What is Cal/OSHA Compliance?
Cal/OSHA compliance means complying with all applicable workplace safety and health regulations adopted by California’s Occupational Safety and Health Standards Board and enforced by the Department of Industrial Relations’ Division of Occupational Safety and Health.
Prior to the passage of the Occupational Safety and Health Act in 1970, many States had already enacted workplace safety and health regulations. Consequently, Section 18 of the OSH Act permits States to develop their own OSHA plans based on existing safety and health regulations – provided the State Plans are at least as effective as the federal OSHA program.
California was one of the first States to develop an OSHA State Plan. In 1973, the California Occupational Safety and Health Act established the Occupational Safety and Health Standards Board. The Board was tasked with adopting safety and health standards for California, or adopting federal OSHA standards if no existing State standard covered the same issue.
The responsibility for enforcing the California OSHA State Plan was delegated to the Division of Occupational Safety and Health within the Department of Industrial Relations. To distinguish the Division of Occupational Safety and Health from other State agencies using the DOSH acronym, the California OSHA State Plan was given the name Cal/OSHA.
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How Does Cal/OSHA Differ from Federal OSHA?
Cal/OSHA differs from federal OSHA in numerous ways depending on the industry and the hazards to workplace safety and health. Employers need to be aware of these differences when developing a Cal/OSHA compliance checklist in order to ensure compliance with all applicable regulations. Examples of how Cal/OSHA differs from federal OSHA in healthcare include:
Injury and Illness Prevention Program
Since 1991, all employers in California have been required to implement an Injury and Illness Prevention Program. Among other requirements, the Program must consist of procedures for identifying and evaluating workplace hazards, procedures for correcting unsafe or unhealthy conditions and work practices, and procedures for employee training and instruction.
The Program also requires systems for communicating hazards to employees, for employees to report hazards, and for ensuring Cal/OSHA compliance by employees. Cal/OSHA has published guidance to help employers develop an Injury and Illness Prevention Program, yet the failure to comply with this requirement has been the most cited Cal/OSHA violation for the past eight years.
Workplace Violence Prevention Plan
As part of an Injury and Illness Prevention Program, most types of healthcare organizations are required to develop a workplace violence prevention plan (Title 8 CCR §3342). The plan must identify where risks of workplace violence exist, and employers must implement engineering or work practice measures to minimize employee exposure to the risk of workplace violence.
Employees must receive training on how to recognize the potential for workplace violence, workplace violence prevention methods, the procedures to follow in the event of a workplace violence incident, and how to report incidents. All reported incidents must be investigated and recorded in a Violent Incident Log, and qualifying incidents must be reported to Cal/OSHA.
Ergonomics, Back, and Musculoskeletal Injuries
Under federal OSHA, the requirement to prevent ergonomic injuries falls under the General Duty standard. However, in California, if more than one employee suffers a repetitive motion injury, employers are required to identify all work practices that involve identical physical activities and implement an ergonomics program to minimize the risk of a repetitive motion injury.
Under the same Ergonomics Article of the Cal/OSHA regulations, qualifying healthcare organizations are also required to implement a patient protection and health care worker back and musculoskeletal injury prevention plan that covers safe patient handling, workforce training, and the rights of employees to refuse to lift, reposition, mobilize, or transfer a patient.
Bloodborne Pathogens and Sharps Injuries
For most industries, California’s Bloodborne Pathogens and Sharps Injuries requirements are similar in many respects to federal OSHA standards. However, it is important organizations in the healthcare industry are aware of the requirement to record how needleless systems, needle devices with engineered sharps injury protection, and non-needle sharps are selected.
There are also more comprehensive reporting requirements for sharps injuries, and unique exemptions to Cal/OSHA compliance inasmuch as healthcare professionals can forgo engineering controls if, in their clinical judgement, the use of a control will jeopardize patient safety or the success of a medical, dental, or nursing procedure involving a patient.
Lower Permissible Exposure Limits (PELs)
A further difference between federal OSHA compliance and Cal/OSHA compliance is Permissible Exposure Limits (PELs) to hazardous substances. While OSHA’s PELs have remained mostly unchanged since they were published in the 1970s (or subsequently added), Cal/OSHA’s PELs are frequently updated and, in some cases, are significantly lower.
Cal/OSHA’s PELs also cover some hazardous substances that do not appear on the federal OSHA list (i.e., Acrylonitrile), and – in addition to some Time Weighted Average PELs being lower than federal OSHA – there are several instances when Cal/OSHA’s Short Term Exposure Limit PELs are significantly lower than federal OSHA (i.e., many Dimethylamine based products).
Aerosol Transmissible Diseases (ATDs)
Although applicable to all general industry, Cal/OSHA’s Aerosol Transmissible Disease regulations cover multiple diseases and pathogens to which workers in the healthcare industry can be exposed (Title 8 CCR §5199 Appendix A). Where a risk of exposure exists, employers must implement an ATD exposure control plan and provide effective controls against exposure.
In addition to engineering and work practice controls and personal protective equipment, employers in the healthcare industry are required to offer free vaccinations to susceptible healthcare workers against illnesses such as influenza, measles, and mumps. If healthcare workers declined the vaccinations, they are required to complete a declination statement.
What Does Cal/OSHA Compliance Consist Of?
Cal/OSHA compliance consists of identifying which workplace safety and health regulations apply to the organization. Thereafter it is necessary to inspect workplaces to identify and correct unsafe or hazardous conditions, implement plans, policies, and procedures to comply with the regulations, and train employees on the plans, policies, and procedures.
Similar to federal OSHA compliance, Cal/OSHA compliance requires employers to keep records of work-related illnesses and injuries and report them on Form 300A. However, whereas the federal OSHA reporting requirements (mostly) apply to organizations with 250 or more employees, the Cal/OSHA reporting requirements apply to organizations with eleven or more employees.
Although many Cal/OSHA compliance requirements are identical to federal OSHA compliance requirements, some are unique to Cal/OSHA or have more stringent requirements than their federal equivalent. The Department of Industrial Relations has produced a guide to Cal/OSHA compliance with includes a list of online resources employers can use to help them comply with Cal/OSHA.
The Penalties for Cal/OSHA Violations 2025
On January 27, 2025, the Department of Industrial Relations updated the penalties for Cal/OSHA violations. Under the requirements for OSHA State Plans, states’ penalties for OSHA violations must be identical to, or higher than, those applied by federal OSHA. In the case of Cal/OSHA, the 2025 penalties are slightly higher than those applied by federal OSHA:
- The maximum penalty for general and regulatory violations, including posting and recordkeeping violations, is $16,285 per violation (Federal OSHA = $16,131).
- The maximum penalty for willful and repeat violations is $162,851 (Federal OSHA = $161,323).
- The maximum penalty for violations classified as serious is $25,000 (Federal OSHA = $16,131).
- The minimum penalty for willful violations is $11,632 (Federal OSHA = $11,524).
The penalties for Cal/OSHA violations can be adjusted depending on the size of an organization, the organization’s cooperation with an investigation, and the organization’s previous history of Cal/OSHA compliance. The full list of civil penalty adjustments can be found in Title 8 CCR §336. Due to the potential for penalties for Cal/OSHA violations to escalate quickly, organizations uncertain about their Cal/OSHA compliance obligations are advised to speak with a Cal/OSHA compliance professional.
Cal/OSHA News
California Extends Workplace Violence Prevention Requirements to Most Employers
California State University Fined for Failing to Assess Potential Workplace Violence
