Slip / Trip / Fall Prevention

Safety device to be implemented:  Shoes For Crews Program

Date of Implementation:  October 2014

Desired Outcomes:

1. To eliminate slips/trips and falls in the kitchen area.
2. To eliminate the need for heavy matting in the kitchen thus reducing lifting and cleaning of the mats.
3. Improve infection control within the kitchen area.

Steps to Implement:

1. Each dietary employee will need to order a full shoe or a slip over shoe by 9-12-2014. Order forms are provided. Part time dietary aides should be offered the Crewguard slip-resistant overshoe.
2. Mats in the kitchen are to be removed once all employees have the full shoe or slip on.
3. Employees will be required to wear the full shoe or slip over shoe during work hours beginning October 1, 2014.
4. Shoes are not to be removed from the facility and are to only be worn at the facility.
5. Facility safety coordinator will complete a weekly report of employee comments during the first month of use and email results.
6. Employee evaluations will be completed at two weeks and at one month after full implementation. Results will be emailed.

General Comments:

1. Shoes, if the wrong size upon delivery, can be exchanged for free with the included Free Exchange Form and Return Shipping Label.
2. Keep a record of shoes ordered by employee name and date the shoe was given to the employee. Shoes/slip overs will be re-ordered yearly for each employee if the shoe needs replacing.
3. You will receive catalogs from Shoes For Crews. Only the style of shoe (Falcon) and the Crewguard overshoe are approved for facility purchase. If an employee wishes any other style, provide them with a catalog and they can order and purchase on their own.

“SHOES FOR CREWS”
PAYROLL DEDUCTION POLICY

Policy: Our Company encourages its staff to wear safe and comfortable shoes. Therefore, Our Company’s staff may purchase Shoes For Crews through a payroll deduction program. Our Company shall deduct the cost of the shoes over two pay periods. If a staff member terminates his/her employment prior to a Shoes For Crews purchase being paid in full, Our Company shall deduct the unpaid balance from the staff member’s final paycheck.

Responsibility: Director

Procedure:

1. The Director shall keep Shoes For Crews catalogues and brochures readily available for staff’s review. Additional catalogues and brochures can be obtained through Shoes For Crews (1-800-523-4448 or www.shoesforcrews.com)
2. The Director shall inform each new staff member of the Shoes For Crews payroll deduction program and the benefits of Shoes For Crews.
3. The Director shall also remind all staff on a regular basis about the Shoes For Crews payroll deduction program and the benefits of Shoes For Crews.
4. Staff shall provide the Director with his/her Shoes For Crews shoe order using the Shoes For Crews Order Form contained within the catalogue and other Shoes For Crews marketing materials.
5. Staff shall also sign the Voluntary Shoe Purchase Agreement for each purchase. This document authorizes Our Company to deduct the shoe purchase from the staff member’s paycheck. This document is located within the catalogue and other Shoes For Crews marketing materials.
6. The Director shall place the staff member’s order via one of the following methods:
1. Phone: 1-800-523-4448
2. Internet: www.shoesforcrews.com
7. The Director shall also fax the Shoes For Crews Order Form and Voluntary Shoe Purchase Agreement to Our Company’s corporate accounting department.
8. Our Company’s corporate accounting department shall deduct ½ of the staff member’s total order from the staff member’s paycheck in each of the two following pay periods.
9. If the staff member decides to return any shoes received from Shoes For Crews, that staff member is solely responsible for returning the shoes to

Shoes For Crews and for obtaining any refund. Our Company is not responsible or liable for any return or refund.

• The Director shall immediately notify Our Company’s corporate accounting department if a staff member’s employment is voluntarily or involuntarily terminated and that staff member ordered Shoes For Crews Shoes within one month prior to termination. This action will allow Our Company’s corporate accounting department to deduct any outstanding balance from the staff member’s final paycheck.
• The Director shall notify Our Company’s corporate Human Resources department if a staff member has a fall related workers’ compensation claim and that staff member was wearing Shoes For Crews at the time of the injury. This action will allow Our Company to attempt to recoup workers’ compensation costs associated with the fall from Shoes For Crews $5,000 Accident Warranty program.

SLIP RESISTANT FOOTWEAR PROGRAM

Company ABC is responsible for providing a safe work environment for our employees. In an effort to reduce slip and fall injuries, we are implementing a program to provide slip resistant footwear to our employees at risk for these injuries.

Each employee in the following departments will be provided one pair of slip resistant footwear at no cost:

Nursing
Dietary
Housekeeping
Maintenance

Each employee will be given a choice between two different styles. These shoes have been demonstrated to last for up to one year, assuming they are worn for work and not abused.

Employees who are provided these shoes are required to wear them as part of their uniform. We are confident that employees wearing these shoes consistently will sustain fewer injuries than usual. Employees failing to comply with this policy will be disciplined verbally and/or in writing. Repeat offenders may be terminated at Company ABC’s discretion.

In the event the employee loses or needs a replacement pair of shoes within a year of receiving their free pair, the employee will have to pay for 75% of the cost of the first replacement shoes and 100% for additional replacements. If Company ABC renews the program beyond this first year, Company ABC will supply eligible employees a new pair of shoes one year from the date they received their first pair. The ordering and replacement of shoes will be coordinated by supervisors and the HR department.

In the event an employee ceases working for Company ABC within 90 days of receipt of these shoes, the employee authorizes Company ABC to deduct out of the employees last paycheck for the cost of the shoes to Company ABC.  The cost of these shoes range from $19-$55 per pair.

Policy and Procedure
Voluntary Payroll Deduction for Slip Resistant Shoes

1. Policy

1. XYZ Corporation is committed to a safe working environment and supports a voluntary payroll deduction program to assist associates with the purchase of slip-resistant shoes that reduce slip and fall injuries.
2. The program is designed for associates’ direct benefit by allowing them to spread the cost of slip-resistant shoes that they may not otherwise be able to afford. In addition, by allowing associates to buy in bulk, the company may be able to provide shoes at a reduced price.
3. While company policy does require that associates in certain positions wear closed-toed, closed-heel, rubber soled shoes, company policy does not dictate the shoes be any specific brand or have any other specific feature.

1. Voluntary Deductions

1. All associates must request a deduction and agree that it is voluntary by signing a written authorization to deduct the cost of the shoes from their paycheck(s);
2. The associate and facility should agree on a repayment plan for the cost of the shoes that is comfortable for both, provided the total cost is repaid in no more than four (4) payroll cycles;
3. The associate requests the shoes and the manager places the order with the vendor providing the slip-resistant shoes;
4. In California, the facility may not deduct a "balloon payment," or any more than the agreed upon regular deduction, if the employment ends and the deductions have not been completed to reimburse the facility for the total cost of the shoes. In non-California facilities, a balloon payment may be permitted if the deduction does not bring the associate below minimum wage plus overtime for all hours covered in the final paycheck. In the event the total cost of the shoes is not recouped upon termination, the facility should work with the associate to obtain full repayment and may pursue legal channels to recover the money.

2. Business Office Procedures

1. For new programs, complete a new vendor credit application for the purchase of shoes and forward to the Home Office Director of Accounting;
2. For new programs, have the vendor complete a W-9 and forward a copy to the Home Office Director of Accounting;
3. For new programs, complete a new vendor request form, as found in the accounting manual;
4. Vendor will invoice facility for shoes purchased during a 30 day billing cycle;
5. Pay vendor invoice monthly through standard A/P processes coding appropriately to each department supply cost code.

3. Payroll

1. The cost of the shoes will be deducted from the associate’s pay in no more than four (4) payroll cycles to repay the cost of the shoes;
• Our payroll service provider will be updated as to amount owed and the deduction code “S” will be used with a year to date accumulator code of 89. A “goal amount” should be established in payroll service provider’s system to stop the deductions when the agreed upon repayment amount is met.
• The deduction code and payroll service provider process will not conflict with pre-tax deductions.