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  • Conducted on

  • Prepared by

  • Location

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  • Informal expectations are in place.

  • Employee health and safety responsibilities are defined in writing.

  • Managers and supervisors use the language specified by corporate for health and safety goals in their annual performance plan.

  • Safety Scorecards are developed, implemented and maintained to measure performance against expectations

  • The discipline process is documented.

  • The Location has implemented the Personal Safety Improvement Plan program (PSIP)

  • Individual annual performance reviews occur for managers, supervisors and others with defined safety goals.

  • Safety Scorecards are reviewed by the individual and top management each month.

  • Inspection scoring or trending results are a Safety Scorecard criteria.

  • PSIP Meetings are attended by top management as well as the employees direct supervisor.

  • Managers and supervisors understand how they are being measured and their current status.

  • Managers' and supervisors' health and safety performance is weighted into their overall performance rating during annual reviews.

  • Employees understand what their health and safety responsibilities are.

  • Employees are held accountable for unsafe work practices and recognized for safe work practices

  • Safety Scorecard results are at or above 90%. When scores are below 90%, management is engaging personnel to improve performance.

  • Individual performance improvement plans are developed for low performers.

  • All employees receive individual annual performance reviews for health and safety expectations.

  • Health and safety expectations and requirements are specified in all employees’ job descriptions.

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.