Campus Leader Review of Bypass, Electrical Safety

• Site Name

• Conducted on

  Date

• Campus Leader

• Site EHSS Lead

• Others invovled in review

• This review is based on an ask of Campus Leaders to review specific program elements associated with bypass safety, electrical safety, PTW process and Life Saving Rules. The template was built to organize the information and to review consistently across sites.

Permit to Work - Procedures and Training

• Does the site have a procedure on Permit to Work?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• What is the procedure number or name?

• Does the procedure reference the J&J standard?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• Has the site procedure been reviewed against the J&J standard and Technical Standard to ensure all requirements are captured in the site procedure?

  Yes

  No

• Does the site have a training program on PTW?

  Yes

  No

• Select the frequencies at which training is provided (select all that apply).

  Select Initial Initial Only Annual Every 3 Years When they were rolled out

  • Initial
  • Initial Only
  • Annual
  • Every 3 Years
  • When they were rolled out

• Does the training include a "hands-on" element to confirm understanding?

  Yes

  No

  N/A

• Is there a PTW IOSS leader?

  Yes

  No

  N/A

PTW Authorization Table

• Is there a permit Authorization matrix for the site? (A listing of who can approve specific permits)

  Yes

  No

• Is the Permit Authorization Matrix current? (meaning the names on the matrix are all still in place)

  Yes

  No

• How often is the table reviewed / updated?

• How are approvers trained on their responsibilities?

• How is competency determined of an approver before adding their name to the table?

• Are all of the current names on the authorization matrix knowledgeable of their responsibilities and have the skills to fulfill their role?

Safety Bypass - Procedures and Training

• Does the site have a procedure on safety bypass?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• What is the procedure number or name?

• Does the procedure reference the J&J standard?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• Has the site procedure on Safety Bypass been reviewed against the J&J standard and Technical Standard to ensure all requirements are captured in the site procedure?

  Yes

  No

• What tasks require safety bypass?

• Have engineering solutions been assessed to eliminate the need to bypass safety devices?

  Yes

  No

  N/A

• Does the site use the standard J&J permit?

  Select Yes No Yes, but have modified to be site specific

  • Yes
  • No
  • Yes, but have modified to be site specific

• Is there a safety bypass IOSS leader?

  Yes

  No

  N/A

• Does the site have a training program on safety bypass?

  Select Yes No Its part of another training program

  • Yes
  • No
  • Its part of another training program

• Select the frequencies at which training is provided (select all that apply).

  Select Initial Initial Only Annual Every 3 Years When they were rolled out

  • Initial
  • Initial Only
  • Annual
  • Every 3 Years
  • When they were rolled out

• Does the training include a "hands-on" element to confirm understanding?

  Yes

  No

  N/A

• Have personnel involved in by pass activities been retrained consistent with the recent EHSS Action Alert?

  Select Yes No No but has already been scheduled n/a

  • Yes
  • No
  • No but has already been scheduled
  • n/a

Electrical Safety - Procedures and Training

• Does the site have a procedure on electrical safety?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• What is the procedure number or name?

• Does the procedure reference the J&J standard?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• Has the site procedure on electrical safety been reviewed against the J&J standard and Technical Standard to ensure all requirements are captured in the site procedure?

  Yes

  No

• Is there an electrical safety IOSS leader?

  Yes

  No

• Does the site use the standard J&J permit?

  Select Yes No Yes, but have modified to be site specific

  • Yes
  • No
  • Yes, but have modified to be site specific

• Does the site have a training program on electrical safety?

  Select Yes No Its part of another training program

  • Yes
  • No
  • Its part of another training program

• Select the frequencies at which training is provided (select all that apply).

  Select Initial Initial Only Annual Every 3 Years When they were rolled out

  • Initial
  • Initial Only
  • Annual
  • Every 3 Years
  • When they were rolled out

• Does the training include a "hands-on" element to confirm understanding?

  Yes

  No

  N/A

Line Breaking - Procedures and Training

• Does the site have a procedure on line breaking?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• What is the procedure number or name?

• Does the procedure reference the J&J standard?

  Select Yes No J&J procedure is utilized as site procedure n/a

  • Yes
  • No
  • J&J procedure is utilized as site procedure
  • n/a

• Has the site procedure on line breaking been reviewed against the J&J standard and Technical Standard to ensure all requirements are captured in the site procedure?

  Yes

  No

• Does the site use the standard J&J line breaking permit?

  Select Yes No Yes, but have modified to be site specific

  • Yes
  • No
  • Yes, but have modified to be site specific

• Does the site have a line break IOSS leader?

  Yes

  No

• Does the site have a training program on line breaking?

  Select Yes No Its part of another training program

  • Yes
  • No
  • Its part of another training program

• Select the frequencies at which training is provided (select all that apply).

  Initial

  Initial Only

  Annual

  Every 3 Years

  When they were rolled out

• Does the training include a "hands-on" element to confirm understanding?

  Yes

  No

  N/A

Permit Auditing

• How many bypass permits were issued in the past year?

• How many electrical safety permits were issued in the past year?

• How many line break permits were issued in the past year?

• Does the site have an audit program or some way to provide feedback on executed permits?

  Yes

  No

• What type of program is it?

  Select Paper based audit conducted after work completed Paper based while work is in progress Field review while work is in progress

  • Paper based audit conducted after work completed
  • Paper based while work is in progress
  • Field review while work is in progress

• How many permits are reviewed annually?

• What is the frequency of review?

• Were the bypass, electrical safety and line break permits issues in the past 12 months audited?

Life Saving Rules

• Select the frequencies at which LSR training is provided (select all that apply).

  Select Initial Initial Only Annual Every 3 Years When they were rolled out

  • Initial
  • Initial Only
  • Annual
  • Every 3 Years
  • When they were rolled out

• How are LSR's deployed or integrated into the site?

• Are the individuals in this session familiar with the LSR's?

  Yes

  No

• Do you think site employees could name the LSRs?

  Yes

  No

• Do you think employees relate their day to day tasks to the LSR's?

  Yes

  No

Program Reviews

• Please consider the answers to this review during your next PTW program review.