SDX Monthly Unit Safety Support Review

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Incident/Accident Review

• Incidents called in YTD

• Accidents YTD

• EIF target being met?

  Yes

  No

  N/A

• EIF compared to LYTD

• SIF target being met?

  Yes

  No

  N/A

• SIF compared to LYTD

• Per claim charge YTD

• Claims costs incurred YTD

• Most frequent injury type YTD

Documentation Reviewed

• Was the documentation reviewed and how many/ which months were reviewed.

• Monthly safety inspection

  Yes

  No

  N/A

• Monthly safety committee meeting minutes

  Yes

  No

  N/A

• Monthly safety training

  Yes

  No

  N/A

Training; Resources; Recommendations

• Training programs sent to unit or offered to be taught live?

  Yes

  No

  N/A

• Additional resources recommended?

  Yes

  No

  N/A

• Recommendations to be completed prior to next unit visit.