Field Ranking System Audit Form

Field Ranking System Audit Form

• District - Manager/Supervisor Name:

• Month & Year Audited:

• Conducted on

  Date

• Conducted by

• Location
  Address

Employee Behavioural Observation

• How many behavioural observation reports were required?

• How many behavioural observation reports were entered?

• Score of Ratio Required / Completed?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

• Does it support the score entered?

  Yes

  No

  N/A

Training Verification

• Training topic(s) for month per playbook?

• Number of employees were required to complete training?

• Number of employees completed training and passed quiz?

• Score of Ratio Required / Completed?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

• Does it support the score entered?

  Yes

  No

  N/A

HSE procedure / HSE Short

• Topic of HSE procedure of HSE short same as in playbook?

  Yes

  No

  N/A

• Number of employees required to review procedure / safety short?

• Number of employees who completed procedure / short review?

• Score of Ratio Required / Completed?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

• Does it support score entered?

  Yes

  No

  N/A

Vehicle / Tool / PPE Inspection

• Number of Vehicle / Tool / PPE Inspections Required?

• Number of Vehicle / Tool / PPE Inspections Completed?

• Ratio of number required / number completed?

  Ratio N1 /N2 = 1

  Ratio N1 / N2 < 1

  Ratio N1 / N2 > 1

• Does the ratio support the data entered?

  Yes

  No

  N/A

HSE Monthly Meeting

• Number of meetings required?

• Number of meetings held?

• Ratio of required / completed?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

• Does the ratio support the data entered?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

Contractor Performance Evaluations

• Number of Contractor Performance Evaluations Required?

• Number of Contractor Performance Evaluations Completed?

• Ratio of number required / number completed?

  Ratio N1/N2 = 1

  Ratio N1/N2 < 1

  Ratio N1/N2 > 1

• Ratio supports data entered?

  Yes

  No

  N/A

Supervisor HSE Meeting

• Supervisor used the HSE monthly template and covered all the (applicable) agenda items?

  Yes

  No

  N/A

• Supervisor effectively engaged the team, demonstrated positive HSE behaviours and expectations?

  Safe

  At Risk

  N/A

• Employees were attentive and engaged with the supervisor and demonstrated positive HSE behaviours?

  Yes

  No

  N/A

Ranking System Score

• Ranking System Score Entered?

• Verification Score?

• Variation between Ranking System Score / Verification Score = %

• Verification supports Ranking System Score Entered?

  Yes

  No

  N/A