HPM 10.7

Question 1

Commanders shall revoke a uniformed member’s peace officer powers and secure all state-issued firearms whenever the uniformed employee is off duty as a result of a ____________________.

Answer 1

psychological reason, to include stress.

HPM 10.7, Injury, Illness, and Case Management Manual

Question 2

Uniformed employees who are off duty as a result of an industrial or non-industrial injury or illness where a physician has diagnosed that the employee is not capable of performing the ___ California Highway Patrol Officer Tasks shall not engage in any activity requiring the use of peace officer powers.

Answer 2

14

HPM 10.7, Injury, Illness, and Case Management Manual

Question 3

Injuries and illnesses occurring while an employee is traveling to or from a temporary assignment shall be recorded on the Log of the command where the employee is _____________________ at the time of the injury or illness.

Answer 3

permanently assigned

HPM 10.7, Injury, Illness, and Case Management Manual

Question 4

CHP 121s shall also be maintained ____________ for each injury or illness recorded on the Log.

Answer 4

five years

HPM 10.7, Injury, Illness, and Case Management Manual

Question 5

CHP 121 shall be completed by the employee’s supervisor within ___________ of notification of an alleged occupational injury or illness

Answer 5

24 hours

HPM 10.7, Injury, Illness, and Case Management Manual

Question 6

The commander or designee shall ensure the CHP 121 (unless record only or first aid without medical expenses incurred) is filed with the appropriate SCIF office within _________ of notification of an injury or illness.

Answer 6

five days

HPM 10.7, Injury, Illness, and Case Management Manual

Question 7

The ______________________________________________, adopted by the Department, requires employees to report any known physical or psychological condition which might be reasonably expected to adversely affect job performance.

Answer 7

Inconsistent and Incompatible Activities Statement

HPM 10.7, Injury, Illness, and Case Management Manual

Question 8

The employee shall be requested to sign a CHP 121C, Medical Information Release Authorization and identify medical care providers who have treated him/her for a related condition(s) within the past ___________.

Answer 8

ten years.

HPM 10.7, Injury, Illness, and Case Management Manual

Question 9

How often is SCIF contacted regarding the status of an injured employee?

Answer 9

Once a month

HPM 10.7, Injury, Illness, and Case Management Manual

Question 10

The CHP 121D form

(Injury/Illness Status Report) must be submitted to Division by the _____ of each month.

Answer 10

10th

HPM 10.7, Injury, Illness, and Case Management Manual

Question 11

Injury, illness, and hazardous exposure documentation death, serious injury or illness.

Division and the appropriate assistant Commissioner shall be notified immediately by telephone. The following persons shall be contacted in the order listed until one is contacted:

1. 2.
   3.
   4.

Answer 11

1. Appropriate Assistant Commissioner
2. Executive Assistant to appropriate Assistant Commissioner
3. Deputy Commissioner
4. Commissioner

HPM 10.7, Injury, Illness, and Case Management Manual

Question 12

Upon any death or serious injury, a Comm-Net Message shall be transmitted to the appropriate Assistant Commissioner and DRU within _________ of occurrence.

Answer 12

24 Hours of Occurence

HPM 10.7, Injury, Illness, and Case Management Manual

Question 13

CHP 121’s shall be maintained for a period of ________.

Answer 13

5 years

HPM 10.7, Injury, Illness, and Case Management Manual

Question 14

The commander or designee shall review and sign the CHP 121 within _____________ of notification of an injury or illness

Answer 14

3 Days

HPM 10.7, Injury, Illness, and Case Management Manual

Question 15

The commander or designee shall ensure the CHP 121 (unless for record only or first aid without medical expenses incurred) is filed with the appropriate SCIF office within _________ of notification of an injury or illness

Answer 15

5 Days

HPM 10.7, Injury, Illness, and Case Management Manual

Question 16

Within _______ of initial notification of, or any status change of, an employee injury, illness, or hazardous exposure, the supervisor shall record or update the incident on the employee’s CHP 442.

Answer 16

3 Days

HPM 10.7, Injury, Illness, and Case Management Manual

Question 17

The duration of limited duty assignment shall be directed by the nature of the injury or illness and the needs of the department on a case by case basis not to exceed ___________. A commander can authorize up _________ of limited duty assignment.

Answer 17

2 years / 1 year

HPM 10.7, Injury, Illness, and Case Management Manual

Question 18

While on limited duty, employee shall not:

1.
2.
3.

Answer 18

1. Wear a uniform
2. Display a badge
3. Operate enforcement vehicle

HPM 10.7, Injury, Illness, and Case Management Manual

Question 19

The members of the COSC (Command Occupational Safety Committee) shall conduct periodic inspections, at least ___________, of facilities and equipment to identify potentially unsafe work conditions, practices, or situations.

Answer 19

semiannually

HPM 10.7, Injury, Illness, and Case Management Manual

Question 20

If an earthquake with a 4.0 magnitude occurs within ____ miles of the facility, an inspection shall be completed.

Answer 20

50

HPM 10.7, Injury, Illness, and Case Management Manual

Question 21

If a death, serious injury, or illness occurs, the Division of Occupatinal Safety and Health (DOSH) shall be notified by telephone within _________ hours (by the commander).

Answer 21

8 Hours

HPM 10.7, Injury, Illness, and Case Management Manual
Chptr. 3 (3-4)