Let me set the stage for what you are about to read.
SB 553 went into effect on July 1, 2024. It requires every California employer — with very few exceptions — to establish, implement, and maintain a written Workplace Violence Prevention Plan. Not think about one. Not intend to create one. Have one, in writing, and have it operational.
This template gives you the framework. Every required section is here. Every fill-in-the-blank field maps to a specific SB 553 requirement. The guidance notes tell you what to put in each section and why.
But I need you to understand something before you start filling in blanks: this template is a framework, not a finished plan. A WVPP that reads like a template — generic language, placeholder names, vague procedures — will fail inspection exactly as thoroughly as having no plan at all. I wrote an entire article about why (see article 213). The template gives you the structure. You supply the specifics that make it your plan and nobody else's.
---
WORKPLACE VIOLENCE PREVENTION PLAN
[YOUR COMPANY NAME]
**Plan Effective Date:** _______________
**Most Recent Review/Update:** _______________
**WVPP Administrator:** _______________ (Name, Title)
**Plan Location(s):** _______________ (Where physical and/or digital copies are accessible to all employees)
---
Section 1: Purpose and Scope
1A: Purpose Statement
> [COMPANY NAME] is committed to providing a safe and secure workplace free from actual and threatened violence for all employees, contractors, temporary workers, visitors, and other individuals at our workplace(s). This Workplace Violence Prevention Plan (WVPP) establishes policies, procedures, and responsibilities for preventing workplace violence and responding effectively when incidents occur, in compliance with California Labor Code Section 6401.9 (SB 553).
**[GUIDANCE: The purpose statement above is standard language. You may customize it but must retain the commitment to all categories of people listed — employees, contractors, temps, visitors. SB 553 covers everyone at your workplace, not just employees.]**
1B: Scope
This plan applies to:
- [ ] All company workplace locations (list): _______________
- [ ] All employees regardless of position, shift, or employment status
- [ ] All contractors, subcontractors, and temporary workers performing work at company locations
- [ ] All visitors, clients, customers, patients, and members of the public present at company locations
This plan does NOT apply to:
- [ ] Employees working remotely from their personal residences (unless the workplace violence involves a coworker or work-related contact)
- [ ] Other exclusions (if applicable): _______________
**[GUIDANCE: SB 553 has limited exemptions. Healthcare facilities with existing Cal/OSHA workplace violence prevention plans under Title 8 §3342 are exempt. Employees who telework from locations not controlled by the employer are exempt for that location. Law enforcement agencies are exempt. If you are unsure whether an exemption applies to you, assume it does not.]**
1C: Definitions
For purposes of this plan, "workplace violence" means any act of violence or threat of violence that occurs in a place of employment, including but not limited to:
- **Type 1 — Criminal Intent:** Violence by someone with no legitimate business relationship to the workplace (robbery, trespass, active shooter)
- **Type 2 — Customer/Client:** Violence by a customer, client, patient, or other person receiving services
- **Type 3 — Worker-on-Worker:** Violence by a current or former employee against another employee
- **Type 4 — Personal Relationship:** Violence by someone who has a personal relationship with an employee (domestic violence that spills into the workplace)
**[GUIDANCE: These four types come from Cal/OSHA's established framework. Your WVPP must address all four types applicable to your workplace. Most workplaces face all four. Do not exclude a type simply because you believe it is unlikely — the inspector will ask why you excluded it.]**
---
Section 2: Responsible Persons
2A: WVPP Administrator
| Field | Entry |
|-------|-------|
| **Name** | |
| **Title** | |
| **Phone** | |
| **Email** | |
| **Responsibilities** | Plan maintenance, training coordination, incident log review, annual review scheduling, employee communication |
| **Authority** | Authority to implement corrective actions, modify procedures, allocate resources for plan compliance |
2B: Backup Administrator
| Field | Entry |
|-------|-------|
| **Name** | |
| **Title** | |
| **Phone** | |
| **Email** | |
| **Assumes Responsibilities When** | Primary administrator is absent, unavailable, or involved in an incident |
2C: Additional Responsible Persons
| Role | Name | Title | Responsibilities |
|------|------|-------|-----------------|
| **Executive Sponsor** | | | Ultimate authority, budget approval, policy decisions |
| **HR Contact** | | | Employee relations, restraining orders, accommodation, discipline |
| **Security Contact** | | | Physical security, access control, security assessments |
| **Facility Manager** | | | Physical environment, lighting, locks, cameras, building access |
| **Supervisor Responsibilities** | [All supervisors] | | Recognize warning signs, receive reports, implement procedures, document |
**[GUIDANCE: SB 553 requires you to name the person or persons responsible for implementing and maintaining the plan. "The management team" is not a person. Name individuals. When individuals change roles or leave the company, update this section immediately — do not wait for the annual review.]**
---
Section 3: Employee Involvement
3A: How Employees Participate in Plan Development and Implementation
Describe the specific mechanisms through which employees are involved:
- [ ] **Safety Committee** — Committee name: _______________, meeting frequency: _______________, employee representatives: _______________
- [ ] **Employee Surveys** — Frequency: _______________, topics covered: _______________
- [ ] **Suggestion/Feedback System** — Method: _______________ (physical box, digital form, hotline)
- [ ] **Review and Comment Period** — Employees were provided the draft WVPP on _______________ with comments due by _______________
- [ ] **Training Feedback** — Feedback solicited during training sessions and documented in training logs
- [ ] **Incident Debriefings** — Affected employees participate in post-incident review
- [ ] **Other:** _______________
3B: How Employee Input Is Incorporated
> Employee feedback received through the mechanisms described above is reviewed by the WVPP Administrator within ___ business days. Substantive suggestions are evaluated for feasibility and effectiveness. Changes adopted from employee input are communicated to all employees within ___ business days and documented in the plan revision log (Section 10).
**[GUIDANCE: This is the section most templates get wrong. SB 553 explicitly requires employee involvement — not just notification, involvement. The inspector will ask employees whether they were given an opportunity to participate in plan development. If they say no, your documentation is contradicted by the people it is supposed to protect. Make the involvement real, then document it.]**
---
Section 4: Workplace Hazard Assessment
4A: Assessment Details
| Field | Entry |
|-------|-------|
| **Assessment Date** | |
| **Conducted By** | |
| **Assessment Method** | [ ] Physical walkthrough [ ] Employee interviews [ ] Incident history review [ ] Security assessment [ ] Crime data review [ ] Industry benchmarking |
| **Locations Assessed** | |
4B: Hazard Identification
Complete for each identified hazard:
| # | Hazard Description | Violence Type (1-4) | Location | Who Is at Risk | Current Controls | Risk Level (H/M/L) | Additional Controls Needed |
|---|--------------------|-----------------------|----------|----------------|------------------|---------------------|---------------------------|
| 1 | | | | | | | |
| 2 | | | | | | | |
| 3 | | | | | | | |
| 4 | | | | | | | |
| 5 | | | | | | | |
| 6 | | | | | | | |
| 7 | | | | | | | |
| 8 | | | | | | | |
4C: Workplace-Specific Risk Factors
Check all that apply to your workplace(s):
**Physical Environment:**
- [ ] Public-facing operations (retail, service counter, reception)
- [ ] Cash handling
- [ ] Late night or early morning operations
- [ ] Isolated or remote work areas
- [ ] Poor lighting in parking areas, stairwells, or corridors
- [ ] Inadequate access control (unlocked doors, no visitor management)
- [ ] Multiple entry/exit points that are not monitored
**Operational Factors:**
- [ ] Employees work alone
- [ ] Employees handle controlled substances or valuables
- [ ] Employees make home visits or work at client locations
- [ ] Services involve volatile or emotionally charged situations
- [ ] Employee terminations or disciplinary actions
- [ ] High-stress work environment
- [ ] History of workplace violence incidents at this location
**Population Factors:**
- [ ] Employees with known restraining orders or protective orders
- [ ] Patients or clients with history of violent behavior
- [ ] Public access without screening or check-in procedures
- [ ] Adjacent to high-crime area
**[GUIDANCE: The hazard assessment is the foundation of your entire WVPP. A thorough assessment leads to specific controls. A superficial assessment — "we checked the boxes and found no hazards" — is not credible in any workplace that interacts with the public, handles money, or has more than a handful of employees. Be honest. Identifying hazards is not an admission of failure — it is evidence of diligence.]**
---
Section 5: Corrective Actions and Hazard Controls
5A: Controls Currently in Place
| # | Hazard Addressed | Control Measure | Type (Engineering/Admin/PPE) | Responsible Person | Last Verified |
|---|------------------|-----------------|------------------------------|--------------------|----|
| 1 | | | | | |
| 2 | | | | | |
| 3 | | | | | |
| 4 | | | | | |
| 5 | | | | | |
5B: Planned Corrective Actions
| # | Hazard Addressed | Corrective Action | Responsible Person | Target Date | Budget/Resources | Status |
|---|------------------|--------------------|--------------------|-------------|------------------|--------|
| 1 | | | | | | |
| 2 | | | | | | |
| 3 | | | | | | |
5C: Hierarchy of Controls
Apply controls in this priority order:
- **Elimination** — Remove the hazard entirely (e.g., discontinue cash transactions, implement delivery-only)
- **Engineering Controls** — Physical barriers, access control systems, surveillance cameras, panic alarms, improved lighting
- **Administrative Controls** — Policies, procedures, buddy systems, scheduling adjustments, de-escalation protocols
- **Personal Protective Equipment** — Body-worn cameras, personal alarms (last resort, least effective)
**[GUIDANCE: Cal/OSHA expects to see a range of control types. A plan that lists only administrative controls — "we told employees to be careful" — demonstrates a weak approach. Engineering controls (physical changes to the environment) are always more effective than administrative controls (telling people what to do). Show the inspector you understand the hierarchy.]**
---
Section 6: Reporting Procedures
6A: How to Report Workplace Violence
Employees can report workplace violence incidents, threats, or concerns through any of the following channels:
| Channel | Details | Available When |
|---------|---------|----------------|
| **Direct Report to Supervisor** | Employee tells their immediate supervisor verbally or in writing | During work hours |
| **WVPP Administrator** | Contact: _______________ Phone: _______________ Email: _______________ | During business hours |
| **HR Department** | Contact: _______________ Phone: _______________ Email: _______________ | During business hours |
| **Anonymous Reporting** | Method: _______________ (hotline, digital form, physical drop box) | 24/7 |
| **Emergency** | Call 911 for immediate danger | 24/7 |
6B: What to Report
Employees are encouraged and required to report:
- Physical assaults or attempted assaults
- Verbal threats of violence (direct or implied)
- Intimidation, bullying, or harassment that could escalate
- Possession or display of weapons
- Stalking behavior
- Property damage motivated by anger or intimidation
- Suspicious activity by unknown persons
- Domestic violence situations that may affect the workplace
- Any situation that makes an employee feel unsafe
6C: Non-Retaliation Policy
> [COMPANY NAME] strictly prohibits retaliation against any employee who reports workplace violence, threats, hazards, or concerns in good faith. Retaliation includes but is not limited to termination, demotion, reduction in hours, reassignment, or any adverse employment action. Employees who believe they have experienced retaliation should report to _______________ (name/title) or _______________ (alternative contact). Reports of retaliation will be investigated promptly and independently of the original report.
**[GUIDANCE: The non-retaliation provision is not optional. SB 553 requires it. But beyond the legal requirement, think about this practically: if employees fear retaliation, they will not report. If they do not report, you will not know about threats until they become incidents. The reporting system only works if employees trust it. The non-retaliation policy is the foundation of that trust.]**
---
Section 7: Emergency Response Procedures
7A: Active Threat Response
> In the event of an active threat (armed individual, active shooter, violent attack in progress):
**RUN — HIDE — FIGHT (in that order)**
- **RUN:** If a safe escape route is accessible, evacuate immediately. Leave belongings. Help others if possible without endangering yourself. Call 911 once safe.
- **HIDE:** If evacuation is not possible, find a secure location. Lock and barricade doors. Silence phones. Stay out of sight. Remain hidden until law enforcement gives the all-clear.
- **FIGHT:** As an absolute last resort, when your life is in imminent danger and escape/hiding are impossible, take action to disrupt or incapacitate the attacker.
7B: Response to Threats (Non-Imminent)
| Threat Level | Indicators | Response |
|--------------|-----------|----------|
| **Level 1 — Concerning** | Unusual behavior, vague statements, minor intimidation | Document, report to supervisor and WVPP Administrator, monitor |
| **Level 2 — Elevated** | Direct verbal threats, escalating behavior, property damage | Report immediately, separate parties, HR assessment, consider security |
| **Level 3 — Imminent** | Weapon display, physical assault, active attack | Call 911, activate emergency procedures, evacuate or shelter |
7C: Emergency Contacts
| Contact | Name | Phone | When to Call |
|---------|------|-------|-------------|
| **911** | — | 911 | Imminent danger, active threats, injuries |
| **Local Police Non-Emergency** | | | Non-imminent threats, suspicious activity |
| **WVPP Administrator** | | | All incidents, after immediate danger resolved |
| **HR Department** | | | Employee relations, protective orders, personnel issues |
| **Employee Assistance Program (EAP)** | | | Counseling, support services for affected employees |
| **Building Security** | | | Access control, escort requests, suspicious persons |
7D: Post-Incident Procedures
- Ensure immediate safety of all persons
- Provide first aid and summon medical assistance as needed
- Secure the scene (do not disturb evidence if law enforcement may investigate)
- Notify the WVPP Administrator within ___ hours
- Notify HR within ___ hours
- Complete an incident report (see Incident Report Template, article 236)
- Update the Violent Incident Log within ___ hours
- Conduct post-incident debriefing within ___ business days
- Offer EAP services to affected employees
- Conduct root cause analysis and identify corrective actions
- Update WVPP if the incident reveals gaps in the plan
**[GUIDANCE: Your emergency response procedures must be specific to your facility. "Evacuate the building" requires knowing WHERE employees go, WHICH routes they take, WHO accounts for them, and HOW you communicate the all-clear. Walk through each scenario in your actual building and write procedures that match your reality, not a generic template.]**
---
Section 8: Training Program
8A: Training Requirements
| Training | When | Who | Duration | Method |
|----------|------|-----|----------|--------|
| **Initial WVPP Training** | Within ___ days of hire | All new employees | Minimum ___ minutes | [ ] Classroom [ ] Online [ ] Both |
| **Annual WVPP Review** | By _______________ each year | All employees | Minimum ___ minutes | [ ] Classroom [ ] Online [ ] Both |
| **Post-Incident Training** | Within ___ days of an incident | Affected employees + all employees (as appropriate) | As needed | Classroom recommended |
| **New Hazard Training** | When new hazard identified | Affected employees | As needed | Varies |
| **Supervisor Training** | Initial + annual | All supervisors and managers | Minimum ___ minutes | Classroom recommended |
8B: Training Content
All WVPP training sessions must cover:
- [ ] The company's workplace violence prevention policy
- [ ] The four types of workplace violence
- [ ] How to recognize warning signs and escalating behavior
- [ ] Reporting procedures (all channels, non-retaliation guarantee)
- [ ] Emergency response procedures (RUN-HIDE-FIGHT, threat levels)
- [ ] Location-specific hazards identified in the hazard assessment
- [ ] De-escalation techniques
- [ ] How to obtain protective/restraining orders (and how to inform the company)
- [ ] Available support resources (EAP, counseling, crisis hotlines)
- [ ] Employee's right to participate in plan development
- [ ] How to access the written WVPP
8C: Training Documentation
All training sessions must be documented using the Training Log Template (article 237), including:
- Date, time, duration, location
- Trainer name and qualifications
- Content covered
- Attendance roster with signatures
- Questions asked and answered
- Absent employee tracking and make-up training plan
**[GUIDANCE: SB 553 requires training. It requires training to be documented. And it requires that the training cover the specific hazards of your workplace — not just generic workplace violence awareness. If your training is a generic video followed by a sign-in sheet, it is technically training, but it is not what the law contemplates, and a good inspector will recognize the difference.]**
---
Section 9: Violent Incident Log
9A: Log Requirements
SB 553 requires employers to maintain a violent incident log. This log must record every workplace violence incident, including the following information **without identifying the victim or the person who made the threat:**
| Field | Description |
|-------|-------------|
| **Date, time, and location** | When and where the incident occurred |
| **Detailed description** | What happened — factual narrative |
| **Violence type** | Type 1, 2, 3, or 4 |
| **Classification** | Threat, physical assault, property damage, other |
| **Circumstances** | Events leading up to the incident |
| **Person(s) involved** | Role/category only (employee, customer, visitor) — NOT names |
| **Consequences** | Injuries, property damage, psychological impact |
| **Actions taken** | Immediate response and corrective actions |
9B: Log Template
| # | Date/Time | Location | Description | Type | Classification | Circumstances | Persons (Role Only) | Consequences | Actions Taken |
|---|-----------|----------|-------------|------|----------------|---------------|----------------------|-------------|---------------|
| 1 | | | | | | | | | |
| 2 | | | | | | | | | |
| 3 | | | | | | | | | |
9C: Privacy Requirements
- The violent incident log must NOT contain the name of the person who was the victim of workplace violence or the person who made the threat
- Use role descriptors only: "warehouse employee," "customer," "former employee," "unknown individual"
- The full incident report (with names) is maintained separately and kept confidential
- The log is made available to Cal/OSHA upon request and to employees and their representatives for review
**[GUIDANCE: The incident log and the incident report are different documents. The incident report (article 236) contains all details including names — it is an internal document. The incident log is a summary record that protects privacy while maintaining the record. Both are required. Do not combine them.]**
---
Section 10: Plan Review and Revision
10A: Review Schedule
| Review Type | Frequency | Conducted By | Next Scheduled |
|-------------|-----------|--------------|----------------|
| **Annual Review** | Every 12 months | WVPP Administrator + employee representatives | |
| **Post-Incident Review** | After every workplace violence incident | WVPP Administrator + involved parties | As needed |
| **Triggered Review** | When new hazards identified, operations change, or corrective action deficiency found | WVPP Administrator | As needed |
10B: Revision Log
| Version | Date | Revised By | Sections Changed | Reason for Change |
|---------|------|-----------|------------------|-------------------|
| 1.0 | | | All (initial plan) | Plan creation |
| | | | | |
| | | | | |
| | | | | |
10C: Annual Review Checklist
During each annual review, verify:
- [ ] All responsible persons are current (names, titles, contact information)
- [ ] Hazard assessment has been updated to reflect current conditions
- [ ] Corrective actions from prior reviews are complete
- [ ] Incident log has been reviewed for trends and patterns
- [ ] Reporting procedures are functional and accessible
- [ ] Emergency response procedures reflect current building layout and personnel
- [ ] Training program is current and all employees are trained
- [ ] Employee involvement mechanisms are active
- [ ] Plan is accessible to all employees at all locations
- [ ] All referenced documents (EAP information, emergency contacts, hotline numbers) are current
**[GUIDANCE: The annual review is not a checkbox exercise. It is a systematic evaluation of whether your plan works. Read your incident log from the past year. Did the reporting procedures work? Did employees actually use them? Did your response procedures prove adequate? Did your training prepare people for what actually happened? Answer those questions honestly, update the plan accordingly, and document the review. That is what SB 553 requires.]**
---
Section 11: Plan Accessibility
This WVPP is available to all employees through the following:
- [ ] Physical copy posted at: _______________
- [ ] Physical copy available in: _______________ (HR office, break room, safety bulletin board)
- [ ] Digital copy on company intranet at: _______________
- [ ] Digital copy available upon request from: _______________
- [ ] Copy provided to each employee upon hire: [ ] Yes [ ] No
- [ ] Copy provided to employee representatives upon request: [ ] Yes [ ] No
- [ ] Available in languages other than English: [ ] Yes — Languages: _______________ [ ] No
**[GUIDANCE: SB 553 requires that the plan be available to employees and their representatives. "Available" means employees know it exists and can access it without asking for special permission. If your plan is locked in the HR director's desk drawer, it is not available. If your plan is only in English and 40% of your workforce speaks Spanish as their primary language, it is not effectively available.]**
---
Signatures
By signing below, the undersigned confirm that this Workplace Violence Prevention Plan has been developed with employee involvement, reviewed for completeness, and approved for implementation.
| Role | Name | Signature | Date |
|------|------|-----------|------|
| **Company Owner/Executive** | | | |
| **WVPP Administrator** | | | |
| **HR Representative** | | | |
| **Employee Representative** | | | |
| **Employee Representative** | | | |
---
Appendices Checklist
Attach the following documents to complete your WVPP:
- [ ] **Appendix A:** Workplace diagrams/floor plans showing exits, assembly points, panic alarm locations, security camera locations
- [ ] **Appendix B:** Hazard assessment worksheets (see Hazard Assessment Template, article 239)
- [ ] **Appendix C:** Training materials and training log templates (see Training Log Template, article 237)
- [ ] **Appendix D:** Incident report form (see Incident Report Template, article 236)
- [ ] **Appendix E:** Violent incident log
- [ ] **Appendix F:** Emergency Action Plan (see EAP Template, article 240)
- [ ] **Appendix G:** Restraining order/protective order notification procedures
- [ ] **Appendix H:** EAP and support resource information
- [ ] **Appendix I:** Relevant Cal/OSHA standards and SB 553 text
---
*Protekon builds, implements, and maintains Workplace Violence Prevention Plans for California employers. Not templates — fully customized plans built around your workplace, your hazards, your people, and your operations. Our managed compliance program includes the plan, the training, the incident documentation system, the annual review, and the updates when the law changes. You run your business. We run your compliance.*