Clayton Homes - EHS Checklist

• Plant

• Prepared by

• Date

  Date
• Location
  Address

• INSTRUCTIONS
  
  1. Answer "Yes", "No", "Not 100%", "N/A" on the questions below.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link

SAFETY

• Administrative

• Safety Manual

• Is the manual complete and updated?

  Yes

  No

  Not 100%

  N/A

• Is LO/TO section certified by EHS Manager?

  Yes

  No

  Not 100%

  N/A

• Does manual have correlating training documents for:

• - BBP?

  Yes

  No

  Not 100%

  N/A

• -HAZCOM?

  Yes

  No

  Not 100%

  N/A

• -LO/TO?

  Yes

  No

  Not 100%

  N/A

• -CPR trained First responders/Hep B?

  Yes

  No

  Not 100%

  N/A

• -Powered industrial truck training?

  Yes

  No

  Not 100%

  N/A

• -Arc flash suit and training?

  Yes

  No

  Not 100%

  N/A

• -Are line roll operators certified in writing?

  Yes

  No

  Not 100%

  N/A

• -Respiratory program or signed Append. D for Masks?

  Yes

  No

  Not 100%

  N/A

• -Heat stress?

  Yes

  No

  Not 100%

  N/A

• Does the facility have a safety matrix?

  Yes

  No

  Not 100%

  N/A

• Is the matrix utilized effectively?

  Yes

  No

  Not 100%

  N/A

• Does the facility have communication centers?

  Yes

  No

  Not 100%

  N/A

• Are the centers effective?

  Yes

  No

  Not 100%

  N/A

• Has a PPE hazard assessment been conducted in the last year?

  Yes

  No

  Not 100%

  N/A

• Does the team have a safety plan to cover goals, incentives theme and banner?

  Yes

  No

  Not 100%

  N/A

• Hazard Assessment/Recognition Program

• Does the facility have a hazard assessment inspection program?

  Yes

  No

  Not 100%

  N/A

• Are hazards being tracked by department?

  Yes

  No

  Not 100%

  N/A

• Are CARs and root cause analysis being completed on hazards?

  Yes

  No

  Not 100%

  N/A

• OSHA Recordkeeping

• Are OSHA logs being maintained properly to include the previous five years?

  Yes

  No

  Not 100%

  N/A

• Are CARs being conducted on recordable injuries?

  Yes

  No

  Not 100%

  N/A

• Is root cause analysis effective?

  Yes

  No

  Not 100%

  N/A

• Is the first aid log being properly maintained?

  Yes

  No

  Not 100%

  N/A

• Safety Committee

• Is the Safety Committee meeting monthly and are minutes being kept properly?

  Yes

  No

  Not 100%

  N/A

• Respirable Crystalline Silica

• Does the facility have a written exposure control plan?

  Yes

  No

  Not 100%

  N/A

• Has the facility completed a exposure assessment with air sampling?

  Yes

  No

  Not 100%

  N/A

• Are there signs posted in regulated areas?

  Yes

  No

  Not 100%

  N/A

• Hearing Conservation

• Are hearing tests conducted annually?

  Yes

  No

  Not 100%

  N/A

• Are STS being handled appropriately?

  Yes

  No

  Not 100%

  N/A

• Facility Safety

• Are thermographic scans being conducted every two years?

  Yes

  No

  Not 100%

  N/A

• Are hoist inspections being conducted annually?

  Yes

  No

  Not 100%

  N/A

• Are hoist inspections being conducted daily/monthly?

  Yes

  No

  Not 100%

  N/A

• Is the property checklist completed by EHS Manager monthly?

  Yes

  No

  Not 100%

  N/A

• Is the plant close up checklist completed daily?

  Yes

  No

  Not 100%

  N/A

• Is the AED being maintained properly?

  Yes

  No

  Not 100%

  N/A

• Are corrective actions complete from Fortier audits?

  Yes

  No

  Not 100%

  N/A

• Are sprinkler drain tests done quarterly an documented?

  Yes

  No

  Not 100%

  N/A

• Is sprinkler and alarm system evaluated by third party annually?

  Yes

  No

  Not 100%

  N/A

• Are required posting present? (Right to know, Safety Policy, Enviro. Policy, OSHA 300A,Hearing Cons., W/C, Bomb threat)

  Yes

  No

  Not 100%

  N/A

• Physical Walk

• Are the following programs in place and effective:

• Fall Protection?

  Yes

  No

  Not 100%

  N/A

• Suspended Loads?

  Yes

  No

  Not 100%

  N/A

• Powered Industrial Trucks?

  Yes

  No

  Not 100%

  N/A

• Line Roll?

  Yes

  No

  Not 100%

  N/A

• Cut resistant gloves?

  Yes

  No

  Not 100%

  N/A

• Electrical cords and boxes?

  Yes

  No

  Not 100%

  N/A

• Electrical safety inside home?

  Yes

  No

  Not 100%

  N/A

• Housekeeping?

  Yes

  No

  Not 100%

  N/A

• Fire extinguishers?

  Yes

  No

  Not 100%

  N/A

• Floor jacks (Koni or scissor lifts)?

  Yes

  No

  Not 100%

  N/A

• Dust control?

  Yes

  No

  Not 100%

  N/A

• Flammable storage?

  Yes

  No

  Not 100%

  N/A

• Step access to house and tables?

  Yes

  No

  Not 100%

  N/A

• Material Handling?

  Yes

  No

  Not 100%

  N/A

• Eye Wash stations?

  Yes

  No

  Not 100%

  N/A

• No blocked exits or panel boxes?

  Yes

  No

  Not 100%

  N/A

• Hitch lock?

  Yes

  No

  Not 100%

  N/A

• Machine guarding?

  Yes

  No

  Not 100%

  N/A

ENVIRONMENTAL

• Compliance

• Does team have a storm water plan with up to date training?

  Yes

  No

  Not 100%

  N/A

• Are samples up to date?

  Yes

  No

  Not 100%

  N/A

• Does the plant have an air permit and in compliance?

  Yes

  No

  Not 100%

  N/A

• Are material usages being sent to Strata monthly?

  Yes

  No

  Not 100%

  N/A

• Are the usages tracked by physical means (not purchasing)?

  Yes

  No

  Not 100%

  N/A

ISO Program

• Does the HBF have an ISO Coordinator?

  Yes

  No

  Not 100%

  N/A

• Is the manual being properly maintained?

  Yes

  No

  Not 100%

  N/A

• 6.1.2c Aspects reviewed annually and updated every 3 years?

  Yes

  No

  Not 100%

  N/A

• Planning - 6.2.2b Correctly filled out and tracking progress?

  Yes

  No

  Not 100%

  N/A

• Objective Tracking - Does 6.2.1, 6.2.2a & 9.1.1 all have matching overall objectives?

  Yes

  No

  Not 100%

  N/A

• Are all meetings being conducted IAW the program?

  Yes

  No

  Not 100%

  N/A

• Have CARs been conducted for all noted deficiencies?

  Yes

  No

  Not 100%

  N/A

• Is root cause analysis effective?

  Yes

  No

  Not 100%

  N/A

• Is required training conducted? 7.2 a&b

  Yes

  No

  Not 100%

  N/A

• Does the team have an effective ISO communication board?

  Yes

  No

  Not 100%

  N/A

• Is the ISO program effective and moving towards completing listed goals & objectives?

  Yes

  No

  Not 100%

  N/A

COMPLETION

• Auditor's Name and Signature

  Sign