HSE Annual Audit. Commercial Operations LATAM

• Document No.

• Conducted on

  Date

• Prepared by: Fernando Villalobos

• Location
  Address

PART I. HSE MANAGEMENT

• Is the HSE Policy posted at S+N facilities in a visible place?

  Compliant

  Non-Compliant

  N/A

• Have the country managing director signed his/her adherence to the HSE Policy?

  Compliant

  Non-Compliant

  N/A

• Is there a HSE annual strategic plan to cover local commercial operations?

  Compliant

  Non-Compliant

  N/A

• Has the HSE Manual been divulged and implemented in local commercial operation?

  Compliant

  Non-Compliant

  N/A

• Have HSE objectives been developed based on corporate procedure GPR-HSE-007.1 HSE Objectives and Improvement Plans Rev B ?

  Compliant

  Non-Compliant

  N/A

• Has the CO emissions report been sent to Corporate HSE on a quarterly basis?

  Compliant

  Non-Compliant

  N/A

• Is there an active Safety Committee in place? (When required by local law)

  Compliant

  Non-Compliant

  N/A

PART II. HSE PROGRAM

• Has the local commercial operation an active HSE program/system?

  Compliant

  Non-Compliant

  N/A

• Is the HSE program/system aligned with Corporate HSE Policies and Procedures?

  Compliant

  Non-Compliant

  N/A

• Is the HSE program/system aligned with local HSE Regulations?

  Compliant

  Non-Compliant

  N/A

• Is HSE program/system included as a subject on the new hire orientation training? (GPR-HSE-009.2 HSE Orientation, Induction and Training Rev B)

  Compliant

  Non-Compliant

  N/A

• Does the commercial operation keep records of HSE corporate and/or local regulatory audits/inspections? (GPR-HSE-008.2 HSE Auditing Rev B)

  Compliant

  Non-Compliant

  N/A

PART III. RISK MANAGEMENT

• Has been conducted a risk assessment covering commercial, surgical services and warehousing operations based on GPR-HSE-003.1 Management of Task Risks through Job Hazard Analysis/Risk Assessment (JHA/RA) Rev C?<br><br>

  Compliant

  Non-Compliant

  N/A

• Has been determined a risk hierarchy control? (Engineering controls/Administrative controls/Personal Protective Equipment)

  Compliant

  Non-Compliant

  N/A

• Are employees informed about the risks present in their work areas?

  Compliant

  Non-Compliant

  N/A

• Are the employees properly trained on the risk control measures in their work areas?

  Compliant

  Non-Compliant

  N/A

PART IV. CORRECTIVE ACTIONS

• Are corrective actions generated as a result of a work related incident? ​

  Compliant

  Non-Compliant

  N/A

• Are corrective actions generated as a result of a HSE Corporate or Regulatory Audit ? ​

  Compliant

  Non-Compliant

  N/A

• Are Single Point Lessons (SPL's) communicated throughout the commercial operation ?

  Compliant

  Non-Compliant

  N/A

• Are corrective actions met in a scheduled deadline?

  Compliant

  Non-Compliant

  N/A

• Is evidence attached when a corrective action has been closed ?

  Compliant

  Non-Compliant

  N/A

• Is there an emergency response plan implemented for local commercial operations ?

  Compliant

  Non-Compliant

  N/A

• Is there an Emergency Response team properly trained on the emergency response plan?

  Compliant

  Non-Compliant

  N/A

• Are emergency drills conducted at least once a year involving all the commercial operation employees?

  Compliant

  Non-Compliant

  N/A

• Are disciplinary actions taken when employees do not follow HSE procedures and/or local regulations?

  Compliant

  Non-Compliant

  N/A

PART V. INCIDENT INVESTIGATION

• Are all significant incidents reported to the Global HSE Director?<br>

  Compliant

  Non-Compliant

  N/A

• Are work related incident report immediately to affected employee supervisor and local HSE contact?

  Compliant

  Non-Compliant

  N/A

• Are work related incidents reported and investigated according to GPR-HSE-008.1 Management of Incidents, Injuries and Dangerous Occurences Rev C ?

  Compliant

  Non-Compliant

  N/A

• Are work related incident information included on the Period OSHA and Sustainability report on a monthly basis?

  Select Compliant Non-Compliant N/A

  • Compliant
  • Non-Compliant
  • N/A

• Are work related incidents reported to local Health & Safety authorities?

  Compliant

  Non-Compliant

  N/A

PART VI. CONTRACTOR SAFETY

• Do commercial operations implement the requirements described on GPR-HSE-003.17 Control and Safety of Visitors and Contractors at S&N Sites Rev B?

  Compliant

  Non-Compliant

  N/A

• Is there a HSE contractor orientation training implemented on site?

  Compliant

  Non-Compliant

  N/A

• When directly supervised by S+N work related cases occurred to contractor workers are included on the monthly sustainability report ?

  Compliant

  Non-Compliant

  N/A

• Do contractor companies meet an approval process, based on corporate and local regulations?

  Compliant

  Non-Compliant

  N/A

PART VII. WASTE MANAGEMENT

• Is there a waste stream classification program implemented on site ?

  Compliant

  Non-Compliant

  N/A

• Are dangerous and non dangerous waste, disposed and treated as required by local regulations and corporate procedure GPR-HSE-003.34 Management and Minimization of Waste Rev B?

  Compliant

  Non-Compliant

  N/A

• Are there waste reduction initiatives implemented on site ?

  Compliant

  Non-Compliant

  N/A

• Are waste management metrics reported on a quarterly basis to the Sustainability report?

  Compliant

  Non-Compliant

  N/A

• If required, has the safe work boundary been delineated using a safety barricade or tape?<br>

  Compliant

  Non-Compliant

  N/A

• Does the commercial operation keep documentation of waste shipments?

  Compliant

  Non-Compliant

  N/A

PART VIII. STORAGE AND HANDLING OF CHEMICAL PRODUCTS

• Are Safety Data Sheets available of the stored chemical products ?

  Compliant

  Non-Compliant

  N/A

• Is Personal Protective Equipment worn if recommended by the chemical product manufacturer ?

  Compliant

  Non-Compliant

  N/A

• In case of chemical product leakage ,is there a containment system or chemical spill kit available ?

  Compliant

  Non-Compliant

  N/A

• Are flammable and combustible liquids stored inside of an approved FM cabinet?

  Compliant

  Non-Compliant

  N/A

• Does the facility meet the maximum storage capacity for flammable and combustible liquids?

  Compliant

  Non-Compliant

  N/A

• Does the flammable and combustible liquid storage area have an installed fire detection & protection system?

  Compliant

  Non-Compliant

  N/A

PART IX. DRIVER SAFETY

• Does the employee/contractor have a valid Driver's license?

  Compliant

  Non-Compliant

  N/A

• Does the employee/contractor have a current vehicle registration?

  Compliant

  Non-Compliant

  N/A

• Does the employee/contractor have a current insurance and accident reporting documents?

  Compliant

  Non-Compliant

  N/A

• If applicable, are vehicle inspection records up to date?

  Compliant

  Non-Compliant

  N/A

EXTERIOR VEHICLE CONDITION

• Is vehicle exterior clean and undamaged?

  Compliant

  Non-Compliant

  N/A

• Is the windshield in good condition (no cracks, stars)?

  Compliant

  Non-Compliant

  N/A

• Vehicle not leaking fluids (water, oil, antifreeze, fuel, etc.)?

  Compliant

  Non-Compliant

  N/A

• All exterior lights functional?

  Compliant

  Non-Compliant

  N/A

• Outside mirrors attached and adjustable?

  Compliant

  Non-Compliant

  N/A

• Are tires in good condition?

  Compliant

  Non-Compliant

  N/A

INTERIOR VEHICLE CONDITION

• Is vehicle interior clean, organized and undamaged?

  Compliant

  Non-Compliant

  N/A

• Are dashboard gauges functioning and warning lights out?

  Compliant

  Non-Compliant

  N/A

• Does vehicle’s horn sound?

  Compliant

  Non-Compliant

  N/A

• Are all interior lights functioning?

  Compliant

  Non-Compliant

  N/A

• Are seat belts and rear view mirror in good condition?

  Compliant

  Non-Compliant

  N/A

VEHICLE SAFETY EQUIPMENT

• If required, is vehicle equipped with an appropriate Fire Extinguisher?

  Compliant

  Non-Compliant

  N/A

• If yes to A, is the inspection record complete and current?

  Compliant

  Non-Compliant

  N/A

• If permitted (or required) by local law, does the employee/contractor have a hands free device?

  Compliant

  Non-Compliant

  N/A

• Does the employee/contractor have a current First Aid Kit?

  Compliant

  Non-Compliant

  N/A

• If required, is the vehicle equipped with Reflective Safety Triangles or other equipment as required by local law?

  Compliant

  Non-Compliant

  N/A

PART X. ERGONOMICS

• Is commercial operation aligned with corporate procedure GPR-HSE-003.30 Workplace Ergonomics Rev.B ?

  Compliant

  Non-Compliant

  N/A

• Has the commercial operation performed an ergonomics assessment (including potential musculoskeletal disorders) at office work stations? <br>

  Compliant

  Non-Compliant

  N/A

MANUAL WEIGHT LIFTING & HANDLING

• Is there a maximum weight to be lifted manually by gender? (consider local regulation if available)

  Yes

  No

  N/A

• Is the commercial operation in alignment with GPR-HSE-003.4 Safe Lifting and Manual Handling Rev B

  Yes

  No

  N/A

• Lifting – Back Straight while lifting or placing?

  Yes

  No

  N/A

• Lifting – tested weight of unknown object before attempting to lift?

  Yes

  No

  N/A

• Lifting – Not twisting (“squaring” hips to pick up and put down location)?

  Yes

  No

  N/A

• Lifting – Lifting with Legs & buttocks, not back? Feet offset for stability?

  Yes

  No

  N/A

• Lifting – Did associate request help lifting >50 lbs (23 Kg)?

  Yes

  No

  N/A

• Lift or Carry – Was employee/contractor “hugging” load to body?

  Yes

  No

  N/A

• Carry – Did employee/contractor create a “clear path” before lift and carry?

  Yes

  No

  N/A

• Overhead – Not lifting objects >14 lbs (6.4 Kg), above 6’10” (2 m)?

  Yes

  No

  N/A

PART XI. SURGICAL SERVICES SAFETY

• Are the surgical services technicians in alignment with GPR-HSE-003.7 Driving on Company Business Rev B?

  Compliant

  Non-Compliant

  N/A

• Are the surgical services technicians in alignment with GPR-HSE-003.6 Management of Biological Hazards Rev B?

  Compliant

  Non-Compliant

  N/A

• Are the surgical services technicians in alignment with GPR-HSE-003.21 Control of Ionizing Radiation Sources Rev B?

  Compliant

  Non-Compliant

  N/A

• Are the surgical services technicians in alignment with GPR-HSE-003.16 Safety of Employees at Non-Smith & Nephew Locations Rev B?

  Compliant

  Non-Compliant

  N/A

PART XII .WAREHOUSE SAFETY

• Is the warehouse operation in alignment with GPR-HSE-003.4 Safe Lifting and Manual Handling Rev B?

  Select Compliant Non-Compliant N/A

  • Compliant
  • Non-Compliant
  • N/A

• When applicable is the warehouse operation in alignment with GPR-HSE-003.12 Safe Use of Powered Industrial Vehicles (Fork Lift Trucks) Rev B?

  Compliant

  Non-Compliant

  N/A

• Is the warehouse operation in alignment with GPR-HSE-003.13 Safe Loading and Off-Loading of Materials Rev B?

  Compliant

  Non-Compliant

  N/A

• Is the warehouse operation in alignment with GPR-HSE-003.18 Safe Storage and Handling of Materials Rev B?

  Compliant

  Non-Compliant

  N/A

RACK STORAGE SAFETY

• Is the warehouse operation conducting a monthly inspection to high bay storage racks covering the following items: <br>• Damaged or corroded uprights <br>• Damaged bracing <br>• Damaged load bars/beams <br>• Damaged or missing back up bars <br>• Load bars are fully engaged and safety clips, pins, or bolts are in place <br>• Loads do not exceed maximum rated capacities <br>• No dents, kinks, or otherwise damaged components <br>• All racks are plumb, level, and square <br>• Rack aisles are clear of obstructions <br>• All components are properly tightened <br>• Grid/mesh between load beams<br>• Presence of upright guarding <br>

  Compliant

  Non-Compliant

  N/A

ACTION PLAN

• 1.

  Yes

  No

  N/A

• 2.

  Yes

  No

  N/A

• 3.

  Yes

  No

  N/A

• 4.

  Yes

  No

  N/A

• 5.

  Yes

  No

  N/A

SURVEY SUMMARY

• COMPLIANT- All requirements are being met.

  Yes

  No

  N/A

• MINOR NON COMPLIANCE- Some requirements are not being met – work is still performed safely.

  Yes

  No

  N/A

• MAJOR NON COMPLIANCE - Significant issues not addressed or repeated non-compliance, work must not proceed until resolved.

  Yes

  No

  N/A

• Is follow up necessary? If YES by whom?

  Yes

  No

  N/A

SIGNATURES

• HSE Representative

  Sign