California Workplace Violence Prevention Plan Template for NEMT: Vans, Dispatch, and the Incident Log

A rider swings at a driver during a wheelchair transfer. A family member threatens dispatch over a late pickup. A stranger tries the van door at a dark dialysis lot at 5 a.m. California’s workplace violence law, Labor Code 6401.9, asks most employers to plan for exactly this, in writing, and to log every incident. This template is that plan, filled in for vans, pickups at homes and clinics, and the dispatch phone.

How to use this template

1. Check which rule applies first. If Cal/OSHA’s health care rule, 8 CCR 3342, covers your work, follow that rule instead of this template. Read the section on who is covered below, and call Cal/OSHA Consultation if you run wheelchair or gurney vans.
2. Bring drivers and dispatchers in from the start. The law requires their active involvement in building the plan, finding hazards, designing training, and investigating incidents. Record how in Part 2.
3. Walk through your operation before you write Part 7: the office, the yard, a few routes, and the pickups that worry drivers most.
4. Fill in Parts 1 to 8, sign the plan, and keep a copy where every employee can reach it at all times: the dispatch desk, each van, and a shared file.
5. Train everyone with Part 8 when the plan starts, and every year after.
6. Print the Part 4 card for every van, and the Part 9 log sheets for dispatch.
7. Review the plan at least once a year, after every incident, and whenever something shows it is not working, using Part 11.

Rider rules and what drivers do in the moment live in your passenger conduct policy, and the de-escalation steps are in difficult NEMT passengers. This plan sits above them: it is how the company finds risks, protects drivers, logs incidents, and learns from them. Pair it with your California IIPP.

The template

Part 1: Plan details and who runs it

Field	Entry
Company name
Effective date
Last reviewed
Plan administrator, name, job title, and phone
Others with a role, and what each does (takes reports, investigates, trains)
Work areas this plan covers	Office, yard, every vehicle, riders’ homes, facilities where we pick up and drop off, and the dispatch phone
Where employees can read the plan at any time
Approved by the owner, signature and date

Part 2: How employees take part

How employees take part	How often	Who
Name hazards and suggest fixes at safety meetings
Join hazard inspections and ride-alongs
Help plan and review training
Report incidents and help investigate them
Review the plan and the incident log each year

Part 3: Other employers we work alongside

List staffing agencies, subcontractors, brokers, and facilities where our drivers wait or stay with riders.

Employer and contact	Their role	Who trains, who logs, and who tells whom after an incident

Part 4: Reporting card for every van and desk

If you feel unsafe or something happened

1. In danger now: get to a safe place and call 911. Then call dispatch.
2. Any threat, attack, or warning sign, even with no injury: tell dispatch or the plan administrator before the end of your shift.
3. You can also report to the police or to Cal/OSHA. To report to the company without giving your name (optional): ________________
4. No one is punished for reporting, for refusing to stay in a situation that feels dangerous, or for taking part in an investigation.
5. We look into every report and tell you what we found and what we will change.

Contact	Phone
Dispatch
Plan administrator
After hours

Part 5: Making sure everyone follows the plan

Method	How we do it
Training	New hires before their first shift, everyone each year
Recognition	Praise drivers who report hazards and follow check-in rules
Retraining	After a missed check-in or a skipped step
Discipline	Under our written policy, for anyone, including supervisors, who ignores the plan or retaliates against someone for reporting

Part 6: Emergencies

Situation	What the driver does	What dispatch does
Weapon shown or attack under way	Get out of reach. Leave the van if that is safer. Call 911.	Call 911 with the van’s location. Send no other driver into the scene.
Threat from a rider in the van	Stop in a safe, public, well-lit place and call dispatch	Stay on the line, decide with the driver whether to end the ride, and call 911 if needed
Danger at a pickup	Do not get out. Lock the doors and drive away to a safe place.	Call the rider or facility, and tell the broker the trip could not be done safely
Duress word used on a call or radio	Keep the call open if you can	Call 911 with the van’s last location at once
Threat at the office	Follow the office plan: lock the door, move away from the threat, call 911	Warn every driver headed to the office

Duress word: ______________. Office shelter room and exit route: ______________.

Part 7: Hazards we found and how we fix them

Inspect when the plan starts, after every incident, whenever you learn of a new hazard, and on a schedule: every ______ months.

Hazard	Our fix	Done, by whom and when
Drivers work alone	Check-in with dispatch at every pickup and drop-off, and live van location
A rider with a history of violence or threats	Flag it in trip notes, assign an experienced driver, and ask the broker for an attendant
Early morning, late night, or dark pickup spots	Ask the facility for a lit door, wait inside the locked van, and check in on arrival
Cash fares	Card or invoice only, or a small cash limit, and no cash left in the van
Riders who are intoxicated or in crisis	The refusal and safe-stop rules in our conduct policy
Angry callers on the dispatch line	Script for ending a threatening call, and every threat written in the log
Strangers at the van or yard	Locked doors, a locked and lit yard, and cameras
A former partner of an employee comes to the office	Visitor rule, locked entry, and the employee may tell us in confidence
Conflict between coworkers	Report to the plan administrator, never handled by the people involved

Part 8: Training record

Train when the plan starts, every year after, and again when a new hazard is found or the plan changes. Use words and a language each employee understands.

Topic covered	Done
This plan, how to get a free copy, and how to help shape it
The definitions and rules in Labor Code 6401.9
How to report to us or to the police without fear of reprisal
The hazards in our work, the fixes in Part 7, how to get help, and how to avoid physical harm
The violent incident log, and how to get copies of our records
Questions and answers with someone who knows the plan

Session date	Trainer name and qualifications	Attendee name	Job title	Signature

Part 9: Violent incident log (one sheet per incident)

Outside the “Completed by” line, write no names, addresses, phone numbers, trip numbers, or other details that could identify anyone. Use job titles and “rider.”

Field	Entry
Date, time, and location
Type: 1 (stranger with criminal intent), 2 (rider, family member, or visitor), 3 (coworker, supervisor, or manager), 4 (someone with a personal relationship to an employee)
Detailed description
Who did it: rider, rider’s family or friend, stranger with criminal intent, coworker, supervisor or manager, partner or spouse, parent or relative, other
Circumstances: usual duties, poor lighting, rushed, low staffing, alone, unable to get help, community setting, unfamiliar or new place
Where: in the van, at a pickup or drop-off, office, yard or parking area, other
Kind of incident: physical attack, attack with a weapon or object, threat of force or of a weapon, sexual assault or threat, animal attack, other
Was law enforcement called? What did they do?
What we did to protect employees from a continuing threat
Completed by: name, job title, and date

Part 10: After an incident

1. Get first aid or call 911. Make sure the employee is safe and is not alone.
2. Protect everyone from a continuing threat, such as removing the driver from that rider’s trips until the review is done.
3. If an employee dies or is seriously injured, such as a hospital admission beyond observation, report it to Cal/OSHA right away and no later than 8 hours after you learn of it, unless it came from a crash on a public road.
4. If the injury needs treatment beyond first aid or costs time beyond the shift, give the employee a workers’ comp claim form within one working day.
5. Report it to the broker or facility as your contract requires.
6. Fill in the Part 9 log, and investigate using the record below.
7. Tell employees what you found and what will change, then review the plan in Part 11.

Investigation record	Entry
Log sheet date it relates to
What happened, from the employee and any witnesses
Why it happened
What we changed, and when
Employees told of the results on
Investigated by, and date

Keep medical details out of this record.

Part 11: Plan review

Review date	Reason: yearly, after an incident, or a gap found	Incident log reviewed	Changes made	Employees who took part

Part 12: Records and how long we keep them

Record	Keep at least	Where it is kept
Hazard inspections and fixes (Part 7)	5 years
Violent incident log (Part 9)	5 years
Incident investigations (Part 10)	5 years
Training records (Part 8)	1 year

What Labor Code 6401.9 requires, part by part

The plan has to be written, in effect at all times in every work area, and specific to the hazards and fixes for each operation. Cal/OSHA’s FAQ says even its own model plan does not ensure compliance, so tailor every part. The sample rows in Parts 6 and 7 are starting points to change.

Template part	What it covers	Labor Code 6401.9
Part 1	Who runs the plan and their roles	(c)(1) and (c)(2)(A)
Part 2	Employee involvement	(c)(2)(B)
Part 3	Coordinating with other employers	(c)(2)(C)
Part 4	Reporting, no retaliation, and sharing results	(c)(2)(D) and (F)
Part 5	Making sure everyone follows the plan	(c)(2)(E)
Part 6	Emergencies, alerts, and getting help	(c)(2)(G)
Part 7	Finding and fixing hazards	(c)(2)(I) and (J)
Part 8	Training topics and records	(e) and (f)(2)
Part 9	Violent incident log	(d)
Part 10	After an incident and the investigation	(c)(2)(K) and (f)(4)
Part 11	Yearly and after-incident review	(c)(2)(L)
Part 12	Records	(f)

The violent incident log

You log every workplace violence incident, with or without an injury, based on what the employees involved and witnesses say and what the investigation finds (6401.9(d)). Three points catch NEMT owners:

• Threats count. A threat of violence includes verbal or written statements, texts, and other electronic messages that convey an intent to cause physical harm and serve no legitimate purpose (6401.9(a)(5)). A caller who threatens a dispatcher belongs in the log.
• Intent does not matter. In its August 6, 2024 FAQ, Cal/OSHA answered a school district: bites, scratches, and hair pulling by special education students are Type 2 violence and must be logged whether or not they were intentional. A rider with dementia who scratches a driver is the same kind of entry.
• Animals only sometimes. An animal attack is workplace violence when a person uses the animal as a weapon (Cal/OSHA FAQ). A loose dog that bites a driver at a pickup is an ordinary work injury, not a log entry.

Injuries from violence can also belong on the Cal/OSHA Form 300 if they meet its recording criteria, such as days away from work or treatment beyond first aid. The violent incident log does not replace it. For your own fuller account of what happened on a trip, use the incident report form.

Training and records

Training happens when the plan is first set up and every year after, with extra training when a new hazard turns up or the plan changes (6401.9(e)). It has to be effective and in vocabulary and a language your staff understand. Training records list the dates, a summary of the content, the trainers’ names and qualifications, and each attendee’s name and job title (6401.9(f)(2)). The IIPP rule lets employers with fewer than 10 employees instruct orally and keep lighter records (8 CCR 3203), but the 5-year and 1-year minimums in 6401.9(f) have no small-employer exception.

After an incident

Part 10 adds the reporting duties that sit next to the plan. Cal/OSHA must hear about an employee’s death or serious injury or illness immediately, and no later than 8 hours after you know (8 CCR 342(a)). A serious injury means in-patient hospitalization beyond observation or testing, an amputation, the loss of an eye, or serious permanent disfigurement, and excludes a crash on a public street or highway outside a construction zone (8 CCR 330(h)). For an injury that needs treatment beyond first aid or costs time beyond the shift, the employer gives a claim form within one working day of learning of it (Labor Code 5401). See workers’ comp for NEMT.

An employer can also ask a court for a workplace violence restraining order on an employee’s behalf after harassment, violence, or a credible threat of violence at work (Code of Civil Procedure 527.8, as amended effective January 1, 2026).

Who needs a plan, and who follows 3342 instead

Labor Code 6401.9 applies to all employers, employees, and places of employment in California, with a short list of exemptions (6401.9(b)). Three matter to a NEMT company.

• Health care work under 8 CCR 3342. Facilities, service categories, and operations covered by Cal/OSHA’s Violence Prevention in Health Care rule are exempt, and Cal/OSHA’s FAQ says a place that must follow 3342 does not also follow 6401.9. That rule’s scope includes “emergency medical services and medical transport.” In its 2016 Final Statement of Reasons, the Standards Board explained that medical transport covers transport outside an emergency response, such as moving a patient from one facility to another, which is not necessarily done by paramedics. Ambulance crews of EMTs and paramedics fall inside it. Whether a wheelchair or gurney van company is inside it depends on your operation, so ask Cal/OSHA Consultation (free, 1-800-963-9424) and keep its answer on file. The law also exempts any employer that complies with 3342 (6401.9(b)(2)(B)), so a company that follows 3342 in full meets the law either way. Cal/OSHA’s model plan for general industry tells employers covered by 3342 not to use it.
• Small places the public cannot enter. A place of employment is exempt only when fewer than 10 employees work there at any given time, it is not accessible to the public, and you follow the IIPP rule (6401.9(b)(2)(F)). Every van carries riders, and drivers work in riders’ homes and at clinics, so treat your drivers’ work as covered. A home office or a yard no rider or visitor enters, with under 10 staff on site, can fit the exemption.
• Teleworkers. A dispatcher working from a place of their own choice that you do not control is exempt for that work (6401.9(b)(2)(E)).

Cal/OSHA can also order an exempt employer to comply (6401.9(b)(3)). For your hazard review in Part 7, Cal/OSHA’s general industry page lists working alone, night and early morning hours, exchanging money, and working with passengers or clients known or suspected to have a history of violence among the factors that raise it. It also names robberies of taxi and ride-hailing drivers as Type 1 violence. The federal side of driver safety is in the OSHA guide for NEMT companies.

Cal/OSHA’s permanent standard: where it stands

The law tells the Standards Board to adopt a permanent workplace violence standard by December 31, 2026 (6401.9(h)). As of October 2026 it is still a Cal/OSHA discussion draft. The September 2026 draft of a new title 8 section 3343 keeps the exemptions for work covered by 3342 and adds employer-provided transportation under the employer’s control to its scope. It also narrows the small-site exemption to places with fewer than 10 employees at all times during the preceding 365 days. Cal/OSHA set an in-person advisory meeting on that draft for October 27, 2026 in Oakland. The draft can still change, and none of it is in force. Until a standard is adopted, follow Labor Code 6401.9 as written, and watch Cal/OSHA’s rulemaking page for the final text.

For the rest of what a NEMT company needs in California, from Medi-Cal enrollment to vehicle rules, see the California guide.