay, the injured person(s) be taken directly to the emergency ward of the nearest hospital accompanied by a member of staff or parent or appropriate legal guardian. 3.6 All employees should be aware of the location of the nearest hospital. 3.7 Discretion should be used in implementing any emergency preparedness procedures, if applicable. 3.8 AP414-3 Evacuation of a School in the Event of an Emergency, should be put into effect, if required. Durham Catholic District School Board Page 3 of 4

Title: Accident/Personal Injury (AP414-2) Administrative Area: Operations 3.0 Procedures (Cont d) 3.9 Reports documenting accident(s) which occur on School/Board premises should be sent promptly to: 4.0 Sources 3.9.1 in the case of students, volunteers, parents, visitors Superintendent of Business/CFO Business Services, 652 Rossland Road West, Oshawa, ON L1J 7M8 (Catholic Education Centre); 3.9.2 in the case of employees WSIB/Disability Management Officer, 650 Rossland Road West, Oshawa, ON L1J 7C4 (Catholic Education Centre). Ontario School Board Insurance Exchange (OSBIE) 5.0 References Occupational Health and Safety Act Workplace Safety and Insurance Act O.Reg. 834 Critical Injury Defined 6.0 Related Forms and s Work Related Incident Report Form (5502) Evacuation of a School in the Event of an Emergency (AP414-3) Occupational Health and Safety Policy (PO318) Exceptional Health Conditions Policy (PO606) Concussion Management and Prevention (PO614) Concussion Management (AP614-1) Durham Catholic District School Board Page 4 of 4

DURHAM CATHOLIC DISTRICT SCHOOL BOARD Work Related Incident Investigation Report (to be completed by Principal/Supervisor) IF THIS IS A CRITICAL INJURY AS DEFINED BY THE OCCUPATIONAL HEALTH AND SAFETY ACT, PLEASE CONTACT THE HEALTH AND SAFETY OFFICER AND FAX IMMEDIATELY TO 905.576.1981 A DELAY COULD RESULT IN A MINIMUM FINE OF $250.00 A. Employee Information Name: (Surname - First Name) Address: (including Postal Code) School/Department: Telephone: Date of Employment: Occupation: (At time of work related incident) Home: Work: Family Doctor: Number of years in occupation: Social Insurance Number Language (Other than English) B. Details of Incident Type of Incident (check one): Date & Time of Incident: Struck or contact by Caught in, on or between Over exertion/strain Other (specify) Struck against or contact with Fall (specify) Exposure to: (d/m/y) @ Date & Time Reported: (d/m/y) @ a.m. p.m. a.m. p.m. Describe in detail the following: (a) sequence of events leading up to the incident, (b) where the incident occurred, (c) what the employee was doing at the time, (d) the size, type & weight of equipment or materials involved: (e) type of injury (ie: scrape, bruise, strain, fracture, cut, etc.), part(s) of body involved and specify left or right side Please fax to: 905.576.1981 5502-08/98 Distribution: Forward to Health & Safety Officer, Catholic Education Centre

Names, addresses & telephone numbers of witnesses or persons having knowledge of incident: To your knowledge, has the employee had a previous similar disability/incident? Yes No If yes, please provide details. Which of the following conditions contributed to the incident (please number in order of importance - 1, 2, 3) Operating without authority Failure to secure or warn Working at unsafe speed Unsafe equipment Unsafe loading, placing, mixing, combining, etc. Unsafe position or posture Working on moving or dangerous equipment Distracting, teasing, wilful misconduct Failure to use personal safety devices Wheeled equipment operation Not guarded or improperly guarded Inadequate illumination Fire, explosion, atmospheric hazard Hazardous personal attire Unsafe design or arrangement Hazardous method or procedure Outside hazardous condition Other (specify): Details of property damage:(if any) C. Result NO INJURY INJURY INJURY Hazardous Situation No W.S.I.B. Claim - first aid only W.S.I.B. Claim Medical Attention Employee s Signature: Supervisor s Signature: Date: INJURY W.S.I.B. Claim Lost Time D. Prevention of Recurrence Check off action(s) that you have taken and indicate date action(s) taken to prevent recurrence; mark other corrective actions intended but not yet taken with a P. Reinstruction of person involved Action to improve inspection Actions to improve design/procedure Reassignment of person involved Equipment repair or replacement Check with manufacturer Order job safety analysis done Correction of congested area Improved personal protective equipment Installation of guard or safety devices Inform all department staff Other (specify) Describe how you have or will implement the above action(s) to prevent recurrence and include timelines: E. Additional Comment Please fax to: 905.576.1981 5502-10/06 Distribution: Forward to Health & Safety Officer, Catholic Education Centre