Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Management System

Documented Safety Policy

  • Do they have a safety policy?

  • What level is the Safety Policy at?

  • Signed by CEO

  • Annually reviewed with changes recorded

  • Complies with 45001 section 5(2)

  • Does the policy set safety as a top priority for the organisation and is a meaningful document

  • Health & Safety Management Plan

  • Injury and Illness Prevention Plan (IIPP)

  • undefined

  • Is the policy easily accessible by employees and regularly reviewed with employees

  • Accessed through intranet or displayed in various locations

  • Policy review meeting attendance record

  • undefined

  • Do employees understand that they are responsible and accountable for compliance with the safety policy

  • Roles & Responsibilities documernted and signed by individual

  • undefined

  • Do employees see the safety policy as the guiding philosophy for all company safety programs, standards, and procedures

  • Employee Feedback Survey

  • Employee Feedback Questionnaire

  • Safety Walk Round question

  • undefined

  • Does Sr. Leadership and company safety committee review the policy regularly and make changes as the organisation develops

  • Safety Committee Meeting Report / Minutes

  • Management Review Report

  • Safety Policy Ammendments (recorded)

  • undefined

  • Do all employee activities comply with the safety policy

  • RAMS

  • Training

  • Permits to Work

  • Tool tethers

  • PPE compliance

  • Hazard Alert recording

  • undefined

  • Is valuing employees clearly visible in the policy

  • How does the company value employees?

  • Health assessments

  • Safety rewards

  • Safety committees

  • No blame culture / Open Door Policy

  • Mental Health Training

  • Appraisals

  • Is the policy reviewed with all new employees before the begin work

  • How are new employees introduced to the policy?

  • Employee Induction

  • Permastellisa Site Induction

  • The safety policy is a written declaration of the company’s dedication to excellence in safety issues and the priority that safety has in the operation of the company.

  • undefined

  • undefined

  • The safety policy is considered when management makes decisions.

  • Production Meeting Minutes

  • Designer Meetings

  • Project Strategic Workshop

  • Project Health and Safety Plan

  • Factory Meetings

  • Interviewing Manager(s)

  • undefined

  • All employees know the safety policy and allow it to guide their daily actions.

  • Interview Employees on Safety Policy / Procedures

  • Hazard Alert Report Level

  • Clean working areas

  • Correct PPE being worn

  • undefined

  • Employees clearly understand the role they play to enable the company to reach the goal of zero injuries and incidents

  • Reporting Hazards

  • Understanding of safey working practices

  • undefined

Management Commitment, Accountability & Review

  • Level of Commitment, Accountability and Review

  • Managers have completed safety leadership training.

  • All Managers know their role to improve safety performance and lead the development of safety performance plans.

  • Roles & Responsibilities to improve safety performance documented

  • Management Safety Meeting Minutes

  • Safey Perfomance Plan(s)

  • How are Manager's roles defined and communicated?

  • Are safety performance plans developed?

  • Safety and accountability for safety is a frequent topic of discussion between managers and their employees

  • Safety Walk rounds

  • Safety Committee meeting minutes

  • Survey employees

  • How is Safety and Accountibility communicated between Managers and their Employees?

  • A system exists to address employee concerns about safety and safety issues are corrected if it is believed that an injury or incident is certain to occur if not addressed

  • Permasteelisa Hazard Alert system used and issues addressed

  • Reasons for not using Hazard Alert system

  • Management takes a hands-on proactive approach to health and safety leadership

  • Health and Safety is represented at high level management meetings

  • Does management at all levels clearly understand the safety management system, plans initiatives to improve safety performance and reinforce good performance?

  • 45001 Training and refresher

  • Safety Meeting Report / Minutes

  • Safety initiatives recorded and implemented

  • Managers conversations substantiated with evidence

  • How is the Safety Management System communicated to all Managers

  • How do managers plan initiatives, improve safety and reinforce performance

  • Does management actively support and promote safe working practices and processes and convincingly communicates that safety is manageable and good for business?

  • Safety Meeting minutes

  • Motivational talks with employees

  • Employee survey

  • How are safe working practices promoted and communicated?

  • Does management actively participate in safety meetings, training, audits, and incident and injury investigations?

  • undefined

  • undefined

  • Does management communicates safety expectations and ensures that all employees understand and “buy-into” safety goals and objectives.

  • undefined

  • undefined

  • Management uses the 12 essential elements as part of their safety improvement efforts.

  • Management Commitment

  • Safety Accountability and Responsibilities

  • Appointment of Key Safety Personnel

  • Coordination of Emergency Response Planning

  • SMS Documentation

  • Hazard Identification

  • Safety Risk Assessment and Mitigation

  • Safety Performance Monitoring and Measurement

  • Management of Change

  • Continuous Improvement of the SMS

  • Training and Education

  • Safety Communication

  • undefined

  • Management personally demonstrates their commitment to safety.

  • Steering Committee

  • Annual Safety Plan

  • Safety Tours

  • Hazard Alert Usage

  • undefined

  • Management demands high standards of performance from their organisation.

  • Performance Evaluations includes Health Safety Objectives

  • Monthly Health and Safety Review Meetings

  • undefined

  • Management allocates resources to continuously improve safety performance.

  • Objectives and Targets Plans

  • Health and Safety Budget

  • Planned Training Courses

  • undefined

  • Management at all levels lead by example, demonstrate their commitment to safety, emphasises the goal of zero injuries and incidents and supporting plans to reach this goal

  • Zero Injury / Incident Goal Signage / Clothing

  • Multi Year Safety Plan Objective

  • Involvement in Risk Assessment Process

  • Recorded motivation talks by Senior Management

  • Employee Survey Response

  • undefined

  • Safety is considered in all management decisions and given the same priority as cost, production, quality, and profitability

  • Equipment chosen for safety related features and not cost

  • Training courses that exceed normal requirements

  • Factory refurbishment includes safety budget

  • undefined

  • Management’s commitment to safety is sincere and felt by all employees

  • Multi-year Plan through Steering Committee

  • Employees Question Audit Response

  • undefined

  • Employees trust management and believe their commitment to safety is sincere

  • Employee Survey Response

  • undefined

Safety Management System Overview & Structure

  • Level of Safety Management System Overview and structure

  • Program elements of the HSMS exist and are documented.

  • Individual responsibility

  • The establishment and role of the health and safety committee or representative

  • Applicable health and safety legislation requirements, and organizational health and safety rules

  • Safe work procedures

  • Worker orientation

  • Training and education

  • Workplace inspections

  • Hazard identification, assessment, and control

  • Reporting and investigating incidents

  • Emergency planning

  • Medical and first aid

  • Health and safety promotion, including psychological health and prevention of harassment and violence

  • Review of the health and safety program

  • undefined

  • An approved improvement plan is documented

  • Health and Safety management Plan

  • undefined

  • There is a “Plan, Do, Check, Act” component to the safety program elements

  • Management Manual

  • Risk Assessments

  • Job Task Analysis

  • Safety Inspections

  • Safety Walks

  • Incident close out

  • Risk Reviews

  • undefined

  • There is an annual safety plan that is used to improve safety each year

  • Policy or goals statement (Management Leadership)(Objectives and Targets)

  • Worker Participation (Roles and Responsibilities)

  • Hazard Identification and Assessment

  • Hazard Prevention, Controls and Safe Practices

  • Incident mitigation improvement program

  • Employee Training Program and communication

  • Evaluation and Improvement (Lessons Learned)

  • Management of Employees and Contractors

  • undefined

  • The annual safety improvement plan exists and is managed on site

  • Objectives and Targets are Identified, Monitored and Communticated

  • Worker participation in behavioural inititatives

  • undefined

  • Role and Responsibilities identified

  • Hazard Alert (GiMS) utilised & promoted

  • Hazard control implementation

  • undefined

  • Line management plays the leadership role in managing the SMS

  • All elements of the HSMS exist and are used by operations and safety teams

  • Risk Evaluation Procedure

  • Incident Investigation Procedure

  • Risk Register

  • CoSHH Register

  • RAMS / Job Risk Analysis

  • Document Control

  • undefined

  • The Annual Safety Plan is communicated for all employees to read and participat

  • Annual Plan signed

  • Annual Safety is monitored by a steering committee

  • Steering Committee has Employee Safety Representatives

  • undefined

  • Regular reviews are held to ensure the organisation is on track to achieve the annual safety plan

  • Management Meeting Reviews

  • Steering Committee has regualr meeting e.g. monthly

  • Management System Review meeting minutes

  • undefined

  • Regular compliance audits are conducted for legal and company requirements

  • Annual Audit Planner

  • Group Audit

  • ISO Internal Audit planner

  • ISO External Audit

  • undefined

  • The organisation conducts annual evaluations of the effectiveness of the safety management system

  • Management Review Report

  • Management System Review meeting

  • undefined

  • The evaluation includes an analysis of the safety trends, progress of safety goals and objectives, document review, interviews with team members, supervisory and managers, and test and verify activities

  • Management Meeting Report

  • Interview Reports

  • HSMS Evaulation Audits

  • undefined

  • The program evaluation is documented including detailed findings, systemic gaps, opportunities for improvement, and corrective action plan

  • HSMS Evaulation Audit

  • undefined

  • The annual plan was developed from a multiyear plan

  • undefined

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.