1. Does your company have an inventory of safety and health beliefs, principles, desired behaviors, and / or key elements?
Response
Yes
No
Accountable Person or Owne
Sr. Mgmt.
Project Mgmt.
Supervisors
Workers
Safety Dep
Documented
Yes
In Progress
No
Communicated or Implemented
Yes
In Progress
No
Verified or Audited
Annually
Quarterly
Monthly
Other
No
Other
Attach document.
2. Does your company have an inventory of safety and health beliefs, principles, desired behaviors, and / or key elements?
3. Has your company established any safety and health performance goals?
4. Attach description of how your company's Senior Management demonstrates commitment and leadership for safety and health considerations.
5. Does your company have a safety and health Management System?
6. Has your company identified safety and health roles and responsibilities for employees? Yes
No
7.Does your company have a dedicated safety and health staff?
8. Who is ultimately accountable for safety and health in your company?
9.Does your company have a formal set of safety and health rules, policies, and work practices (i.e. Safety Manual or equivalent)?
10. Does your company have a structured safety and health training program?
11.Does your company have a structured safety and health orientation process?
12. Does your company have a process to identify and mentor inexperienced workers (i.e. Short Service Employee Program or equivalent)?
13. Does your company actively promote employee safety and health participation and awareness programs for all levels of employees (i.e. Safety Suggestion Program or equivalent)?
14. Does your company track performance of pro-active safety activities -- such as quality of Job Safety Analysis', number of behavioral observations, etc?
(i.e. Leading Safety Performance Indicators or equivalent)?
15.Does your company have a structured process to ensure compliance with local and / or applicable safety and health regulations?
16.
Does your company utilize management of change processes which address safety and health considerations?
17.Does your company have an emergency response plan?
18.Does your company have processes in place to capture and apply safety and health learnings and best practices?
19.Does your company utilize a pre-employment medical and fitness-for-duty screening process?
20. Does your company have guidelines related to employee's working extended shifts or rotations? Yes
No