OSHA Challenge Administration Annual Report CY '23

OSHA Challenge Administrator Annual Report CY 2023.xls

Voluntary Protection Program Information

OSHA Challenge Administration Annual Report CY '23

OMB: 1218-0239

Document [xlsx]

Download: xlsx | pdf

Overview

Overview
1 - Admin. Annual Report
2 - Summary of Rates
3 - Participant 1 Info
4 - Participant 2 Info
5 - Participant 3 Info
6 - Participant 4 Info
7 - Participant 5 Info
8 - Participant 6 Info
9 - Participant 7 Info
10 - Participant 8 Info
11 - Participant 9 Info
12 - Participant 10 Info

Sheet 1: Overview

OSHA Challenge
Administrator Annual Report

Included in this spreadsheet are:

Tab 1. Administrator Annual Report
Tab 2. Summary of Participant Injury and Illness Rates - Autofills
Tabs 3 - 12. Individual Participant Information

1.) Some fields in this spreadsheet are programmed to fill these forms automatically.
Do not manually enter data into these fields. All of Tab 2 autofills.
2.) The year has been entered in all applicable boxes.
3.) Each participant is to have their own tab. If you have more than 10 participants, copy the file
of blank annual reports before entering information first. Ensure that you have enough annual
report files for the total number of your participants.
4.) Ensure that all fields are filled in correctly.
5.) Remember to submit an updated OCTPS for each participant along with this summary.
6.) Ensure that the data inputted are consistent and accurate.

*To access these documents, please click on the tabs at the bottom of this form.*

The OSHA Challenge Administrator must prepare the Administrator Annual Report each year along with an OSHA Challenge Tracking Participant Status (OCTPS) form for each participant. Both the annual report and all OCTPS forms must be submitted electronically to your OSHA Challenge Liaison [email protected] no later than March 25.

Sheet 2: 1 - Admin. Annual Report

OSHA Challenge
Administrator's Annual Report

Administrator Name		Year
West Virginia University Safety and Health Extension		CY2023

Section 1. Administrator Information Update
Name	West Virginia University Safety and Health Extension
Site Address	3604 Collins Ferry Rd.
City, State, Zip	Morgantown, WV 26506
Section 2. Administrator Contact Information Update
Administrator Contact Name	Mark Fullen
Administrator Contact Title	WVU Extension Director
Administrator Contact Phone Number	3042933200
Administrator Contact Fax Number	3042935905
Administrator Contact E-mail Address	[email protected]
Section 3. Coordinator Contact Information Update
Coordinator Contact Name	Amanda Mason
Coordinator Contact Title	WVU Extension Specialist
Coordinator Contact Phone Number	3042933167
Coordinator Contact Fax Number	3042935905
Coordinator Contact E-mail Address	[email protected]
Section 4. Participant Information Updates



Section 5. Input from Challenge Administrators
1.) Please provide a couple of examples of significant achievements accomplished by your Challenge participants during the past year.








2.)Do you have any suggestions for improving OSHA Challenge?
Update tracking forms







OSHA Challenge
Administrator's Annual Report
3.) Additional comments:









Form Approved
OMB# 1218 – 0239 Expires 09-30-2014
Public reporting burden for this collection of information is voluntary and is estimated to average 20
hours per response, including the time for reviewing instruction, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate, or any other aspect of this collection of information
including suggestions for reducing this burden to the Office of Partnerships and Recognition,
Department of Labor, Room N-3700, 200 Constitution Avenue, N.W., Washington, DC 20210.

Sheet 3: 2 - Summary of Rates

OSHA Challenge
Summary of Participant Injury and Illness Rates

Administrator					Year
West Virginia University Safety and Health Extension				CY2023

	Injury and Illness Rates
Participant	TCIR			DART
Name	Current	Baseline	%	Current	Baseline	%
Building Systems Inc.	3.1	2.6	19%	1.0	2.6	-60%

Westlake Chemical	3.0	0.0	#DIV/0!	2.5	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

[Insert Participant Name Here]	#DIV/0!	0.0	#DIV/0!	#DIV/0!	0.0	#DIV/0!

Sheet 4: 3 - Participant 1 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

Building Systems Inc

Year

CY 2020

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

193,698.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

3.1

2.6

0.5

DART

1.0

2.6

-1.6

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Stage II

Sheet 5: 4 - Participant 2 Info

OSHA Challenge Participant Information

Participant								OSHA 300 Log Totals for
Westlake Chemical								Year		CY 2020

G	H	I	J	K	L	M:1	M:2	M:3	M:4	M:5	M:6
0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0

Total Hours Worked			864,649.0				Total Employees			401

Measure				Current
Measure				Year	Baseline	Change
TCIR				3.0	0.0	3.0
DART				2.5	0.0	2.5

Significant Achievements and Milestones
Describe any significant achievements/milestones accomplished by your participants during the past year.
Stage II

Sheet 6: 5 - Participant 3 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2020

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 7: 6 - Participant 4 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 8: 7 - Participant 5 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 9: 8 - Participant 6 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 10: 9 - Participant 7 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 11: 10 - Participant 8 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 12: 11 - Participant 9 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

Sheet 13: 12 - Participant 10 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2020

M:1

M:2

M:3

M:4

M:5

M:6

0.0

Total Hours Worked

0.0

Total Employees

Measure

Current

Year

Baseline

Change

TCIR

#DIV/0!

0.0

#DIV/0!

DART

#DIV/0!

0.0

#DIV/0!

Significant Achievements and Milestones

Describe any significant achievements/milestones accomplished by your participants during the past year.

File Type	application/vnd.ms-excel
Author	Annis, Jackie - OSHA
Last Modified By	Harris, Richard - OSHA
File Modified	2024-01-25
File Created	2004-02-03