Title Page
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Company Name
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Address of Company
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Prepared by
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Phone Number
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Location
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Conducted on
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Signature
Company's injury/illness information for previous year
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(a) Total Recordable Incident Rate (Rate = (c) x 200,00 /(g))
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(b) Lost Time Incident Rate (Rate + (d) x 200,00 / (g))
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(c) Number of Injuries and Illnesses
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(d) Number of Lost Workday Cases
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(e) Number of Injury Related Fatalities
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(f) Total Number of Employees
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(g) Employee Hours Worked Per Year (if unknown use # of employees x 2080)
Company Policies & HSE Requirements
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Do you have a written Health & Safety Policy? (Please attached a photo of policy)
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Do you hold Risk Assessments & have they been reviewed recently?
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List your Risk Assessments eg. W&H, COSHH, Noise, Manual Handling, First Aid, Mechanical Lifting etc
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Do you hold a Fire Risk Assessment? (Under Regulatory Reform (Fire Safety) Order 2005 or Equivalent Legislation)
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Do you hold Accident Records?
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Do you have current Employer's Liability Insurance and do your employees have access?
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Does the company have a Drug & Alcohol Policy
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Is the company a member of a trade association or professional body, If so, who?
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Do you have a No Smoking Policy?
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Do all employee's have the right to work in UK or Valid work permit to work in the EU if located there?
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Does the company have an Emergency Response Plan (ERP)?
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Date the ERP was last updated
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Have Vehicles & Equipment been properly inspected, maintained and serviced by an approved appropriate qualified company?
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Are all vehicles & equipment in date maintenance?
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Do you train staff in the correct and safe use of all equipment including Ground Support Equipment?
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Does the Company Manage Waste as per local requirements? (A waste disposal license or works with a licensed contractor)
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For catering companies, do staff have a Supervising Food Safety in Catering Certification?
Cleaning Materials, Chemical Risk and other Biohazards Exposure
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Does the company have a COSHH / Chemical products register that includes Safety Data Sheets(SDS)?
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Have all staff received training in the use of COSHH / Chemicals?
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Are all chemicals stored in the correct chemical cabinets and in accordance with the Safety Data Sheets (SDS)?
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Are suitable and sufficient risk assessments in place to cover the risks from biohazards, including pandemic (eg COVID)?
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Where flammable or combustible products are used, are suitable fire prevention precautions in place? (eg. Aircraft cleaning)
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Confirm only Original Equipment Manufacturer (OEM) recommended products are used for cleaning and maintaining surfaces such as: Wood, plastic, leather & avionics etc.
Training
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Do employees where required to drive as part of their employment hold a current and valid EU/UK driving license?
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Do employees who are required to drive airside hold the necessary Airside Driving Permit (ADP)?
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Do you carry out driving license annual reviews for employees required to drive as part of their employment?
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Is the Director/Manager IOSH Level2 in Managing Safety at Work qualified?
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Where applicable, are all staff trained to carry out Working@Height?
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Does the company run a Permit to Work system (PTW)?
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Are staff trained on the operation of aircraft doors and access panels where they are required to operate as part of their duties?
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Are all staff trained in the reporting of any concerns to the Pilot in Command (PIC), maintenance managers or supervisors in line with EASA 376/2014 and ICAO Annex 13?
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Does the company have a documented effective and auditable Quality Assurance System to ensure the provision and maintenance of facilities, equipment and competent personnel for safe operations?
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Within the company, have individuals been designated for specific roles and are their authorization levels been properly documented?
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Where applicable, are all daily, weekly and monthly checks carried out and records retained for at least 12 months?
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Are staff training records available to witness proficiency and competencies?
Security
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Do you have a Security Policy?
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Is your company GDPR compliant?
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Do you carry out employee background checks prior to hiring?
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Do your staff have the correct airside access passes?
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Do all staff hold An Aviation Security qualification appropriate to their role in accordance with National Regulation?
Other / External Audits
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Have you had any external audits carried out in the last 24 months?
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What date was your last external audit?
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Who carried out your last external audit and what part of your operation was audited? (eg De-icing, Fueling, catering etc)
Any Supplementary information regarding process and procedures, specific Training or Certification your company has:
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Add additional info in the text box to the right.