Does the company's health and safety program contain the following ?

  • 1. Heath and Safety Policy Statement (Corporate)

  • 2. Hazard Assessment

  • 3. Safe Work Practices

  • 4. Safe Job Procedures

  • 5. Company Rules

  • 6. Personal Protective Equipment (PPE)

  • 7. Preventative Maintenance Program

  • 8. Training and Communication

  • 9. Inspections

  • 10. Investigations and Reporting

  • 11. Emergency Preparedness

  • 12. Statistics and Records

  • 13. Legislation

  • 14. Manitoba Supplement

1 Health and Safety Policy Does the employer have a written health and safety policy that :

  • 1.1 Is signed by he president , CEO or local senior management ? D

  • 1.2 Includes management's commitment to provide a safe and healthy work environment ? D

  • 1.3 Recognizes the rights of workers to work in a safe and healthy work environment ?

  • 1.4 Is current and dated ? D

  • 1.5 Is Reviewed annually by management ?

  • 1.6 I prominently posted or made available to the worker ? O or I

  • 1.7 Address accountability and responsibility for health and safety for all workplace parties D and I

  • Award 3 points for the written assignment of responsibilities

  • Award 3 points based on the majority of positive interview responses.

  • 1.8 Expresses a commitment to work in a spirit of consultation and cooperation with the workers ? D

  • 1.9 Is understood by personnel ? I

2 Hazard Assessment, Analysis and Control

  • 2.1 Are written hazard assessments conducted as required ? D and I

  • 4 Points based on receipt of completed pre-job assessments

  • 3 Points based on a majority of positive responses to the interview questions.

  • 2.2 Does the employer use a on-going hazard assessment process ? D and I

  • 3 Points based on verification of documentation.

  • 3 Points based on a majority of positive responses to the interview questions.

  • 2.3 Are appropriate personnel involved in the hazard assessment process ? D and I

  • Award 3 points based on verification of documentation.

  • Award 2 points based on majority of positive interview responses.

  • 2.4 Are hazards identified ? D

  • 2.5 Are hazards prioritized ? D

  • 2.6 Is there a list of identified critical tasks ? D

  • 2.7 Are controls developed for identified hazards ? D

  • 2.8 Are controls implemented in a timely manner ? D or O

  • 2.9 Are appropriate personnel involved/informed of the control strategies ? D and I

  • 2.10 Does the company have a process for evaluating and monitoring sub-contractors ? D

  • 2.11 Does management support the on-going application of the hazard assessment process ? D and I

3 Safe work Practices

  • 3.1 Does safe work practices accurately reflect the company's activities D and O

  • 3.2 Have applicable safe work practices written ? D and O

  • Award 2 points based on review of the company's written safe work practices.

  • Award 3 points based on observations that the written safe work practices accurately reflect the company's worksite activities .

  • 3.3 Are they understood by workers ? D

  • 3.4 Are they readily available ? O or I

  • 3.5 Are they followed by employees on a regular basis ? O or I

  • 3.6 Have both management and workers participated in the development and/or review of safe work practices ? D or I

4 Safe Job Pracedures

  • 4.1 Do the safe job Procedures accurately reflect the employer's activities ? D and I

  • 4.2 Have all critical safe job procedures been written ? D and O

  • Award 3 points based on a review of the company's written safe job procedures.

  • Award 2 points based on observations that the written safe job procedures accurately reflect the company's worksite activities.

  • 4.3 Are they understood by workers ? O

  • 4.4 Are safe job procedures followed on a regular basis ? O and I

  • 4.5 Are these procedures available and easily accessible to workers ? O and I

  • 4.6 Have both management and workers participated in the development and/or review of safe work procedures ? D or I

5 Company Rules

  • 5.1 Are the rules clearly stated in writing ? D

  • 5.2 Are the rules prominently posted or provided to each employee ? O or I

  • 5.3 Do workers understand company and site specific rules? I

  • 5.4 Does the program address non-conformance and progressive disciplinary actions ? D

  • 5.5 Are all rules applied/enforced consistently with all personnel ? D and O

6 Personal Protective Equipment (PPE)

  • 6.1 Is there a written policy for PPE ? D

  • 6.2 Are employees made aware of the requirements for PPE? D and I

  • 6.3 Do all personnel have access to basic PPE ? O or I

  • 6.4 Is specialized PPE available to workers when required ? O and I

  • 6.5 Is the correct PPE used by all personnel when required ? O

  • 6.6 Are there written procedures for the proper fitting, care and use of specialized PPE ? D

  • 6.7 Are personnel given instruction or training in the use of PPE as required ? D and I

  • 6.8 Is there criteria used to select PPE? D and I

  • 6.9 Is there a system in place to regularly inspect and maintain basic/specialized PPE ? D

7 Preventative Maintenance Program Does the preventative maintenance program of facilities, tools,equipment and vehicles include :

  • 7.1 An inventory of items to be maintained ? D

  • 7.2 Maintenance meeting manufacturer and regulatory standards ? D and I

  • 7.3 The use and completion of schedules and checklists as required ? D

  • 7.4 Records with a description of corrective actions taken ? D

  • 7.5 A system to effectively remove defective tools, equipment and vehicles from service ? D and I

  • 7.6 (7.5) is it followed ? O or I

  • 7.7 Does a qualified/competent person preform the inspection and maintenance ? D and I

8 Training and Communication

  • 8.1 Does the employer have a formal orientation program ? D

  • 8.2 Is an orientation mandatory for all new personnel starting work ? D

  • If this question can be verified thru interview award 2 points.

  • 8.3 Is there a standardized written orientation form ? D

  • 8.4 Does the form provide for signatures of both worker and the person conducting the orientation ? D

  • 8.5 Are mandatory training requirements verified or training provided before starting work ? D and I

  • 8.6 Are training records maintained ? D

  • 8.7 Is job specific training provided and documented as required ? D and I

  • 8.8 Does a qualified person conduct job specific training ? D

  • 8.9 Have supervisors received training in workplace inspections and health and safety responsibilities ? D

  • interview response

  • 8.10 Is a system in place to measure knowledge and competency ? D and I

  • 8.11 Does the employer hold scheduled health and safety meetings ? D and I

  • 8.12 Does senior management attend/participate in health and safety meetings ? D and I

  • 8.13 Is a prepared agenda followed and are minutes and attendance of the meeting kept ? D

  • 8.14 does two-way communication exist during these meetings ? D and I

  • 8.15 Are tailgate/toolbox meetings held regularly and documented as per policy ? D

9 Inspections

  • 9.1 Is there a written policy for inspections ? D

  • 9.2 Does the policy include frequency of inspections ? D

  • 9.3 Is the required frequency being met ? D

  • 9.4 Is there a form or checklist used for inspections ? D

  • 9.5 Are supervisors preforming inspections as required ? D and I

  • 9.6 Are workers involved in the inspection process ? D or I

  • 9.7 Are all areas inspected as required ? D

  • 9.8 Are identified deficiencies corrected in a timely manner ? D and I

  • 9.9 Does senior management participate and/review the inspection process ? D and I

  • 9.10 Are inspections reports posted and/or communicated to appropriate personnel ? O or I

10 Investigations and Reporting

  • 10.1 Is there a written investigation policy and reporting procedure(s) ? D

  • 10.2 Is the policy being followed ? D and I

  • Award 1 point if documentation on file verifies that initial investigation reports are completed within 24 hours.

  • Award 2 points if documentation on file verifies that serous incidents are thoroughly investigated.

  • Award 1 point based on a majority of positive interview responses.

  • 10.3 Are standardized forms readily available and used ? D

  • 10.4 Do workers know the reporting procedures ? I

  • 10.5 Have supervisors been trained in investigation and reporting procedures ? D and I

  • 10.6 Are appropriate personnel involved in investigation ? D

  • 10.7 Are near misses being reported? D and I

  • Award 2 points based on documentation.

  • Award 2 points based on interviews.

  • 10.8 Are recommendations for prevention/remedial action implemented in a timely manner ? D and I

  • Award 2 points based on documentation.

  • Award 2 points based on interviews.

  • 10.9 Are remedial/corrective actions communicated to workers ? I

  • 10.10 Are investigation reports reviewed by management ?

11 Emergency Preparedness

  • 11.1 Are the emergency preparedness plans appropriate to work activities ? D and O

  • Award 2 points based on documentation to verify that the company has developed a generalized plan/ procedure with respect to emergency response. ( ie. fire, first aid, transportation, communication)

  • Award 2 points based on documentation if evidence of a site specific written plans have been developed. ( ie. chemical spill, rescue, confined spaces testing and retrieval, muster point etc.

  • Award 2 points based on observation that a site- specific emergency response plan has been posted/made readily available at each worksite.

  • 11.2 Does the plan include a requirement for training in emergency procedures, roles and responsibilities ? D and I

  • Award 2 points based on documentation to verify that the company has provided workers with instruction/training in emergency procedures and equipment . ( This can be conducted during the employee's orientation or as job specific training )

  • Award 2 points based on confirmation through interviews that employees understand their responsibilities in the event of emergency as well as the site specific requirements.

  • 11.3 Has the emergency response plan been tested for deficiencies and corrective action taken ? D

  • 11.4 Does the employer have a written fire response plan ? D

  • 11.5 Are the correct class and size of extinguishers available , marked and visible ? O

  • 11.6 Are the fire extinguishers regularly inspected and maintained ? D or O

  • 11.7 Is an appropriate emergency communication system available ? O and I

  • 11.8 Are there adequate first aid supplies and facilities ? O

  • 11.9 Are the required number of qualified first aid personnel on site ? O or I

  • 11.10 Is there a means to transport an injured employee to a medical facility ? O and I

12 Statistics & Records

  • 12.1 Is there a process to organize and manage program documentation ? D

  • 12.2 Are adequate health and safety activity summaries developed and maintained ? D

  • 12.3 Are Heath and Safety statistical reports generated on an on-going/regular basis and readily available ?

  • 12.4 Does the company compare health and safety performance year to year ? D

  • 12.5 Are the annual statistics analyzed and needs or trends identified ? D

  • 12.6 Are adequate first aid records kept ? D

  • 12.7 Was an action plan developed based on the most recent audit ? D

  • 12.8 Was that action plan communicated and implemented ? D

13 Legisslation

  • 13.1 Are copies of recent Legislation posted and/or available at each workplace ? O or I

  • 13.2 Does the management/supervisor regularly refer to relevant Legislation and Regulations during job planning ? I

  • 13.3 Are personnel aware of their rights and responsibilities and how to exercise them ? I

  • Award 3 points based on employee understanding of their three fundamental rights ( right to know, right to refuse, right to participate ) and their safety responsibilities ( follow instructions, wear required PPE, do not conduct work in a manner that may endanger themselves or others - identify, communicate and control hazards )

  • Award 2 points based on management/supervisor's understanding of their legal duties and responsibilities ( be familiar with the WSH Act and Regulations, follow and enforce Legislation, participate in the identification, communication and control of hazards - to ensure workers are not exposed to risks to their health and safety, etc )

  • 13.4 Does the employer's accident reporting meet the legislated criteria ? I

14 Safety committee/Worker Safety Representative

  • 14.1.1 Is there a designated Worker Safety Representative at each job site ? D and I

  • 14.1.2 Are committee members or representatives familiar with their legal duties and responsibilities ? D and I

  • 14.1.3 Are committee members or representatives actively involved in hazard identification, communication and control ? D or O or I

  • 14.1.4 Have committee members or representatives received any training in how to carry out these duties and responsibilities ? D

  • 14.1.5 Are committee minutes posted (or if not practicable , made readily available) for all employees to read ? O or I

Regulatory Compliance & Safety Program Directives

  • Does the company have a Hearing Conservation Program ? D

  • Award 1 point based on the creation of a hearing conservation company policy.

  • Award 2 points based on documentation in support of audio metric testing for employees.

  • Award 2 points based on documentation in support of worksite sound monitoring

  • 14.2.2 Is hearing protection made readily available to employees , that includes instruction regarding the limitations and proper use ? O or I

  • 14.3.1 Is there a written directive or procedure in place on the subject of Lockout/Tag-out ? D

  • 14.3.2 Is it adhered to ? O or I

  • 14.4.1 Is there a written directive or plan in place on the subject of workers Working Alone ? D

  • 14.4.2 Is it adhered to ? D or I

  • 14.5.1 Are controlled products properly labelled ? D or O

  • 14.5.2 Are MSDS Sheets current and made readily available at each worksite ? O

  • 15.5.3. Have employees who work with, or in the proximity of controlled products received the appropriate training ? O

  • 14.5.4 Can employees communicate an understanding of the basic elements of WHMIS ? I

  • 14.6.1 Is the written directive or plan on the subject of operator training and/or equipment certification adhered to ? D and I

  • 14.7.1 Does the employer have a system in place to identify and control the risk of?

  • 14.8.1 Does the employer have a written policy with respect to the prevention of harassment in the workplace ? D

  • 14.8.2 Is the policy prominently posted in the workplace ? O

  • 14.9.1 Does the employer have a written policy with respect to the prevention of violence in the workplace ? D

  • 14.9.2 Is the policy prominently posted at the workplace ?

Owner / Prime Contractor / Sub-contractor Interaction

  • 14.10.1 Does the employer understand the role and responsibilities of all parties on a job site ? D or I

  • 14.10.2 Is there a system in place to ensure information is shared ? D or O

  • 14.10.3 Are contractor hazard assessments/inspection forms provided/communicated to the Prime Contractor ? D or O

  • 14.10.4 Is the company owner or senior manger actively involved in safety leadership ? D or O

Site Assessment

  • 14.11.1 Overall, are job site and work area "house keeping" appropriate to minimize incidents ? O

  • 14.11.2 Are work areas properly identified as construction site ? O

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.