Information

  • Generation Audit

  • Location
  • Conducted on

  • Personnel

Element Number One: COMPLIANCE

  • Element 1 : Question 1
    Formal documented methodology for identifying and/or staying current with applicable regulatory requirements?

  • Status

  • Validation

  • Action

  • Element 1 : Question 2
    Company personnel can demonstrate awareness of how they access applicable regulations?

  • Status

  • Validation

  • Action

  • Element 1 : Question 3
    Company tracks and communicates emerging HS requirements and trends well before governmental agencies commenced with rulemaking process? Changes are communicated to affected parties?

  • Status

  • Validation

  • Action

  • Element 1 : Question 4
    Company incorporates regulatory issues into planning of new activities, products and services and analyzes potential impacts on Company operations? Company has identified compliance gaps and developed action plans to gain and maintain compliance?

  • Status

  • Validation

  • Action

  • Element 1 : Question 5
    Company conducts routine compliance audits, identifies areas requiring action, develops action plans and tracks action to completion?

  • Status

  • Validation

  • Action

Element Number Two: HAZARD IDENTIFICATION & CORRECTION

  • Element 2 : Question 1
    Formalized and documented methodology for identifying Company HS exposures, hazards and non-compliance?

  • Status

  • Validation

  • Action

  • Element 2 : Question 2
    Company conducted formal hazard analysis of their operations, processes, equipment and tools using methods such as process hazard analysis, job hazard analysis, risk assessments, etc.?

  • Status

  • Validation

  • Action

  • Element 2 : Question 3
    The Company has developed and implemented a plan to reduce the HS risk of its activities, operations, and services?

  • Status

  • Validation

  • Action

  • Element 2 : Question 4
    The Company has a formal documented procedure for reviewing the potential to create significant HS exposures and hazards related to new operations or processes?

  • Status

  • Validation

  • Action

  • Element 2 : Question 5
    Company has conducted and documented all HS exposures and hazards associated with a minimum of 100% of its activities, operations, and/or services?

  • Status

  • Validation

  • Action

Element Number Three: TRAINING & EDUCATION

  • Element 3 : Question 1
    Company has formal systems in place to: 1) identify all personnel whose work may have the potential to create a significant impact on HS hazards and exposures; and 2) assure that those people have received appropriate training and demonstrated proficiency?

  • Status

  • Validation

  • Action

  • Element 3 : Question 2
    Company has identified requisite compliance training programs? Training is current and competency demonstration requirements in place? New employees are provided with basic HS orientation training and are required to demonstrate competency before beginning their job assignment? Transferred employees are trained sufficiently before assuming new job responsibilities?

  • Status

  • Validation

  • Action

  • Element 3 : Question 3
    The Company maintains a formal HS training plan, focused on specific hazards/exposures, which is reviewed and updated on at least an annual basis? Well maintained courses, training logs, and course syllabuses exist?

  • Status

  • Validation

  • Action

  • Element 3 : Question 4
    Company has performed and documented a review of all personnel, including those, with the potential to indirectly impact the Company's HS exposures and hazards (e.g. contractors, purchasing, etc.) and provided appropriate training with respect to their job responsibilities? Review is repeated on at least an annual basis?

  • Status

  • Validation

  • Action

  • Element 3 : Question 5
    Appropriate managers and supervisors receive specific training in HS management systems?

  • Status

  • Validation

  • Action

Element Number Four: EMPLOYEE ENGAGEMENT

  • Element 4 : Question 1
    Visible evidence of HS leadership or employee engagement is provided or available?

  • Status

  • Validation

  • Action

  • Element 4 : Question 2
    Company has formed committees to address basic HS issues?

  • Status

  • Validation

  • Action

  • Element 4 : Question 3
    HS teams and committees are in place, meet regularly, and are led by senior managers? Company evaluates contractor safety performance prior to issueance of contracts? Contractor HS expectations are clearly outlined in the contract and/or scope of work?

  • Status

  • Validation

  • Action

  • Element 4 : Question 4
    Senior Managers conduct HS "walkthrough inspections" at intervals no less frequently than monthly? On-site contractors are informed of, and required to comply with, the Company's HS policy as it applies to their activities?

  • Status

  • Validation

  • Action

  • Element 4 : Question 5
    Company has senior management level committee to review and monitor HS program and performance improvements? Leadership actively solicits employee involvement in setting HS objectives, program planning and review? Employees report near misses, unsafe conditions and behavior?

  • Status

  • Validation

  • Action

Element Number Five: INCIDENT REPORTING & RESPONSE

  • Element 5 : Question 1
    Company has developed formal procedures to address emergency preparedness or incident investigation/response?

  • Status

  • Validation

  • Action

  • Element 5 : Question 2
    Company has developed a system to maintain records of all HS incidents such as injury logs and first aid logs?

  • Status

  • Validation

  • Action

  • Element 5 : Question 3
    Company conducts formal investigations with root cause analysis of all HS incidents? Preliminary incident investigation and root cause analysis is conducted within 24 hours of the incident and finalized within 2 weeks?

  • Status

  • Validation

  • Action

  • Element 5 : Question 4
    Company has developed systems to document and track corrective and preventative actions resulting from incidents and plan tests?

  • Status

  • Validation

  • Action

  • Element 5 : Question 5
    Company personnel meet with local authorities to coordinate emergency and incident response plans and discuss support? Company periodically tests the emergency preparedness and incident response plan and makes changes/updates to the plan based on results of test?

  • Status

  • Validation

  • Action

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.