Parker Services Audit (partial)

• Prepared by

• CUSTOMER NAME:

• DATE OF ASSESSMENT:

  Date

• PLANT/LOCATION NAME:

• ADDRESS
  Address

• PRESENT EMPLOYEE COUNT:

• OFFICE:

• MAIN FACILITY:

• OTHER:

• CONTACT NAME:

• TITLE:

• PHONE:

• E-MAIL ADDRESS:

• EVALUATION PERFORMED BY:

• IF THIS PAGE IS APPLICABLE

  Yes

  No

  N/A

I. MANAGEMENT SUPPORT AND LEADERSHIP

• 1a. Is there a published safety mission/policy statement?

  Yes

  No

  N/A

• 1b. Is the Safety Program in writing and cover basic core elements such as: Management Leadership, Employee Participation, Hazard Identification & Assessment; Hazard Prevention & Control; Education & Training; and Program Evaluation & Improvement?

  Yes

  No

  N/A

• 2. Is it signed by a member of top management?

  Yes

  No

  N/A

• 3. Is there a full-time or part-time person responsible for safety?

  Yes

  No

  N/A

• If part-time, what other duties does this person have?

• 4. How frequently does the general manager, plant manager, etc., perform safety inspections at your location?

  Monthly (25 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 5a.Does the company have an “Executive” Safety Committee?

  Yes

  No

  N/A

• 5b. If yes, how often do they meet?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 5c. Are any of the local top management personnel members of the plant/location safety committee?

  Yes

  No

  N/A

• 6a. Does top management receive reports on safety performance activity?

  Yes

  No

  N/A

• 6b. How often?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 6c. Does the management team develop written measurable or identifiable safety goals/objectives and strategies?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 7. Does top management visibly display their support for the safety program?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 8. Are there written standards concerning what management's responsibility should be in relation to the safety program?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 9. Are safety responsibilities clearly defined in job descriptions of management personnel?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 10. Have all responsible individuals been provided a copy of this, and are they held accountable for the defined responsibilities (using an objective measurement system – i.e., activity based measurements)?

  Monthly (20 pts.)

  Quarterly (15 pts.)

  Semi-annually (10 pts.)

  Annually (5 pts.)

  N/A (net points equals 0)

• 1. Opinions and Recommendations - Management Support

• IF THIS PAGE IS APPLICABLE

  Yes

  No

  N/A

• 1. Are prospective employees given a post-offer health examination?

  Yes

  No

  N/A

• 2. Have any supervisors/employees received certified first aid training and are they current (available on all shifts)?

  Yes

  No

  N/A

• If yes, how many?

• 3. Have first aid facilities been established by a medical doctor and/or hospital/clinic?

  Yes

  No

  N/A

• 4. Is access to first aid supplies controlled and a first aid log maintained?

  Yes

  No

  N/A

• 5. Are first aid supplies updated as to their shelf life?

  Yes

  No

  N/A

• 6. Are there medical personnel available for advice and consultation on matters of plant/facility health?

  Yes

  No

  N/A

• 7. Is there a relationship established with an Occupational Health Physician or local clinic for advice and consultation on matters of facility/plant health?

  Yes

  No

  N/A

• 8. Is there a physician/medical professional that visits the site on a periodic/regular basis to consult on site safety and health initiatives (IH, Respirators, PPE, 1st Aid Supplies, Ergonomics, injury avoidance, etc.)?

  Yes

  No

  N/A

• 9. Are employees provided with an annual communication on their right to access medical and/or exposure records?

  Yes

  No

  N/A

• 10.Is there a written return to work program?

  Yes

  No

  N/A

• 2. Opinions and Recommendations - Medical Program

• IF THIS PAGE IS APPLICABLE

  Yes

  No

  N/A

• 1a. Is the required OSHA injury recording system being completed?

  Yes

  No

  N/A

• 1b. Is the required OSHA 300A Log summary posted from February 1 through April 30?

  Yes

  No

  N/A

• 2a. Is someone in charge of the workers' compensation/claims management program?

  Yes

  No

  N/A

• If yes, title: HR Manager

• 2b. Have proper claims management techniques been implemented?

  Yes

  No

  N/A

• 3. Are frequency and severity rates computed for the facility/plant?

  Yes

  No

  N/A

• If yes, indicate what the most recent rates are:

  Yes

  No

  N/A

• Frequency (TRCR)

• Severity (DART)

• 4. Are accident rates, specific accidents and/or groups of accidents analyzed for trends and accident reduction planning?

  Yes

  No

  N/A

• 4a. Have the areas of exposure or loss been identified:

  Yes

  No

  N/A

• 5. Are members of management informed as to current accident rates, goals, and areas needing improvement (on an ongoing basis)?

  Yes

  No

  N/A

• 3. Opinions and Recommendations - Accident Recording System

• IF THIS PAGE IS APPLICABLE

  Yes

  No

  N/A

• 1. Is there a formal safety orientation program for new employees?

  Yes

  No

  N/A

• 2. Is a specific individual responsible for new employee safety orientation?

  Yes

  No

  N/A

• Title: Safety Advocate

• 3. Does orientation/safety training include review of company safety policy, outline of safety program, location safety rules, emergency plans, safety equipment, overview of required OSHA performance standards, forklift procedures, etc.

  Yes

  No

  N/A

• If yes, explain briefly:

• 4. Do supervisory personnel have department specific checklists, JSA's, JHA's, SOP’s concerning particular department hazards or procedures which must be reviewed with a new or transferred employee upon her/his arrival and include signoff?

  Yes

  No

  N/A

• 5.            Is the new employee evaluated periodically on her/his safety performance?

  Yes

  No

  N/A

• If yes, please indicate how:

• 4. Opinions and Recommendations - Employee Orientation