Section 1

Section 1 - HSE Management
HSE Overview

Does your organization have a written HSE Policy?

Does your organization have an HSE Managment System? Is it certified by a recognized independent authority. If so what was the latest result.


Are health and safety responsibilities clearly identified for all levels of staff?

HSE Consultation

Is there a workplace HSE committee or regular meetings conducted with employees (e.g. safety meetings, tool box talk etc.)?

Are employees involved in decision making over HSE matters?

Does your organization have a HSE representative? Have they received HSE training?

How does your organization identify and communicate HSE issues (e.g. legislative, regulatory, industry)?

HSE Management System

Is a documented Job Safety & Environmental Analysis (JSEA) conducted prior to commencement of a job (i.e. risk identification, assessment, control and review procedures)?

Does your organization have a permit to work system (e.g. Hot Work, Confined Space, etc.)?

Does your organization have a process for the selection, assessment, monitoring and review of sub-contractors that incorporates HSE requirements?

Do you have procedures in place for the maintenance & inspection of plant equipment owned and/or operated by your organization (e.g. front end loader/backhoe, excavator, compressor, borer, electrical equipment, fire-fighting equipment, forklift, etc.)?

Do you have procedures for selection, use, storage, handling, spill management & disposal of hazardous substances and dangerous goods (e.g. corrosives, poisons, flammable liquids and gases, etc.)?

Do you have procedures for identifying, assessing and controlling risks associated with manual handling (e.g. controls in place - hand trucks, forklifts, cranes, etc.)?

Does your organization have procedures to prevent & reduce environmental emissions & damage?

Do your environmental procedures address containment and recovery processes?

Does your organization have emergency response plans and/or management process? (e.g. fire, medical emergencies, environmental issues, etc.)?

Does your organization conduct regular HSE audits of your HSE Management System by external parties?

Hazard Management

Is there a process by which employees can report hazards at workplaces (and potential health, safety & environmental hazards)?

Does this process involve a regular Hazard Register?

How does your organization communicate hazards to your employees and your sub-contractors?

HSE Training & Induction

Are records maintained of all training (certificates & licenses) and induction programs undertaken for employees (existing and new employees) in your organization?

How does your organization plan to manage inductions for personnel involved in projects with ISS?

Is there other specific HSE training for employees?

HSE Workplace Inspection

Does your organization have a process for regular (e.g. weekly, monthly) HSE inspections at worksites?

Are standard workplace inspection checklists used to conduct health, safety and environmental inspections?

How is information presented to stakeholders (i.e. workers, management, clients, etc.)?

Incident Management

Is there a documented incident management and investigation procedure?

Is there a system for the notification of incidents to regulatory agencies?

Is there a system for investigating incidents to determine root causes? Does the system identify and implement appropriate corrective actions?

HSE Offences

Has the organization had any enforcement activity or been convicted for a HSE offense in the past 3 years (e.g. improvement/prohibition notices, etc.)?

Section 2

Section 2 - HSE Performance Monitoring & Statistics
Performance Monitoring

Is there a system for recording and analyzing HSE performance statistics?

Are employees regularly provided with information on your HSE performance?

Current Days Away/Restricted or Transfer (DART) Rate and DART Rate for previous 3 Years

Current Year

Year 1

Year 2

Year 3

Current - YTD Number of First Aid Injuries and for previous 3 Years

Current Year

Year 1

Year 2

Year 3

Total Recordable Incident Rate (TRIR) for current year and previous 3 Years

Current Year

Year 1

Year 2

Year 3

Number of Environmental Incidents & Non-Compliances for current YTD and previous 3 Years

Current Year

Year 1

Year 2

Year 3



Final Rate


Click + to add people involved in the HSE process

People Involved
Full Name and Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.