Refraline Group of Companies

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Scope of Audit

Opening meeting

List attendees and their roles.

• Complete attendance register

• Objectives of the audit. -Not to reject the system -re-currence may point to system failure - cant cover all aspects. -where no non-conformance detected does not mean non exist sample of activities.

• Review of audit programme:

• Company representative

• Names

• Function of company representative:

• Time of closing meeting:

• Confidentiality

• Reasons for aborting audit:

• Invite questions

• Comments

Overview of organisation

• Comments

Results of previous audits:

• Comments

4.5.1 Performance measurement and monitoring

• Progressive statistical data: <br> Injury/occupational illness/diseases statistics for current and previous 12 months<br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Damage statistics for current and previous 12 months<br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Environmental incidents for current and previous 12 months <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Non conformance statistics for current and previous 12 months <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Annual consolidation of progressive year's statistics for comparative purposes <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Statistics consolidated and available in graphic format <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Analysis of statistics <br> <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Statistics categorised and analysed to identify trends <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Medical trends for non occupational illness/diseases evaluated to identify possible <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• underlying work/hobby health hazard exposure sources <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• At least an annual report to top management on incident statistic analysis (covers identified risks, increasing/decreasing trends) <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Occupational health variances to form part of statistical data and used for remedial action <br> <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Statistics published and circulated <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Statistical tabled for discussions at SHE committee meetings <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

4.5.1 Performance measurement and monitoring

• Monitor the SHE performance of employees and the effectiveness of risk control measures <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

4.5.1 Planned job observation

• Supervisors in possession of up to date JSA/WSWP's <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Supervisors trained in the correct method and purpose of task observations <br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Deviation trends analysed and associated system weakness identified and corrected<br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

5.6.1 Management Review - General

• Does top management review the organization's quality management system, at planned intervals, to ensure its continuing suitability, adequacy and effectiveness?<br>

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Does this review include assessing opportunities for improvement and the need for changes to the quality management system?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Does this review include assessing opportunities for improvement and the need for changes to the quality policy and quality objectives?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Have records from management reviews been maintained (see 4.2.4)

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Comments:

Review input:

• Does the input to management review include information on results of audits

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• customer feedback?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• process performance and product conformity?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• status of preventive and corrective actions?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• follow-up actions from previous management reviews?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• changes that could affect the quality management system?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• recommendations for improvement?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Comments:

5.6.3 Review Output

• Does the output from the management review include any decisions and actions related to improvement of the effectiveness of the quality management system and its processes

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• improvement of product related to customer requirements

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• resource needs?

  Yes

  No

  N/A

• 4 - fully implemented and apply 3 - implemented partly elective 2 - implemented / partly implemented -not satisfactory 1 - no evidence of effective application (even if implemented) 0 - not addressed at all

• Comments:

Closing meeting

• Attendance register

• Signing

  Sign

• Feedback on deviations and findings

• Invite questions

Sign off

• Auditor's signature

  Sign

• Site representative and management signature

  Sign

• Date and time

  Date