by Jonathan Shull, CEO
As 2014 comes to a close, I thought I would share some reflections on the events of the past and on the progress we continue to make together.
Public sector risk pools got their start in the mid-1970s when insurance carriers became wary of potential “deep pocket” judgments against local governments. Municipal insurers inflated their rates, and many of Southern California’s cities were feeling the crunch.
Recognizing the need to diffuse the strain of increasingly burdensome costs, the California Contract Cities Association began searching for new ways to protect cities from liability. Following two years of work by committees made up of council members, city managers, finance officers, city attorneys, and consultants, the Southern California Joint Powers Insurance Authority, as it was known then, officially came into being on June 29, 1977, with a total of thirty-three cities signing the Joint Powers Agreement.
With its governing body made up of elected officials, and its clearly established risk management goals, those insurance companies that had abandoned the municipal insurance market were now showing interest in providing coverage to the SCJPIA because they thought it was “a good program with good-sized premiums and good risk management goals.”
Those risk management goals established over thirty-five years ago continue to guide the Authority as we move forward. Member risk management field audits have evolved into the innovative LossCAP program in place today. The occasional training seminar of the past has now expanded to an unsurpassed training program that reached nearly 26,000 member employees last year.
As with the council members, city managers, finance officers, city attorneys, and consultants who worked to create the California JPIA in the 1970s, it is through the active participation and guidance of the members that the California JPIA continues to be one of the most distinguished risk-sharing pools in the state. With a delegate from each entity sitting on the Board of Directors, members have a direct voice in shaping the policies and procedures that guide the Authority and the services it provides. The California JPIA is a self-governed public risk pool dedicated to addressing the risk management needs of its members. It is because of the participation and guidance of our members that the California JPIA continues to be one of the most distinguished public risk pools in the state.
I’m grateful to be surrounded by such a great team. Many of you interact frequently with the Authority’s risk managers, training staff, and program managers. However, I would like to acknowledge the Authority’s administrative and support staff that work in the office and take care of the many details—coordinating training workshops, preparing meeting agendas, drafting coverage letters, and responding to members’ inquiries—that allow us to better serve the members.
Four new staff members have joined the California JPIA team. Roy Angel is the Authority’s new Senior Risk Manager and will serve members in the Central Coast region (Santa Barbara, San Luis Obispo, Ventura, and Monterey counties). Courtney Morrison is the Authority’s new Administrative Analyst. Courtney is responsible for various information resources for members including: the new California JPIA website, the white paper series, ADA resources, policy templates and checklists, and the sidewalk inspection and maintenance program. Denise Covell and Robin Baccanti joined the staff in July as Office Assistants. Denise supports the executive division (Denise’s voice is the friendly greeting you hear when you call the California JPIA office), and Robin supports the training division and assists with training workshop logistics.
Thank you for your continued support of the California JPIA. We wish you very happy holidays and a great New Year.
Upcoming Academies: Parks and Recreation, and Leadership Academy
by Michelle Aguayo, Training Coordinator
Parks and Recreation Academy
The California JPIA Parks and Recreation Academy is set to take place February 3 – February 5, 2015 at the La Bellasera Hotel in Paso Robles. This three-day academy is designed for parks and recreation directors, managers, and supervisors. The Academy will provide strategies for developing new programs and evaluating existing ones, staffing, overseeing special events, and providing safe environments in parks and aquatic centers.
Butch DeFillippo and Dr. Nancy White, with PlaySafe, LLC, will present Parks and Recreation Risk Management, a session dealing with managing risk in recreation facilities, programs, and services. Topics include: the legal aspects of risk, practical methods for identifying risk, taking appropriate actions to mitigate risk, and continual assessment of safety. They will also present Playground Safety and Defending Your Agency against Playground Litigation featuring discussion on common playground injuries, safety, guidelines, hazards versus risk, and playground programs that will help agencies address these issues.
Dr. Todd Seidler, member of the planning team for PlaySafe, LLC will present Safe Facilities: Conducting a Facilities Risk Review, where participants will review the inspection process and ways to eliminate or avoid hazardous conditions and injuries within their facility. He will also present Emergency Plans, a session identifying the most likely emergencies facing agencies today, the development of an emergency action plan, and training staff to properly carry it out in the event of an emergency or catastrophic event. Seidler will present Recreation for Tomorrow: Keeping Safety First with Dr. Nancy White, focusing on current risk management issues in recreation facilities, along with practical solutions for mitigating risk and removing/addressing hazards.
Contracts and Joint Use Agreements, presented by Marjorie Segale, with Segale Consulting, will discuss strategies to protect agencies against financial loss through contracts, contractual risk transfer and its importance, and approaches for avoiding risk assumption. She will provide guidelines for writing and executing contracts and joint use agreements.
Scott Grossberg, partner with Cihigoyenetche Grossberg & Clouse, will present Aquatic Facilities, a discussion of effective risk management strategies for reducing liability, increasing safety, and improving operations of aquatic facilities. He will also present Participant Waivers, Releases and Facility Use Agreements as well as a session on Background Checks, Volunteers, and Part-time Employees.
Registration is limited to 30 participants. The cost to attend the Academy is $375 for members/$775 for non-members and includes two nights at the La Bellasera hotel, breakfast and lunch, and materials.
For further information or to register for the Parks and Recreation Academy, click here.
The California JPIA Leadership Academy is set to take place February 23 – February 25, 2015 at the Hyatt Regency in Indian Wells. The demands on local governments are increasingly complex and challenging, requiring leaders to be more effective and accountable in an era of limited resources. This three-day academy is designed for senior management to respond to these demands by expanding their ability to think strategically and apply skills that will enable them to achieve effective, sustainable results.
The sessions are practitioner-focused and designed to enhance organizational effectiveness. Participants will assess and explore their personal behavioral preferences and how they may affect their relationships with employees. They will also acquire approaches to identify differences between root cause and proximate cause, gain tools and strategies for resolving conflict, realize and increase the benefits of trust, and enhance the effectiveness of their communication, internally and externally.
John Perry, President of Human Productivity Systems, will present The Job-Person-Environment Assessment, a session that reveals the behavioral challenges senior management is likely to face in their current positions and how those challenges impact their energy to get the job done.
The Trust, Strategic Thinking and Innovation session will be presented by Forrest Story, principal consultant for Public Sector Excellence. Forrest will give participants the opportunity to identify leadership practices that engender trust, make trust-building a part of their strategic focus, and stay out of the counterproductive and trust-killing practice of “over-managing” and “under-leading.”
Jeff Bills, President of Confidence Consulting, will present the Organizational Risk Management session, which discusses what leaders can do today to minimize incidents from going wrong. The session will focus on the five pillars of a successful organization and will provide informed leaders with ideas to improve performance in the workplace.
Participants will learn about skills that empower more positive personal ethical decision-making in thePublic Service Ethics/Making Decisions in the Gray Zone session, presented by Forrest Story. Forrest will present strategies that expand upon leadership excellence, including being open and honest, and adhering to the highest set of personal standards that are consistently reflected in our behavior.
Dr. Steve Albrecht, PHR, CPP, will present The Conflict Resolution: Leadership Strategies, Tools, and Techniques to Help Employees Get Along session, which will teach participants to use new communication skills, team-building, group problem-solving tools, mediation/empathic listening skills, and knowledge of social intelligence to help create and enforce ground rules for workplace civility, appropriate behavior, and ultimately, better employee performance.
Strengthening Your Agency will be presented by Lizz Pellet, Vice President of Educational Sales for The Sourcing Institute. In an organization, employee behavior is affected by the organizational culture. Culture can be found in any organization no matter how small or large. Defined, organizational culture is how an organization carries out its activities and how management relates to its employees and its community. Organizational culture gives employees a sense of identity. It makes them feel part of the organization because they understand what is expected of them. When they are given a role to play in order to help the organization achieve its objectives, they know their duties thus have a purpose in the organization.
Registration is limited to 30 participants. The cost to attend the Academy is $375 for members/$775 for non-members and includes two nights at the Hyatt Regency hotel, breakfast and lunch, and materials.
For further information or to register for the Leadership Academy, click here.
Workers’ Compensation Premium Rate Ranking Summary
by Jeff Rush, Workers’ Compensation Program Manager
If you think the costs of workers’ compensation in California are expensive, you are right. If you think they’re the most expensive in the country, I’m sorry to inform you that a recently issued report confirms that belief. The Oregon Department of Consumer and Business Services issues a biennial study of rates in all 50 states, and California’s rates were just ranked as the highest in the nation.
The study focuses on the cost of coverage across 10 classifications of employees. While many of the Authority’s exposures, such as public safety and public works are not among these classifications, the study does create a baseline by which the cost of a state’s system and benefit structure can be compared to those of other states.
California was toward the top of this list nearly a decade ago before the 2004 reform was implemented. The effects of that reform led to California falling from the top 10 before ascending back to the number 3 position two years ago. The workers’ compensation system is still working through the implementation of many aspects of the 2012 reform and not all of the projected savings have materialized, thus allowing California to return to the top (or bottom) of this rather dubious list.
California JPIA Website: Evidences of Coverage
The California JPIA recently updated its website www.cjpia.org in order to provide better information and service to members. Overall, this means members will be able to find information more easily and also have access to more self-service options.
Members can easily make requests for evidence of coverage letters by completing a user-friendly submission form found on the Authority website.
Evidence of coverage letters provide documentation of liability and workers’ compensation coverage and are commonly issued to third parties such as individuals, vendors, companies, schools, and other agencies.
Members are able to immediately download basic evidences of coverage after completing the submission form, but for evidences of coverage that name a third party as an additional protected party (or additional insured), approval must be provided by the Authority after the submission form is received. Approval is typically given within two business days after receiving all needed documentation from the member, including an executed copy of the agreement or contract for the activity.
Evidence of coverage letters can be requested online by visiting the Coverage Evidences, Documents, and Certificates page, listed under the Protection heading on the home page’s menu bar.
For more information on this feature, please contact Jim Thyden, Insurance Programs Manager, at email@example.com or (562) 467-8784.
by Roy Angel, Senior Risk Manager
Workplace accidents happen. In fact, thousands occur throughout the United States every day. They are expensive. The actual cost of a workplace injury can be substantial. Yet for every dollar an employer spends on the direct costs of a worker’s injury or illness, they will spend much more to cover the indirect and hidden costs, such as:
- Productive time lost by an injured employee;
- Productive time lost by employees and supervisors attending to the accident victim;
- Clean-up and start-up of operations interrupted by the accident;
- Time to hire or to retrain other individuals to replace the injured worker until his/her return;
- Time and cost for repair or replacement of any damaged equipment or materials;
- Cost of continuing all or part of the employee’s wages, in addition to compensation;
- Reduced morale among your employees and, perhaps, lower efficiency;
- Increased workers’ compensation insurance rates;
- Overtime paid to cover the lost productivity of the injured worker; and
- Cost of completing paperwork generated by the incident.
The cause of most accidents is due to the failure of people, equipment, supplies, or surroundings to behave or react as expected. In California, it is the employer’s responsibility by law to create a safe and healthy workplace for his/her employees. It is the employer’s duty to prevent accidents in the workplace.
Accident investigation is a very effective tool in the prevention of future accidents. The accident investigation determines how and why these failures occur, and it allows the employer to drill down to the root cause of the accident. It also enables risk managers to track trends, thus providing the tools to be proactive. By using the information gained through an investigation, a similar, or perhaps more disastrous, accident may be prevented.
All accident investigations should be in writing and adequately identify the cause(s) of the accident or near-miss occurrence. They should be conducted by trained individuals, and with the primary focus of understanding why the accident or near-miss occurred and what steps can be taken to prevent recurrence.
The Cal/OSHA – Guide suggests the following:
- The investigation should describe what took place that prompted the investigation: an injury to an employee, an incident that caused a production delay, damaged material, or any other conditions recognized as having a potential for losses or delays.
- The investigation must obtain all the facts surrounding the occurrence: what caused the situation to occur; who was involved; was/were the employee(s) qualified to perform the functions involved in the accident or near-miss; was/were the employee(s) properly trained; were proper operating procedures established for the task involved; were procedures followed, and if not, why; and where else this or a similar situation might exist, and how it can be corrected.
- The person conducting the investigation must determine which aspects of the operation or processes require additional attention. It is important to note that the purpose here is not to establish blame, but to determine what type of constructive action can eliminate the cause(s) of the accident or near-miss.
- Action already taken to reduce or eliminate the exposures being investigated should be noted, along with those remaining to be addressed. Any interim or temporary precautions should also be noted. Any pending corrective action and reason for delaying its implementation should be identified.
- Corrective action should be identified in terms of not only how it will prevent a recurrence of the accident or near-miss, but also how it will improve the overall operation. This will assist the investigation in selling his/her solutions to management. The solution should be a means of achieving not only accident control, but also total operation control.
- If you have a safety and health committee, its members should review investigations of all accidents and near-miss incidents to assist in recommending appropriate corrective actions to prevent a similar recurrence.
- Thorough investigation of all accidents and near-misses will help identify causes and needed corrections, and can help determine why accidents occur, where they happen, and any accident trends. Such information is critical to preventing and controlling hazards and potential accidents.
Earlier this year, the Authority implemented a pool-wide program to gather information to help members control the frequency and severity of workers’ compensation claims.
The root cause program is designed to identify the underlying cause of the claim for two reasons. First, members will learn of the system or control that failed and resulted in the claim. This information can then be used for their own internal purposes, such as safety meetings. Second, the information will help the Authority deliver member-specific training, risk management, and organizational support designed to prevent the claim from recurring in the future.
The collection of the root cause information will occur through the intake desk at York Risk Services. The desk will make contact with the employee’s supervisor after the 5020 report has been filed. The supervisor will be asked a set of questions to determine what was the actual root cause that resulted in the employee’s injury or illness. This should occur within five days of the filing of the 5020 report.
The root cause information will then be imported into the Authority’s database, which will then provide metrics to members, including conditions that existed which led to the employee’s injury or illness.
Peace Officer Not Entitled to Appeal Assignment Transfer—C.A.
(Reprinted by the Metropolitan News Enterprises, December 10, 2014)
State law does not guarantee a peace officer the right to an administrative appeal of a non-punitive assignment transfer that does not involve loss of tangible benefits, the Court of Appeal for this district ruled yesterday.
Div. Four affirmed Los Angeles Superior Court Judge James Chalfant’s denial of writ and declaratory relief sought by the Los Angeles Police Protective League on behalf of Felicia Hall and Won Chu.
“In this case we hold that the Public Safety Officers Procedural Bill of Rights Act (POBRA) (Gov. Code, §3300 et seq.) does not afford officers the right to an administrative appeal of a transfer of assignment, which does not affect compensation or other specified rights, solely because the transfer may lead to negative employment consequences, or upon the officer’s belief to that effect,” Presiding Justice Norman Epstein wrote. “Instead, as the statute specifically requires, the transfer must be ‘for purposes of punishment.’”
The union claimed that Hall and Chu were entitled to bring administrative appeals under the act.
Hall, a sworn member of the Los Angeles Police Department since 1985 and a lieutenant since 2003, challenged her 2011 transfer from the Robbery/Homicide Division, where she had headed the Sexual Assault Section, to the Juvenile Division.
The transfer came about after her superiors questioned whether she had the “interpersonal skills” needed in the previous assignment. They said the transfer was in the best interests of the department, and Hall did not lose pay or rank.
Hall, however, claimed that the transfer cost her overtime hours and the use of a department vehicle, was personally stigmatizing, and made it less likely she would be promoted to captain eventually.
Chu, a sworn officer since 1985 and a detective since 2000, had been assigned to Rampart Division until 2011, when it was determined that because of multiple accusations of misconduct, one of which had earlier resulted in a formal reprimand for making inappropriate remarks of a sexual nature, it would be in Chu’s and the department’s best interests if he were to make a “fresh start” in another assignment.
Chu was expressly notified that the transfer was non-disciplinary and given a choice as to where he would be assigned. He claimed, however, that as a result of the transfer, he was monitored by the LAPD risk management executive committee; placed on restrictive duty status, which prohibited him from carrying a gun; and suffered from a damaged reputation within the LAPD.
Epstein, writing for the Court of Appeal, rejected the union’s arguments that the transfers of Hall and Chu were punitive in nature, despite being labeled to the contrary by the department.
“An agency may have many reasons, quite apart from punishment, for transferring an employee who is not performing at a satisfactory level in his or her particular assignment,” Epstein wrote. “Courts have noted the difference between a transfer to punish deficient performance and to compensate for the deficient performance.”
In this case, he elaborated, the department had presented substantial evidence that the transfers were not punitive. Hall, he noted, had a heavily criticized management style, while Chu’s superiors had legitimate concerns that because the misconduct allegations were widely known within the division, Chu’s effectiveness as a detective had been compromised.
He went on to say that there was no showing that any of the negative consequences alleged by Hall or Chu amounted to punishment.
The department effectively rebutted Hall’s claim of lost overtime by pointing out that there are no guarantees of overtime, and that it was unlikely Hall would have had significant overtime opportunities had she remained in her former assignment, because the department has been cutting down on overtime in recent years, Epstein said.
Nor did Hall show that the loss of her department vehicle was punitive, as opposed to being based on the fact that she would not need the car in her new assignment, he explained.
In Chu’s case, Epstein wrote, the claimed injuries were speculative or not shown to have been caused by the transfer, the presiding justice said.
The case is Los Angeles Police Protective League v. City of Los Angeles, B250922.
The Court Report
Court of Appeal Revives Suit Against County Over Auto Rollover
(Reprinted from the Metropolitan News Enterprise, December 8, 2014)
The Court of Appeal for this district Friday reinstated a lawsuit by a woman who claims the poor maintenance of a stretch of Palmdale Blvd. in an unincorporated part of the county caused an automobile rollover resulting in major injuries.
Justice Richard Aldrich, writing for Div. Three, said there were triable issues as to whether the county properly maintained the road and whether any failure to do so caused Veronica Barragan’s car to leave the road and roll up, and then down, a hill. The opinion was not certified for publication.
Barragan has disclaimed any memory of the accident, which occurred as she was driving westbound but alleged on the basis of physical evidence and expert opinion that she failed to see the curve around the hill due to poor visibility. When she realized that her right wheels were off the paved road and on the soft shoulder, she pulled strongly to the left, crossed the centerline, then overcorrected to the right, causing her to crash into the hill, she alleges.
Drinking, Inattention Claimed
The county maintains that Barragan’s alcohol use, although its own expert agreed that she did not drink close to the legal limit, and inattention to the road caused the rollover, since there were clearly readable signs announcing the curve and the 45 mph speed limit.
Barragan did not present the county with a tort claim within the statutory six-month period. In a prior appeal, the court ruled that she was entitled to relief from the presentation requirement based on evidence that her injuries were so serious she did not think to consult a lawyer until she saw an attorney’s television commercial after the time period had run.
After that ruling, the county moved to dismiss the action as a sanction for fraud. It cited newly discovered evidence that Barragan’s fiancé had been taking photographs and otherwise investigating the accident, and that her mother had consulted an attorney, who had declined to take the case, during the six-month period.
A Los Angeles Superior Court judge granted the motion to dismiss. A separate motion for summary judgment, based on the merits of the negligence claim, was granted as well. Aldrich, however, said the judge erred in imposing a terminating sanction based on fraud committed by persons other than the plaintiff.
The justice emphasized that the trial judge did not find any express misstatements on the part of the plaintiff, instead finding that the omission of an explanation of the efforts of her mother and fiancé on her behalf constituted an implied misrepresentation on her part.
While there was evidence supporting the trial judge’s view of the facts, Aldrich said, he was “troubled by the conclusion that this constitutes deliberate and egregious misconduct.”
Given that there were no false responses to discovery, no assertions that Barragan’s fiancé did not investigate or Barragan’s mother did not contact counsel, and no claim that Barragan’s declaration was a complete statement of “every fact conceivably relevant to the determination of excusable neglect, rather than the facts Barragan believed best supported her case,” the dismissal was an abuse of discretion, the jurist concluded.
Turning to the summary judgment ruling, Aldrich said the trial judge erred in ruling that the signage made the curve not dangerous as a matter of law.
The justice explained that while it was undisputed that a driver using high beam headlights would have seen the signs in time to handle the curve safely, it was disputed whether a reasonable driver would necessarily be using high beams. And the county’s expert, Aldrich noted, conceded that a reasonably cautious driver using low beams would not have seen the signage in time to navigate the curve.
The jurist also cited the testimony of plaintiff’s experts that a driver proceeding at the 45 mile per hour speed recommended by the sign would not have sufficient time to see the curve and safely navigate it.
The plaintiff was represented on appeal by Donald G. Liddy and Barry M. Wolf; the county by John M. Coleman of Coleman & Associates and Timothy Coates and Carolyn Oill of Greines, Martin, Stein & Richland.
The case is Barragan v. County of Los Angeles, B245832.
The Court Report
Court of Appeal Rules: Can’t Require Return of Privileged Documents Provided Under PRA
(Reprinted from the Metropolitan News-Enterprise, December 11, 2014)
The City of Los Angeles, in inadvertently supplying privileged documents in response to a Public Records Act (“PRA”) request, waived confidentiality and the documents can be used as evidence in litigation, the Court of Appeal for this district held yesterday.
The Ventura-based Div. Six decided the appeal, affirming a decision by Los Angeles Superior Court Judge Lee Edmon, who is slated to become presiding justice of Div. Three on Jan. 5.
Edmon denied the city’s motion to force a man who is suing it, in connection with a challenge to a “telephone users tax,” to return the documents and to disqualify his lawyer, San Diego attorney Rachele R. Rickert.
The city argued that the records that were erroneously delivered pursuant to the PRA should be treated the same as privileged matter that is inadvertently produced in discovery.
Agrees With Edmon
Writing for the appeals court, San Luis Obispo Superior Court Judge Earle Jeffrey Burke, sitting on assignment, said that Edmon “accurately observed” that “disclosure of documents under the [PRA] is not the same as disclosure in the course of litigation discovery.”
He quoted her as saying in her order:
“Unlike litigation discovery, where inadvertent disclosure is expressly protected from waiver by statute (see Evid. Code, § 912; Code Civ. Proc., § 2031.285), any privileged document disclosed pursuant to the [PRA] is waived as to the world ‘[n]otwithstanding any other provisions of the law[.]’ (Gov. Code, § 6254.5.)”
“Nothing in the PRA gives the entity producing it either the right to recover it or a mechanism to seek its return….[B]ecause the documents were disclosed to Ms. Rickert, the City is precluded from denying disclosure to anyone who asks.”
Rickert Acted Properly
The city sought to disqualify Rickert and her law firm, Wolf Haldenstein Adler Freeman & Herz, on the ground that by asking the city for records by means of improperly communicating with a party that was represented by counsel. Responding, Burke wrote:
“Judge Edmon concluded that ‘Ms. Rickert used the [PRA] for exactly the purpose the Legislature intended. Nothing in [her] request targeted privileged information. It merely requested generic categories of public records relating to the adoption of a citywide tax ordinance that Ms. Rickert believed to be unlawful. It is difficult to conceive of a request more squarely within the Legislature’s intent in enacting the [PRA].’ We agree.”
He also quoted Edmon as saying:
“As the City concedes, Rule 2-lOO(c) expressly permits an attorney to contact a represented public official about the subject matter of the official’s representation in order to preserve the attorney’s right to petition the government….Ms. Rickert’s exercise of her statutory and constitutional rights to petition her government regarding a matter of public importance was entirely within the scope of permitted professional conduct, and there is no basis to disqualify her or any members of her law firm under Rule of Professional Conduct 2-100.”
The case is Ardon v. City of Los Angeles, 2014 S.O.S. 5587.
Copyright 2014, Metropolitan News Company
California’s Labor Commissioner Releases New Poster and Notice Related to Paid Sick Leave
California’s Division of Labor Standards Enforcement (DLSE) has published a poster and wage notice for employers to use in compliance with AB 1522, California’s new mandatory sick pay law. On September 10, 2014, Governor Jerry Brown signed the Healthy Workplaces, Healthy Families Act of 2014. The Act requires California employers to provide employees with one hour of paid sick leave for every 30 hours worked starting on July 1, 2015. The Act also required the DLSE to create a poster and updated wage notice for employees. The poster summarizes the Act’s accrual and use rules and invites employees to file a complaint with the Labor Commissioner if they believe that they have been a victim of retaliation or discrimination.
Updated Section 2810.5 Notice The Act requires the DLSE to amend its Wage Theft Prevention Act “Notice to Employee” form (Labor Code § 2810.5). This is a mandatory notice provided to all non-exempt employees at the time of hire and within seven days of a change if the change is not listed on the employee’s pay stub for the following pay period. The new notice includes information about the accrual and use of paid sick time. It also notifies employees that they are protected from retaliation or termination for using accrued paid sick leave. Employees are also advised that they have the right to file a complaint against an employer violating the Act
The Healthy Workplaces, Healthy Families Act poster and new section 2810.5 notice form and can be found on the Department of Industrial Relations website.
Employers who willfully violate the posting requirements will be subject to a civil penalty of not more than $100 per offense.