HSE Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

HSE Audit Details

Audit Details

• Auditees

• Site:

• Regional Director

• Critical Facilities Manager:

• Safety Champion

HSE Auditor

• HSE Representative / Appointed Auditor

• Date:

  Date

HSE 01-00: Health and Safety Audit

Specific HSE Plan

• Are all required OSHA Posters posted prominently? Note: This includes the "OSHA Job Safety and Health: It's the Law" Poster and OSHA Form 300a when/if necessary

  Yes

  No

  Partial

  N/A

• Are all appropriate signs, posters, labels and other necessary designators posted to warn employees of potential hazards?

  Yes

  No

  Partial

  N/A

• Do employees have access to safe tools and equipment that are in good repair and free from hazard?

  Yes

  No

  Partial

  N/A

• Notes:

HSE Responsibilities / Accountability

• Is there a record of regularly held safety meetings for all employees?

  Yes

  No

  Partial

  N/A

• Is there appropriate and adequate Personal Protective Equipment (PPE) readily available for employee use?

  Yes

  No

  Partial

  N/A

• When asked, can the supervisors and employees describe the processes used to initiate a work-stop / restart event?

  Yes

  No

  Partial

  N/A

• When asked, Can the supervisors and employees describe the 5 step process?

  Yes

  No

  Partial

  N/A

• Do supervisors and employees demonstrate an awareness of their responsibilities to adhere to safe work practices as well as promote a safe workplace for all employees? Note: This should include awareness and acknowledgement of possible consequences for violations?

  Yes

  No

  Partial

  N/A

• Notes:

Recordkeeping

• Is there a record of Vendor HSE Rules and Regulations on file that is being reviewed periodically?

  Yes

  No

  Partial

  N/A

• Are there current, and ongoing, records for Safety Meetings, or Permit To Work (PTW)?

  Yes

  No

  Partial

  N/A

• Is there a First Aid Log available for use by employees?

  Yes

  No

  Partial

  N/A

• Notes

Inspections and Assessments

• Are work center and/or office inspections being completed and logged on a weekly basis?

  Yes

  No

  Partial

  N/A

• Is there a record of electrical safety gloves being inspected on a semi-annual basis?

  Yes

  No

  Partial

  N/A

• Notes

Event Notification and Escalation

• Have supervisors and employees been trained in the recognition and proper response to situations or events that warrant an incident notification to the Managing Director

  Yes

  No

  Partial

  N/A

• Is the 24 hr. Management Incident Notification Slide readily available for use in the response to a workplace incident?

  Yes

  No

  Partial

  N/A

• Is the Corporate HSE Injury & Incident Report Form readily available?

  Yes

  No

  Partial

  N/A

• Notes

Emergency Preparedness

• Has a site-specific Emergency Action Plan been fully developed for use in response to manmade and natural emergencies?

  Yes

  No

  Partial

  N/A

• Have all employees been trained in the site emergency notification procedures with associated training records on file?

  Yes

  No

  Partial

  N/A

• Are emergency telephone numbers posted near telephones, employee notice boards and other conspicuous locations?

  Yes

  No

  Partial

  N/A

• Notes

Spill Prevention and Response

• Is there a complete Safety Data Sheet (SDS) library available for employee use?

  Yes

  No

  Partial

  N/A

• Are all hazardous containers/products that are stored on-site properly labeled to identify any associated hazards? Note: Labels should be consistent with the Safety Data Sheet information

  Yes

  No

  Partial

  N/A

• Has the site Hazardous Materials List been reviewed by the auditor and found to be complete and being routinely updated?

  Yes

  No

  Partial

  N/A

• Have employees been trained in evaluating, identifying and responding to potential and actual spill situations? Note: This should include the proper use of response materials, response material location, as well as proper use of PPE

  Yes

  No

  Partial

  N/A

• Are all appropriate warning signs, response materials and storage means available on site for spill prevention and response?

  Yes

  No

  Partial

  N/A

• Note

Workers’ Compensation Claims Management

• Are all appropriate Reporting forms available or readily accessible in the event of need? This should include the OSHA 300A

  Yes

  No

  Partial

  N/A

HSE Training

• Are regular HSE meetings being scheduled, attended and documented with records kept on file?

  Yes

  No

  Partial

  N/A

• Are monthly meetings being conducted with supervisors to review HSE performance and improvement initiatives?

  Yes

  No

  Partial

  N/A

• Are HSE related issues being tracked and monitored until fully resolved?

  Yes

  No

  Partial

  N/A

• Are all employees completed with HSE New Hire Orientation

  Yes

  No

  Partial

  N/A

• Are all employees up to date on HSE Training?

  Yes

  No

  Partial

  N/A

• Are all employees complete or on target to complete their required Qualifications on time?

  Yes

  No

  Partial

  N/A

• Have supervisors and managers identified the training needs of employees and are subsequently ensuring that such training is completed? How is this being evaluated?

  Yes

  No

  Partial

  N/A

• Is there a record available to verify that employees have been trained, or are in process of being trained, in regard to job specific PPE usage?

  Yes

  No

  Partial

  N/A

HSE 05-00: Plans and Programs

Blood-borne Pathogens

• Are the required Blood-borne Pathogen Exposure Control Plans, Employee Medical Records and employee required training for the site fully completed and available for review?

  Yes

  No

  Partial

  N/A

• Are hand washing stations or other sanitizing/antiseptic solutions available at all locations where there is a potential for blood-borne pathogen exposure?

  Yes

  No

  Partial

  N/A

Medical, First Aid and Exposure-to Records

• Are First Aid supplies readily available to employees with a First Aid Log being maintained either manually or electronically?

  Yes

  No

  Partial

  N/A

Personal Protective Equipment

• Are the Employee Training Records and Training and Certification Log for personal protective equipment up-to-date and available to be reviewed upon request?

  Yes

  No

  Partial

  N/A

• Are all appropriate checklists and assessments being utilized by supervisors and employees and available for review upon request?

  Yes

  No

  Partial

  N/A

• Has it been determined that there is an adequate, ample and readily available supply of PPE for employee use during the completion of work tasks?

  Yes

  No

  Partial

  N/A

Electrical Safety

• Electrical Site Assessment been completed to determine whether or not employees can be affected by or exposed to electrical hazards (high or low voltage) prior to the assignment of work?

  Yes

  No

  Partial

  N/A

• Have all employee job responsibilities been evaluated using Hazard Risk Category Classification and required training been identified?

  Yes

  No

  Partial

  N/A

• Is there a record of employee electrical safety training available for review upon request?

  Yes

  No

  Partial

  N/A

• Is there a fully functioning and implemented Lockout/Tag out program available for employee use?

  Yes

  No

  Partial

  N/A

Hearing Conservation

• Has training or a hearing conservation program been fully implemented and documented for employees who are exposed at or above an 8-hour time-weighted average of 85 dBA?

  Yes

  No

  Partial

  N/A

• Has hearing protection has been made available to all employees exposed to an 8-hour time-weighted average of 85 decibels or greater?

  Yes

  No

  Partial

  N/A

Scaffolds

• Is there a record of training or program for all contractors under the charge of SDC supervisors indicating that they have a program that addresses the proper erection and maintaining of scaffolds?

  Yes

  No

  Partial

  N/A

Lead

• Has a list of possible locations of lead containing material been created?

  Yes

  No

  Partial

  N/A

• If the site is suspected of having lead present on surface coatings, is there a record of an annual Lead Awareness Training Program?

  Yes

  No

  Partial

  N/A

• Are there Lead detection swabs or kits available for employee use in determining the presence of lead?

  Yes

  No

  Partial

  N/A

• Note: This is required in instances where SDC technicians are required to perform painting activities

  Yes

  No

  Partial

  N/A

Regulatory Agency Inspections and Inquiries

• Do employees and supervisors demonstrate an appropriate level of knowledge of the proper notification procedures to alert management or other concerned parties upon the arrival of a Compliance Safety and Health Officer (CSHO) at the facility or work location?

  Yes

  No

  Partial

  N/A

• Do employees and supervisors demonstrate an appropriate level of knowledge in regard to their rights, procedures and protections available to them upon the admittance of a CSHO into the facility or work location?

  Yes

  No

  Partial

  N/A

HSE 07-00: Safe Work Planning / Hazard Analysis

Housekeeping

• Housekeeping

• Are aisles, walkways and floors clear of obstructions, possess adequate lighting and free of slip hazards? Note: These areas should also have safe clearances for fire extinguishers and emergency showers as well as a minimum aisle width of 3 feet

  Yes

  No

  Partial

  N/A

• Are walkthrough inspections of workplaces and grounds being conducted weekly? How is this recorded?

  Yes

  No

  Partial

  N/A

Permit To Work

• Are supervisors conducting daily pre-job safety meetings with employees to discuss the provisions of the Permit To Work prior to commencing work?

  Yes

  No

  Partial

  N/A

• Have employees been trained on the correct use of the Permit To Work (PTW)

  Yes

  No

  Partial

  N/A

• Is there a file of PTWs being maintained and available for use future similar jobs?

  Yes

  No

  Partial

  N/A

Hand and Portable Power Tools

• Are hand tools being properly maintained, inspected and in a condition that allows for hazard free employee use?

  Yes

  No

  Partial

  N/A

• Are corded power tools and equipment properly grounded and cords in good condition?

  Yes

  No

  Partial

  N/A

• Is there a record of on-going quarterly inspections being completed on all double and single insulated portable electric tools?

  Yes

  No

  Partial

  N/A

Ladders and Stairways

• Is there a record of employee training in the proper use of ladders and stairways?

  Yes

  No

  Partial

  N/A

• Are ladders properly stored, labeled and secured?

  Yes

  No

  Partial

  N/A

• Is there a Ladder Inspection Program in place including on-going and current records available for review?

  Yes

  No

  Partial

  N/A

Compressed Gas

• Is there a record of employee training in recognition of hazards associated with compressed gases and the methods and means necessary for safe operation?

  Yes

  No

  Partial

  N/A

• Are all compressed gas cylinders, in service or storage, maintained, inspected, in good condition and stored upright?

  Yes

  No

  Partial

  N/A

• Is all appropriate warning signs posted for areas where compressed gas stored?

  Yes

  No

  Partial

  N/A

General Waste Management

• Is there is a comprehensive waste minimization program in place to reduce the generation of non-hazardous waste?

  Yes

  No

  Partial

  N/A

• Is there is a plastic, paper and aluminum recycling program in place?

  Yes

  No

  Partial

  N/A

• Legionella Exposure

  Yes

  No

  Partial

  N/A

• Mold Remediation for Building Managers

  Yes

  No

  Partial

  N/A

• Is the building being periodically inspected for the detection of mold infestation?

  Yes

  No

  Partial

  N/A

• Have employees been trained as to the proper response upon the discovery of a mold infestation as well the hazards associated with mold disruption?

  Yes

  No

  Partial

  N/A

Hazardous Energy Control (lock-out / tag-out)

• Is there a viable and functioning LOTO program in place with all equipment (tags, locks, logbook etc.) in good condition and available for use by all affected employees?

  Yes

  No

  Partial

  N/A

• Is there a record of training for all employees and affected site personnel in regard to proper LOTO procedures?

  Yes

  No

  Partial

  N/A

• Is there a periodic compliance inspection and audit of the LOTO program being performed at least annually?

  Yes

  No

  Partial

  N/A

Fall Protection

• Have all workplace fall hazard surveys, risk assessments, Permit To Work and other appropriate methods been employed to identify tasks and workplaces that may require personal fall protection for employees?

  Yes

  No

  Partial

  N/A

• Is there a site specific fall protection and training plan under the supervision of a Competent Person

  Yes

  No

  Partial

  N/A

• Is a designated competent person performing inspections of fall arrest systems?

  Yes

  No

  Partial

  N/A

Flammable and Combustible Liquid (Use/Storage/Handling)

• Are all flammable liquids stored inside buildings, kept in closed metal containers, in storage cabinets or safety cans, or stored in a storage room not having a door that opens into that portion of the building used by the public?

  Yes

  No

  Partial

  N/A

• Are all appropriate signs in place in areas where flammable or combustible liquids are stored, dispensed or utilized?

  Yes

  No

  Partial

  N/A

• Are all fire extinguishers properly labeled, located, inspected and accessible to employees?

  Yes

  No

  Partial

  N/A

• Is there an auditable record of employee training regarding the safe usage, handling and storage of combustible liquids?

  Yes

  No

  Partial

  N/A

Hot Work and Fire Prevention

• Are employees aware of SDC and client requirements in regard to "hot work" and also adhering to site permitting requirements

  Yes

  No

  Partial

  N/A

• Are portable fire extinguishers being maintained in a fully charged and operable condition and kept in their designated places at all times?

  Yes

  No

  Partial

  N/A

• Is there an Emergency Action Plan is in place with employees aware of their responsibilities and duties in response to a fire or other emergencies?

  Yes

  No

  Partial

  N/A

Welding, Cutting and Brazing

• Is there a Welding, Cutting and Brazing Program (including associated training) established, documented, communicated and applied to any employee, contractor or visitor performing operations with welding, cutting or brazing equipment?

  Yes

  No

  Partial

  N/A

Trenching and Excavation

• Is there a method in place to ensure that all contractors are trained in accordance with SDC established training and safety guidelines for excavations where a trench is laid greater than five-feet deep?

  Yes

  No

  Partial

  N/A

Roof Work Fall Protection

• Have all buildings or structures being managed by SDC been evaluated for roof and skylight hazards

  Yes

  No

  Partial

  N/A

• Prior to tasks being assigned, are they being evaluated using a Work at Height PTW determine if employees can be affected by or exposed to fall hazards?

  Yes

  No

  Partial

  N/A

• Are all PPE and fall arrest equipment readily available to employees and being maintained and inspected appropriately?

  Yes

  No

  Partial

  N/A

Aerial Lifts

• Is there a record of employees been trained (initially and annually thereafter) in the operation and identification of hazards while operating aerial lifts?

  Yes

  No

  Partial

  N/A

• Are lifts being inspected every three-months or after every 105 hours of use?

  Yes

  No

  Partial

  N/A

Action Items:

Health and Safety Culture score for site:

HSE Audit – Section 6:

• HSE Representative / Appointed Auditor

• Printed Name:

• Signature:

  Sign

• Position:

• Date:

  Date

• SDC Manager

• SDC Supervisor

SDC Employee