Title Page

  • Site conducted

  • Conducted on

  • Surveyor

  • Associate Surveyed

Audit and Survey

  • Did you receive orientation prior to beginning your work at Highline?

  • Did you receive additional training for increase of risk jobs such as lockout/tagout, H2S training, etc.?

  • Do you feel you have received the necessary training required to complete your job duties?

  • Have you been trained what to do if you are involved in or witness an incident in the workplace?

  • What do you do if there is an incident? - Please give a brief explanation.

  • 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?

  • What should you do in these situations? - Please give a brief explanation

  • Have you bee trained in the specific duties of the JHSC?

  • Where do you go if you need more information about Safety and Wellness in the workplace?

  • Is there a safety board available that you can find things like information on workers rights, JHSC meetings and members, emergency contact info?

  • Have you been provided with PPE to protect you while you work at Highline?

  • Have you received training on PPE maintenance and upkeep?

  • How do you report a near miss or hazard?

  • If you are being bullied, harassed or threatened; is there a way for you to report the issue?

Comments and Suggestions

  • Do you have any suggestions on how Highline could continue to grow its Safety culture?

Sign Off

  • Associate Signature

  • Surveyor Signature

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