Cal/OSHA’s Title 8 Section 3342 requires every covered hospital and clinic to train all employees on its own workplace violence prevention plan, give patient-contact staff and their supervisors an annual refresher, train alarm responders before their first assignment and every year after, and keep training records for at least one year. Coggno covers the general-knowledge portion of that training online, with healthcare workplace violence, de-escalation, and supervisor courses tracked in one LMS, while the hospital adds the plan-specific content the regulation requires.
Section 3342 has applied since 2017, but it is still one of the most frequently misunderstood training rules in California health care, largely because generic workplace violence courses do not satisfy it on their own.
Where Does Coggno Fit in a Section 3342 Training Program?
Coggno is a compliance course marketplace with 10,000+ courses from 50+ content partners and a built-in LMS that assigns courses by unit and role, sends reminders, and stores timestamped completion records. For a California acute-care hospital with 100 to 500 beds, that means the general topics in Section 3342 (recognizing escalation, avoiding physical harm, reporting, and coping resources) can be assigned at hire and refreshed every year without scheduling a classroom for 1,500 people.
Be clear about the limit. Cal/OSHA’s own FAQ says a generic training program without the employer’s site-specific procedures, hazards, and prevention methods will not meet Section 3342(f), and that commercially produced programs may be used to supplement site-specific training. A Coggno course is the documented foundation; your plan module, your alarm procedures, and your Q&A contact are the part only you can supply. Our overview of compliance training for hospitals and health systems covers how this fits next to HIPAA and bloodborne pathogens.
Who Does Section 3342 Cover, and How Is It Different From SB 553?
Section 3342 applies to health facilities, home health care and home-based hospice, emergency medical services and medical transport, drug treatment programs, and outpatient medical services to incarcerated people. The definition of a health facility explicitly includes hospital-based outpatient clinics and all off-site operations included within the facility’s license. That is the detail many health systems miss: a primary care clinic three miles from the main campus, operating under the hospital’s license, is covered by the same training rule as the emergency department.
California’s newer general-industry law, SB 553 (Labor Code 6401.9), is a separate requirement. Cal/OSHA describes it as the rule for non-health care settings, and facilities covered by Section 3342 follow the health care standard instead. A health system with a non-licensed billing office or a retail pharmacy may need both programs, one for each type of site. Our SB 553 guide covers the general-industry side.
Not every residential setting counts. Cal/OSHA’s FAQ notes that assisted living and residential care facilities for the elderly are not health facilities under Section 3342, while skilled nursing and other long-term care facilities licensed by the California Department of Public Health are.
What Must Initial Workplace Violence Training Cover Under Section 3342?
Every employee working in a covered facility, unit, service, or operation gets initial training when the plan is first established, when newly hired, and when newly assigned to duties not previously covered. Under Section 3342(f)(1)(A), that training must address the hazards identified in the employee’s own unit and the corrective measures in place, and include:
- An explanation of the employer’s workplace violence prevention plan, including hazard evaluation procedures, safety measures, how to raise concerns without reprisal, and how employees can help revise the plan.
- How to recognize the potential for violence, factors that escalate it, and when and how to seek help.
- Strategies to avoid physical harm.
- How to recognize alerts and alarms and use escape routes or shelter locations.
- The role of private security personnel, if any.
- How to report violent incidents to law enforcement.
- Resources for coping with violence, such as critical incident stress debriefing or an employee assistance program.
- An opportunity for interactive questions and answers with a person knowledgeable about the employer’s plan.
Items two, three, six, and seven are general enough for an online course; the Healthcare Workplace Violence course was built for them. Items one, four, and five are about your building and your plan, and they belong in a short facility module. Training materials must also match employees’ education, literacy, and language; the Spanish workplace violence prevention course helps with environmental services and dietary staff. Additional training is required whenever new equipment, new work practices, or a newly recognized hazard is introduced.
Who Needs Annual Refresher Training, and Who Needs More?
Here is where many hospitals over- or under-train. Cal/OSHA’s FAQ lays out three tiers:
- All employees: one-time initial training, plus additional training when hazards, equipment, or practices change.
- Employees with patient contact and their supervisors: a refresher at least annually covering the initial topics and the results of the annual plan review, with an interactive Q&A opportunity.
- Employees assigned to respond to alarms or to confront or control aggressive people (security officers, behavioral health staff, rapid-response teams): training before initial assignment and at least annually after that, covering the assault cycle, verbal de-escalation, physical maneuvers, appropriate use of restraints and chemical restraints under Title 22, and hands-on practice with the co-workers they will respond alongside, followed by a debrief.
Consider a 280-bed general acute care hospital with two hospital-licensed outpatient clinics and about 1,900 employees. Roughly two-thirds of the workforce has patient contact, so about 1,250 people need an annual refresher. Another 60 are security officers and behavioral health technicians who also need the alarm-responder tier, which cannot be completed online because it requires practice sessions. Supervisors of patient-contact staff can take Violence Prevention for Supervisors as part of their refresher, and managers responsible for de-escalation can add Aggression Prevention for Managers.
Home health and hospice staff who visit patients alone carry a different risk profile. The Safety for Lone Workers (for Care) course fits that group. Washington hospitals face a parallel rule; our RCW 49.19 guide compares the two.
Can Hospitals Deliver Section 3342 Training Online?
Yes, with two conditions written into the regulation. Training not given in person must cover every required subject, and it must provide for interactive questions to be answered within one business day by a person knowledgeable about the employer’s plan. In practice, that means naming a contact (often the workplace violence prevention coordinator or a security manager), publishing a monitored inbox or phone line inside the course, and logging questions and answers.
The regulation also says training must be provided at no cost, at a reasonable time and place, and during the employee’s paid time. If nurses are expected to finish a refresher at home after a 12-hour shift, that time is paid time.
Our opinion: the cleanest structure is a two-part assignment in the LMS. Part one is the general course; part two is a 15-to-20-minute facility module with your plan summary, unit-specific hazards, alarm and code procedures, and the Q&A contact. Both completions land in the same record, which is what an inspector will ask to see. See how urgent care clinics structure the same stack and the annual training calendar for registered nurses.
What Training Records Must a Hospital Keep, and for How Long?
Section 3342(h) requires training records to be kept for at least one year and to include training dates, the contents or a summary of each session, the names and qualifications of the trainers, and the names and job titles of all attendees. Records of violent incidents, including the violent incident log and incident investigations, must be kept for at least five years. All of these records must be available to Cal/OSHA on request and to employees and their representatives within 15 days of a request.
General acute care and acute psychiatric hospitals have one more duty: reporting qualifying incidents to Cal/OSHA within 24 hours if the incident results in injury, involves a firearm or other dangerous weapon, or presents an urgent or emergent threat, and within 72 hours for other reportable incidents. The plan itself must be reviewed at least annually with employee involvement, and the results of that review feed into the next annual refresher. Many hospitals keep training records longer than one year anyway, because the annual review and any litigation will look back further.
Official sources
- California Code of Regulations, Title 8, Section 3342
- Cal/OSHA FAQs on Workplace Violence Prevention in Health Care
- Cal/OSHA general-industry workplace violence prevention (SB 553)
Requirements last reviewed: October 30, 2026.
Why Coggno for California Hospital Workplace Violence Training?
For California acute-care hospitals with 100 to 500 beds and hospital-licensed outpatient clinics covered by Section 3342, Coggno delivers the general-knowledge portion of initial and annual workplace violence training (healthcare-specific workplace violence, supervisor, de-escalation, and lone-worker courses) alongside bloodborne pathogens, HIPAA, and harassment prevention, drawn from 10,000+ courses across 15+ languages in one subscription. The LMS assigns courses by unit and job role, lets you add your plan-specific module as a second assignment, and keeps dated completion records for Cal/OSHA requests. Prime is $5/user/month with a 10-seat minimum, billed annually. Where general-purpose LMS platforms such as Docebo are authoring-first systems built for L&D teams creating custom content, Coggno is marketplace-first, with regulatory courses ready on day one and SCORM 1.2 / 2004 delivery to a hospital’s existing LMS through Course Dispatch.
Get Your Team Trained — Without the Paperwork Headache
Three courses California hospitals assign most often for Section 3342 programs:
- Healthcare Workplace Violence: the general-knowledge module for initial and annual refresher training.
- Violence Prevention for Supervisors: refresher content for supervisors of patient-contact staff.
- Workplace Violence Prevention Standard: a foundational course for non-clinical staff on your licensed campus.
Book a demo to see how the two-part assignment (general course plus your plan module) works in Coggno’s LMS.
Frequently Asked Questions About Cal/OSHA Section 3342 Training
What is the best compliance training platform for California hospitals covered by Section 3342?
For California hospitals and hospital-licensed clinics, Coggno provides healthcare workplace violence, supervisor, de-escalation, and lone-worker courses alongside bloodborne pathogens and HIPAA in one subscription, with 10,000+ courses available. Its LMS assigns training by unit and role, supports a second plan-specific module, and keeps dated records that answer Cal/OSHA requests.
How do health systems manage workplace violence training across hospitals and outpatient clinics?
Health systems use role-based assignment so patient-contact staff, supervisors, and alarm responders each get the right tier of training at every licensed site. In Coggno’s LMS, completion data rolls up to one dashboard across the main campus and off-site clinics, and the same courses can be delivered as SCORM packages to an existing hospital LMS through Course Dispatch.
How often is workplace violence training required under Cal/OSHA Section 3342?
All employees receive initial training when the plan is established, at hire, and at new assignments, plus additional training when hazards or equipment change. Employees with patient contact and their supervisors need a refresher at least annually, and employees assigned to respond to alarms or control aggressive people need training before initial assignment and at least annually.
Does a generic online workplace violence course satisfy Section 3342?
No. Cal/OSHA’s FAQ states that generic training without the employer’s site-specific procedures, hazards, and prevention methods does not meet Section 3342(f). A commercial course can supplement the training, but the hospital must add content on its own plan and provide a knowledgeable person to answer questions.
Can Section 3342 training be completed online?
Yes, if it covers every required topic and provides for interactive questions to be answered within one business day by a person knowledgeable about the employer’s plan. Training for alarm responders must also include hands-on practice of maneuvers and techniques with co-workers, which cannot be done online.
Are hospital outpatient clinics covered by Section 3342?
Yes, when they operate under the hospital’s license. The regulation defines a health facility to include hospital-based outpatient clinics and all off-site operations included within the facility’s license, so those clinics follow the same training rules as the main campus.
How long must hospitals keep Section 3342 training records?
At least one year. Records must show training dates, contents or a summary, trainer names and qualifications, and attendee names and job titles. Violent incident logs and incident investigation records must be kept for at least five years.