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Workplace Violence Checklist

The following checklist was created by SUNY General Counsel's Office, and is meant to be used by the campuses as a guidance document when developing and maintaining a Workplace Violence program in accordance with New York State Law.
Click here for a word version of this checklist. 

I. DEVELOP A WORKPLACE VIOLENCE POLICY STATEMENT Written Policy Statement: develop and implement a written policy statement on the employer’s workplace violence prevention program goals and objectives; paragraph (e) of regulation; Full employee participation during policy creation through an Authorized Employee Representative/s (AER) through meetings, questionnaires, committee heads, etc; Policy statement describes workplace violence prevention policy and informs employees of the procedure for reporting incidents of workplace violence or making complaints; describes level of AER participation; Policy is posted where notices to employees are normally posted. II. UNDERTAKE A RISK EVALUATION AND DETERMINATION Risk Assessment & Risk Assessment Walk-through: Employer must perform a risk assessment of its workplace; paragraph (f) of Regulation; Examine records of past workplace violence incidents to determine problem areas or the frequency of particular types of incidents; Evaluate work practices and policies that may impact the risk of workplace violence; Assess the physical environment of the workplace (via a physical walkthrough of the workplace) to determine risk factors, and; Determine presence of factors which may place employees at risk of Workplace Violence; Authorized Employee Representative/s must be physically present during Risk Assessment walk through or the employer must have documented, multiple efforts made to include the Authorized Employee Representative/s and receipts of input from Authorized Employee Representative/s.

DEVELOP A WORKPLACE VIOLENCE PREVENTION PROGRAM; Workplace Violence Prevention Program: Employer must develop a Workplace Violence Prevention program which is based on results of initial risk assessment and related walkthrough; paragraph (g) of regulation; Written Program includes: A list of the risk factors identified in the risk assessment, and The methods the employer will use to prevent future incidents of workplace violence, and A “hierarchy of controls” to reduce or eliminate the identified hazards, in the following order of preference: Engineering Controls: increased lighting, secure building access, security hardware, etc.; Administrative/Work Practice Controls: increased staffing, security guards, training, etc.; Personal Protective Equipment; and The methods the employer will use to address each specific risk identified in the risk assessment; The procedure for reporting incidents of workplace violence; Procedure for retaining written records of these reports; A written outline/lesson plan for employee training on the WPV prevention program; A plan to review (and update, if necessary) the Workplace Violence Prevention program on at least an annual basis; Authorized Employee Representative/s participated in Program Development, by: Providing input as to those situations in the workplace that pose a threat of workplace violence; Providing input on the workplace violence prevention program the employer intends to implement

IV. IMPLEMENT AND ENFORCE THE WORKPLACE VIOLENCE PREVENTION PROGRAM; PROVIDE EMPLOYEE INFORMATION AND TRAINING ; Training of Employees on workplace Violence Prevention Program: All Employees must be trained on the risks of Workplace Violence; Paragraph (h) of regulation.; Current employees trained at least annually; All new hires trained when they begin their employment. Training includes: Information on the risks of workplace violence in the employer’s specific workplace or workplaces; Requirements imposed by the regulations; Location-specific risk factors identified by the risk assessment; Detailed description of the Workplace Violence prevention program; Measures employees can take to protect themselves from identified risks; Procedures employer has implemented to protect employees (e.g. alerts, emergency procedures, security alarms, etc.); How to obtain a copy of the Workplace Violence Prevention Program; Re-Training of employees affected by the changes occurs when significant changes are made to the Program, and at least annually if no changes are made to the program.

ENSURE RECORDKEEPING AND RECORDING OF INCIDENTS OF WORKPLACE VIOLENCE; Develop procedure for recording incidents of workplace violence where incident results in death, days away from work, restricted work, transfer to another job, medical treatment beyond first aid, loss of consciousness, or any “significant injury or illness diagnosed by a physician or other licensed health care professional;” Paragraph (i) of regulation; All incidents of workplace violence or threats of violence are reported to the employer on an Incident Reporting Form which includes: Workplace location and time of day of the incident and A detailed description of the incident (including events leading up to the incident and how it ended) and Names/titles of those involved and Nature of injuries arising from the incident and Names of witnesses.; Filed incident reports are reviewed at least annually by the employer with the participation of the Authorized Employee Representative to: Identify any apparent trends in violent incidents and Review the effectiveness of preventative measures in place. Retain Incident Reports for five years following end of calendar year that report was made.

ESTABLISH COMPLAINT REPORTING PROCEDURE; Develop Procedure for employees to file complaints when the employee believes a serious violation of the employer’s Workplace Violence Prevention Program exists or believes that a workplace violence danger is imminent.; Employees informed they must present a written complaint to their supervisor before filing a complaint with DOL/PESH unless an imminent danger exists and the employee reasonably believes in good faith that reporting to a supervisor would be futile.; After a complaint is filed by an employee, employer given a reasonable period of time for correction; Employees informed they may request an inspection of the alleged violation by DOL/PESH only AFTER notice and a reasonable time to correct are given to the employer, and the employer is unable or unwilling to correct the alleged violation, unless there is an imminent danger; Complaint Procedure informs employees that Employers are specifically prohibited from retaliating against employees for filing complaints or exercising any rights under these regulations, including the filing of a complaint or request for inspection.

 WORKPLACE VIOLENCE DEFINITIONS Workplace Violence: As defined by the regulations, 12 NYCRR § 800.6(d)(11), “workplace violence” is: “[a]ny physical assault or acts of aggressive behavior occurring where a public employee performs any work-related duty in the course of his or her employment.” This may include such conduct as: verbal or physical threats of physical injury; intentional displays of force which cause an employee to fear bodily harm; intentional and wrongful physical contact, without consent, that results in injury; stalking an employee with the intent to cause fear of physical harm, if such stalking arose in the course of employment; or other similar conduct.; Authorized Employee Representatives: An employee authorized by the employees or the designated representative of an employee organization recognized or certified to represent the employees pursuant to Article 14 of the Civil Service Law. 12 NYCRR § 800.6(d)(1). “Authorized Employee Representative” is defined so that it is the same as the definition in the PESH act and will be provided with the same rights as laid out in the FOM and Part 802.; Imminent Danger: (5) Imminent Danger. Any conditions or practices in any place of employment which are such that a danger exists which could reasonably be expected to cause death or serious physical harm immediately or before the imminence of such danger can be eliminated through the enforcement procedures otherwise provided for by this Part. Imminent Danger definition uses the exact same language as the PESH FOM and the FOM should be used to determine if imminent danger exists. 12 NYCRR § 800.6.

The information contained on the SUNY Compliance website is for general campus guidance only and is not intended, nor can be relied upon, as legal advice or the imposition on SUNY campuses of specific policies or requirements.  The site is intended to be an informational-only clearinghouse for some of the laws, rules, and regulations that may impact the State University of New York’s campuses.  Additionally, given the rapid, changing nature of laws, rules and regulations, there may be delays or omissions contained on this site which therefore cannot be relied upon as complete.    For complete compliance information, consult your campus compliance officials or the SUNY Compliance Administrator.  For legal advice, consult your lawyer.


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Last Update - 11/21/12