Title Page

  • Company name

  • Company representative

  • Assessment started on

  • Assessment concluded at

  • Assessment done by:

  • Location

Assessment Overview

  • This assessment is performed to verify the implementation of HSE measures on the ground. It is partly based on the requirements of the Contractors SHE file submitted prior to start of work.Scoring 0: Not assessed 1: No valid documentation or requirement, not present or expired. 2: Documentation exists but is not implemented and updated 3 : Docs are valid , requirements are implemented but are substandard 4:Docs are valid, requirements are implemented , meet a minimum standard 5 Docs are valid ,requirements are implemented, meets standard, used for continuous improvement

HSE management Compliance

    Substandard Behaviour or conditions Observed
  • Substandard condition/ Behaviour

  • What is the potential Risk Level

  • Has the issue been resolved?

Legal Documents:

  • Letter of Good Standing

  • Public Liability Insurance (Min R10M)

  • Contractor Appointment letter (Principal- and Contractors)

  • Notification of Construction – Annexure 2

SHE Plans and Policies

  • SHE Policy

  • Site specific Risk assessment

  • Health and Safety Plan

  • Scope of Work

  • Relevant Authority Registration (Electrical, HCS Contractor)

  • Principal Contractor SHE specifications (If Applicable)

Company Structure:

  • List of All Employee: Name & Specific Designations

  • Org-Chart (Legislative)

  • Legal Appointment Letters (Project Specific)

  • ID Copies / Passports (Working Permits)

  • Driver’s licence / PDP (if applicable)

  • List of All Contractors, Sub-Contractors

Training Matrix:

  • Training Matrix

  • Training Plan

  • Toolbox Talks

  • Toolbox talks Register

Company SHE Committee:

  • SHE Committee Appointments

  • SHE Committee Meeting Minutes

Employee PPE Requirements Registers:

  • PPE Risk Matrix

  • Issue / Return Register

Employee Certificates of Fitness:

  • Pre-Employment Entry Medical Certificates

  • Annual Employee Medical Certificates of Fitness (Annexure 3)

Emergency Response and Preparedness:

  • Site Specific Evacuation Plan

  • Site Evacuation Map

  • Evacuation Drill Reports

First Aid Management:

  • FA Treatment Register

  • FA Kit Inspection Checklist

Incident Management:

  • Incident / Accident Register

  • Incident Flash Report

  • Lesson Learnt

Risk Management:

  • Baseline Risk Assessment

  • Training Registers on Risk Assessments

  • Task Specific Risk Assessments

  • Safe Work Procedures

  • Applicable Permits

  • Daily Safe Task Instruction - DSTI

  • Planned Job/task Observations

Fall Protection / Prevention Management:

  • Fall Protection Risk Assessment

  • Certificates of Competency for Working at Heights

  • Fall Protection Equipment Registers

Hazardous Chemical Substances Management:

  • Hazardous Chemical Substance Register

  • HCS Issue Register

  • SDS’s for All HCS’s (valid for 5 years)

  • Hazardous Waste Register (Removal / Disposal)

  • Hazardous Waste Removal Certificate (if applicable)

  • Waste Management Plan/Procedure

  • Corrective Actions Request Register

  • Non-Conformance Register (NCR)

Monthly Inspections (Registers & Checklists):

  • Checklist Register

  • Various Checklists as per SOW, Equipment used

Audits and Reports:

  • Internal Audit Reports – Contractor

  • Client Audit Reports – Sappi

  • 5S Status Report

  • Site Inspection Reports (Supervisor, Safety Officers)

  • Monthly SHE Performance Reports

  • SHE Representative Monthly Inspections Reports

Communication and learning

  • Are representatives of company registered on SAPPI ESD Whatsapp group for notifications

  • Are representatives of company registered on Google classroom for Sappi ESD coaching and mentoring

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.