Title Page
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Site conducted
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Conducted on
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Surveyor
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Associate Surveyed
Audit and Survey
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Did you receive orientation prior to beginning your work at Highline?
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Did you receive additional training for increase of risk jobs such as lockout/tagout, H2S training, etc.?
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Do you feel you have received the necessary training required to complete your job duties?
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Have you been trained what to do if you are involved in or witness an incident in the workplace?
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What do you do if there is an incident? - Please give a brief explanation.
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Have you been trained on what to do in the event of an emergency such as a fire, gas leak, tornado or a weapon in the workplace?
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What should you do in these situations? - Please give a brief explanation
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Have you bee trained in the specific duties of the JHSC?
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Where do you go if you need more information about Safety and Wellness in the workplace?
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Is there a safety board available that you can find things like information on workers rights, JHSC meetings and members, emergency contact info?
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Have you been provided with PPE to protect you while you work at Highline?
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Have you received training on PPE maintenance and upkeep?
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How do you report a near miss or hazard?
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If you are being bullied, harassed or threatened; is there a way for you to report the issue?
Comments and Suggestions
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Do you have any suggestions on how Highline could continue to grow its Safety culture?
Sign Off
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Associate Signature
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Surveyor Signature