SAFE Work Manitoba

SAFE Work Manitoba Audit Tool

• This audit tool is designed to assist workplaces in measuring their safety and health program against Manitoba minimum standards. By completing this audit tool it shall not be construed as meaning or implying that your organization is in compliance with its legislative or regulatory requirements.
  
  Additional support or consulting assistance can be reached at (204) 957-SAFE (957-7233) or toll free at 1-866-929-SAFE (1-866-929-7233)

• Click button below to link directly to the Manitoba Workplace Safety & Health Act and Regulations
  http:/www.safemanitoba.com/wsh-regulations

Audit Details

• Audit Title / Company Name

• Document No.

• Conducted on

  Date

• Prepared by

• Personnel present

Part 1 - Jurisdiction

• Workplace falls under ____________ jurisdiction

  Provincial

  Federal

Part 2 - Safety Policy

• Is a current safety policy available, signed, and dated by top management?

  Yes

  No

  N/A

• Enter the date that the safety policy is signed

  Date

• Is the company safety policy posted in a visible location?

  Yes

  No

  N/A

Part 3 - Workplace Joint Safety & Health Committee (JSHC)

• Dedicated Safety & Health bulletin board?

  Yes

  No

  N/A

• Are the meeting minutes posted and current?

  Yes

  No

  N/A

• Does the JSHC meet at least quarterly with proper quorum (worker reps > or = mgmt reps)?

  Yes

  No

  N/A

Part 4 - General Workplace Requirements

• Adequate air quality?

  Safe

  At Risk

  N/A

• Slipping or tripping hazards?

  Safe

  At Risk

  N/A

• Drinking water available for workers?

  Yes

  No

  N/A

• Toilet facilities adequate and sanitary?

  Yes

  No

  N/A

• Thermal condition adequate for the work being conducted?

  Safe

  At Risk

  N/A

• Adequate lighting for the work being conducted?

  Yes

  No

  N/A

• Overall housekeeping impression (0=Poor and 100=Excellent)

Part 5 - First Aid Requirements

• Appropiate number of first aiders per shift?

  YES

  NO

• Reference first aider requirements?

  Show

• Reference - Part V

  

• First aid kits/supplies readily available?

  Yes

  No

  N/A

• How well stocked are the first aid kits? (0=empty and 100=fully stocked)

• Reference requirement for first aid kit contents?

  Show

• A first aid kit must contain the following items:
  (a) general:
  (i) a recent edition of a first aid manual,
  (ii) a pair of impervious disposable gloves,
  (iii) a disposable resuscitation mask with a one-way valve,
  (iv) a disposable cold compress,
  (v) 12 safety pins,
  (vi) splinter forceps,
  (vii) one pair of 12 cm bandage scissors,
  (viii) 25 antiseptic swabs,
  (ix) waterless hand cleaner,
  (x) waterproof waste bag;
  
  (b) dressings - each of the following items must be sterile and individually
  wrapped in order to maintain sterility:
  (i) 16 surgical gauze pads (7.5 cm squares),
  (ii) 4 pads (7.5 cm X 10 cm, non-adhesive),
  (iii) 32 adhesive dressings (2.5 cm wide),
  (iv) 2 large pressure dressings,
  
  (c) bandages:
  (i) 3 triangular bandages (1 m each),
  (ii) 2 conforming bandages (10 cm each),
  (iii) 2 rolls of 2.5 cm adhesive tape,
  (iv) 1 roll of 7.5 cm elastic adhesive bandage,
  (v) 2 rolls of 7.5 cm tensor bandage.

Part 6 - Personal Protective Equipment

• Are PPE requirements idenfitied and equipment readily available?

  Yes

  No

  N/A

• Check all that apply

  Select Head Protection Foot Protection Eye / Face Protection Hearing Protection Hand Protection Respiratory Protection High-Visibility Clothing Other

  • Head Protection
  • Foot Protection
  • Eye / Face Protection
  • Hearing Protection
  • Hand Protection
  • Respiratory Protection
  • High-Visibility Clothing
  • Other

• Are workers observed to be wearing their PPE?

  Yes

  No

  N/A

Part 7 - Storage of Materials and Equipment

• Is storage and/or racking systems used in the workplace?

  YES

  N / A

• Are materials stored in a condition of safe loading?

  Safe

  At Risk

  N/A

• Do racking systems meet design requirements?

  Yes

  No

  N/A

• Are racking systems protected from power mobile equipment?

  Yes

  No

  N/A

Part 8 - Musculoskeletal Injuries (MSI's)

• Which MSI risk factors are present in the workplace? (select all that apply)

  Select Repetitive Motion Forceful Exertion Sustained/Awkward Posture Vibration Mechanical Compression

  • Repetitive Motion
  • Forceful Exertion
  • Sustained/Awkward Posture
  • Vibration
  • Mechanical Compression

• Area(s) with MSI risk

• Pictures of MSI Risk

  Media

• Have control measures been implemented to control MSI's

  Yes

  No

  N/A

Part 9 - Working Alone

• Do any workers work alone or in isolation?

  YES

  N / A

• Has a working alone SAFE work procedure been developed?

  YES

  NO

• Is the working alone policy/procedure posted

  YES

  NO

• How have workers been made aware or trained on the working alone policy?

Part 10 - Harassment

• Has a harassment prevention policy been developed?

  YES

  NO

• Is the harassment prevention policy posted?

  YES

  NO

• Date of policy

  Date

Part 11 - Violence in the Workplace

• Has a violence prevention policy been developed?

  YES

  NO

• Is the violence prevention policy posted

  YES

  NO

• Date of policy

  Date

Part 12 - Hearing Conservation and Noise Control

• Are workers exposed to noise in excess of 80dba in the workplace?

  YES

  N / A

• Has a noise survey been conducted in the last 12 months?

  Yes

  No

  N/A

• Is hearing protection available for workers?

  YES

  NO

Part 13 - Egress, Stairs, and Ladders

• Is there safe access and egress to all work areas?

  Safe

  At Risk

  N/A

• Are emergency exits clearly marked and accessible?

  Yes

  No

  N/A

• Are ladders present in the workplace?

  YES

  N / A

• Are ladders appropiate to the workplace and in good shape?

  Yes

  No

  N/A

Part 14 - Fall Protection

• Are employees working at heights of 3 meters or more?

  YES

  N / A

• Is fall protection in place for work at heights at or greater than 3 meters?

  Yes

  No

  N/A

• Are SAFE work procedures developed to prevent falls at the workplace?

  Yes

  No

  N/A

• Is fall protection equipment stored appropriately and in good shape?

  Yes

  No

  N/A

• Are workers trained in fall protection requirements and SAFE work procedures?

  Yes

  No

  N/A

Part 15 - Confined Spaces

• Are there confined spaces in the workplace?

  YES

  N / A

• SAFE Work procedures developed for work in confined spaces?

  YES

  NO

• Workers trained in confined space SAFE Work procedures?

  YES

  NO

• Is appropriate equipment in place for confined space situations?

  YES

  NO

• Has an emergency response plan been developed for confined space situations?

  YES

  NO

Part 16 - Machines, Tools, & Robots

• Are machines or tools used in the workplace?

  YES

  N / A

• Are safegaurds in place for all machines, tools, or robots where required?

  Safe

  At Risk

  N/A

• Are operating controls appropiately located, protected, and identifiable?

  Yes

  No

  N/A

• Are lock out procedures and equipment available where required?

  Yes

  No

  N/A

• Are machines, tools, robots inspected as per manufacturers recommendations?

  Yes

  No

  N/A

Part 17 - Welding and Allied Processes

• Are welding activities performed in the workplace?

  YES

  N / A

• Are SAFE work procedures developed for welding or hot work?

  Yes

  No

  N/A

• Is a hot work permit system implemented?

  Yes

  No

  N/A

• Are flashback arrestors on all gas welding units?

  Yes

  No

  N/A

Part 18 - Radiation

• Are workers exposed to radiation in the workplace?

  YES

  N / A

• Are SAFE work procedures in place for using radiation?

  Yes

  No

  N/A

• Are workers trained and aware of hazards assocaited with radiation exposure?

  Yes

  No

  N/A

Part 19 - Fire and Explosive Hazards

• Appropiate number and type of fire extinguishers present in the workplace?

  Yes

  No

  N/A

• Are fire extinguishers charged, wall mounted, and accessible?

  Yes

  No

  N/A

• Containment in place for flammible, combustable, or contaminated materials?

  Yes

  No

  N/A

• Is there flammible or combustable material in the atmosphere?

  Safe

  At Risk

  N/A

Part 21 - Emergency Washing Facilities

• Is appropiate emegency eye wash/shower equipment in place?

  Yes

  No

  N/A

• Is the emergency equipment accessible, clean, and operational?

  Yes

  No

  N/A

• Are workers trained in the use of emergency washing equipment?

  Yes

  No

  N/A

Part 22 - Powered Mobilie Equipment (PME)

• Is powered mobile equipment (PME) present in the workplace?

  YES

  N / A

• Are PME operators certified

  Yes

  No

  N/A

• Are operators completing pre-shift inspections?

  YES

  NO

• Is all PME equipped with audible warning devices, fire extinguisher, and braking systems?

  Yes

  No

  N/A

• Are all seatbelts and seats operational and in good repair?

  Yes

  No

  N/A

• Is PME being operated in safe manner and used as intended by the manufacturer?

  Yes

  No

  N/A

• Are all PME units annually maintained and have visible load capacity plates

  Yes

  No

  N/A

Part 20 - Vehicular and Pedestrial Traffic

• Is walkway protection required?

  Safe

  At Risk

  N/A

• Are pedestrian and powered mobile equipment lanes marked?

  Yes

  No

  N/A

Part 23 - Cranes and Hoists

• Are cranes or hoists used in the workplace?

  YES

  N / A

• Are crane operators certifed and properly trained?

  Yes

  No

  N/A

• Is a maintenance or annual inspection schedule readily available for all cranes?

  Yes

  No

  N/A

• Is the log book (inspection sheet) available and up to date for cranes 1 tonne or more?

  Yes

  No

  N/A

• Are cranes operated in safe manner(side loading, suspended loads, etc…)

  Safe

  At Risk

  N/A

Part 24 - Pile Driving

• Are there pile driving activities in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for pile driving equipment?

  Yes

  No

  N/A

Part 25 - Overhead Electrical Lines

• Is work conducted near overhead electrical lines?

  YES

  N / A

• Are there SAFE Work procedures for working near overhead electrical lines?

  Yes

  No

  N/A

• Is an emergency plan in place in the event of contact with electrical lines?

  Yes

  No

  N/A

Part 26 - Excavations and Tunnels

• Are excavation and/or tunnels dug in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for excavation work?

  Yes

  No

  N/A

• Are support structures and/or shoring adequate?

  Safe

  At Risk

  N/A

Part 27 - Compressed Air Enviroment

• Are workers exposed to a compressed air environment?

  YES

  N / A

• Are there SAFE Work procedures for working in a compressed air enviroment?

  Yes

  No

  N/A

Part 28 - Scaffolds / Elevated Work Platforms

• Are workers on scaffolds or elevated platforms?

  YES

  N / A

• Are there SAFE Work procedures for using scaffolds or work platforms?

  Yes

  No

  N/A

Part 29 - Falsework and Flyforms

• Are falsework or flyform systems used in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for falsework or flyform systems?

  Yes

  No

  N/A

Part 30 - Temporary Structures

• Are temporary structures assembled in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for constructing or using temp structures?

  YES

  NO

• Appropiate flooring, gaurding, stairways and landings?

  YES

  NO

Part 31 - Roof Work

• Is roof work done in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for roof work?

  Yes

  No

  N/A

• Are workers using appropiate fall protection?

  Safe

  At Risk

  N/A

Part 32 - Precast Concrete

• Is pre-cast concrete used in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for precast concrete work?

  Yes

  No

  N/A

Part 33 - Demolition Work

• Does demolition work take place in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for demolition work?

  Yes

  No

  N/A

Part 34 - Explosives

• Are explosives used in the workplace?

  YES

  N / A

• Are there SAFE Work procedures for the use of explosives?

  Yes

  No

  N/A

• Are the blasters certified?

  Yes

  No

  N/A

Part 35- Workplace Hazardous Materials Information System (WHMIS)

• Are controlled chemicals or biological hazards present in the workplace?

  YES

  N / A

• Is a chemical inventory or matrix available?

  Yes

  No

  N/A

• Is there a WHMIS training program in place?

  Yes

  No

  N/A

• Are all controlled substances labelled properly?

  Yes

  No

  N/A

• Are MSDS sheets available for all controlled substances and current to 3 years?

  Yes

  No

  N/A

Part 36 - Chemical & Biological Hazards

• Are there SAFE Work procedures for chemical or biological hazards?

  Yes

  No

  N/A

• Is monitoring occuring to ensure workers are not exposed to airborn hazards?

  Safe

  At Risk

  N/A

Part 37 - Asbestos

• Is asbestos present in the workplace?

  YES

  N / A

• Is an inventory of asbestos containing materials available?

  Yes

  No

  N/A

• Are there SAFE Work procedures for abatement or an asbestos control plan in place?

  Yes

  No

  N/A

Part 38 - Electrical Safety

• Is electrical work performed in the workplace?

  YES

  N / A

• Is a lockout policy or procedure in place for electircal work?

  Yes

  No

  N/A

• Is an inventory of lockout stations available?

  Yes

  No

  N/A

• Are electrical systems installed and protected as required?

  Safe

  At Risk

  N/A

Part 39 - Health Care Facilities

• Is the workplace a healthcare facility?

  YES

  N / A

• Are there SAFE Work procedures for infectious materials?

  Yes

  No

  N/A

• Are there SAFE Work procedures for patient handling?

  Yes

  No

  N/A

• Are there SAFE Work procedures for waste and laundry?

  Yes

  No

  N/A

Part 40 - Forestry and Arboriculture

• Is the workplace involved in forestry operations?

  YES

  N / A

• Are there SAFE Work procedures for forestry operations?

  Yes

  No

  N/A

• Are haul roads constructed according to requirements?

  Safe

  At Risk

  N/A

Part 41 - Oil and Gas

• Does the workplace have wells that are drilled, operated, or served?

  YES

  N / A

• Are there SAFE Work procedures for drilling, operating, or servicing wells?

  Yes

  No

  N/A

• Is the log book for the rig available and recently inspected?

  Yes

  No

  N/A

Part 42 - Firefighters

• Does the workplace employ firefighters?

  YES

  N / A

• Are there SAFE Work procedures for responding to an emergency?

  Yes

  No

  N/A

• Is equipment inspected?

  Yes

  No

  N/A

Part 43 - Diving Operations

• Are diving operations occurring in the workplace?

  YES

  N / A

• Are there SAFE Work procedures diving operations?

  Yes

  No

  N/A

Auditor Info

• Enter name

• Signature

  Sign

• Select date

  Date