Supervisor’s Checklist for New Personnel
After boxes are completed, send copy to Lab Safety Coordinator (LSC),laurie.stclair@okstate.edu
Date Form Completed
Start Work (and if temp. End) Date
(Non-qualified personnel shall not work with radioisotopes or Particularly Hazardous Substances (PHSs))
Lab Information
Principal Investigator (PI)
New Personnel Name
Program Source, if applicable (INBRE,
Department
List All Work Locations
Medical Insurance (needed for
work-study, TABERC, etc.)
emergency situations)
Status or Title (undergrad, med-student,
After Hours Access (yes or no)
Personal
or OSU paid
.
technician, high school, volunteer, etc.)
Summary of Research Activities (include possible hazards):
A Information
1 “HR Volunteer Statement of Understanding”, complete for
all not paid by OSU and keep in Dept. office,
http://www.osu-tulsa.okstate.edu/hr/forms.php or
2 HR Time Sheets for all who receive OSU paycheck
3 Minors-Annual training for supervisors
http://minors.okstate.edu, send copy of email
certification to LSC
4 “Qualified Person”: at least 1 year of college-level chemistry AND
Yes
No
NA
Comment
If you have questions, contact tulsa.hr@okstate.edu
Contact tulsa.hr@okstate.edu ASAP
For supervisors of new personnel who are
minors=under 18 yrs. Request release forms from
Director of Regulatory Compliance and complete.
If no, who will supervise person:
biology and have received extensive training in a laboratory setting or
have been working in a laboratory setting
5 Add person to Protocols by entering protocol # on this
form, e.g. IACUC, rDNA, Infectious Agent; ensure trained if needed
B Personnel In-Lab Training
List protocol #s:
1 “In-Lab Safety Orientation Checklist”, supervisor
completes with person before they begin, copy to LSC
2 “Worker In-Lab Safety Training List”, list subjects as they
are done-specific to lab, e.g. SOPs, SDSs
3 PPE Training + Signature, “Hazard Assessment Tool for
Personal Protective Equipment Use” Sections 3 & 4
C Personnel Online Training
http://www.healthsciences.okstate.edu/research/safet
y/lab/forms.php
http://www.healthsciences.okstate.edu/research/safet
y/lab/forms.php
http://www.healthsciences.okstate.edu/research/safet
y/lab/forms.php
1 Blood Borne Pathogen Training (annual) + Quiz, for those
who work with blood containing materials or assigned to
do first aid
2 Hepatitis B Vaccination Declination Form, for all who take
BBP Training (HBV paid by OSU, except for volunteers)
3 Laboratory Safety Training (every 3 years) + Quiz, for those
who do lab work
4 Biosafety Training (initial, ensure trained on any changes),
for those who work with microbiological materials, RG 1
and above, copy to LSC
5 Radiation Safety Training + Quiz, for those who work with
http://www.healthsciences.okstate.edu/research/safet
y/bloodborne.php
radioactive materials, either “new employee” or “annual”
6 Radiation Training for Ancillary Personnel, for those who work
in a lab that contains radiation materials
7 IACUC Training, for those who work with animals
March 2015
http://www.healthsciences.okstate.edu/research/safet
y/bloodborne.php; 5th bullet
http://www.healthsciences.okstate.edu/research/safet
y/lab/training.php
http://www.healthsciences.okstate.edu/research/safet
y/biological/training.php ; supervisor fills out “Training
Documentation Form” in first paragraph before training begins
http://www.healthsciences.okstate.edu/research/safet
y/radiation/training.php
http://www.healthsciences.okstate.edu/research/safet
y/radiation/training.php#ancillary
http://www.healthsciences.okstate.edu/research/anim
al/training.php