Title Page
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Conducted on
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Prepared by
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Location
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Department/Areas Reviewed:
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Completed by:
AREA
Emergency Prepare
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If No, list corrective actions*
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Are you trained and current in First Aid/CPR/AED/BBP?
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If not why?
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Have your reviewed with team members on what to do in the event of an earthquake, power outage and winter storm event?
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if not why?
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Are all Near Miss and first aids reported and given the same importance as incidents involving team member injuries?
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If not why?
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Are Team Members aware of the Serious Injury Fatality Prevention (SIF) focus and the rationale for the SIF focus?
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if not why?
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Are all incidents reported wtihin 24 hours of knowledge of the event?
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If not why?
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Are all spills reported and documented with a spill report form?
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If not why?