OSHA Challenge Administration Annual Report CY '23

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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

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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 harris.richard@dol.gov no later than March 25.

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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				m.fullen@mail.wvu.edu
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				amanda.mason@mail.wvu.edu
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.

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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!

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Sheet 4: 3 - Participant 1 Info

OSHA Challenge Participant Information
Participant								OSHA 300 Log Totals for
Building Systems Inc								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			193,698.0				Total Employees			98
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

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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
				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

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Sheet 6: 5 - Participant 3 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

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

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.

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Sheet 7: 6 - Participant 4 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 8: 7 - Participant 5 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 9: 8 - Participant 6 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 10: 9 - Participant 7 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 11: 10 - Participant 8 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 12: 11 - Participant 9 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

Year

CY 2016

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

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.

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Sheet 13: 12 - Participant 10 Info

OSHA Challenge Participant Information

Participant

OSHA 300 Log Totals for

[Insert Participant Name Here]

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

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.