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  5. District Requirements for Reporting A Serious Injury/ Illness to CalOSHA

Reporting must be done within 8 hours of the incident or knowledge of the incident

Cal/OSHA Enforcement Unit District Office

Phone: (707) 649-3700
Fax: (707) 649-3712

American Canyon District Office
3419 Broadway Street
Suite H8
American Canyon, CA 94503

Cal OSHA Reporting Checklist:

  • Time and date of accident
  • Employer’s name, address, and telephone number
  • Name and job title or badge number of person reporting the accident
  • Address of accident or event
  • Name of person to contact at the site of accident
  • Names & address of injured employee(s)
  • Nature of Injury
  • Location where injured employee(s) was (were) taken for medical treatment
  • List and identity of other law enforcement agencies present at the site of accident/event
  • Description of accident/event and whether the accident scene or instrumentality has been altered