Senior Management Safety Culture Survey - Generic

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

Introductory Section

• What is the title of your role with this organisation?<br>

  Yes

  No

  N/A

• How long have you worked for the organisation?

  Yes

  No

  N/A

• Identify any specific aspects of this individual's position in the organisation

  Yes

  No

  N/A

• What do you see to be your individual role in safety at this organisation?

  Yes

  No

  N/A

Commentary

• General Comments

  Yes

  No

  N/A

• Upon your commencement at the organisation what instructions, training or induction were you given specifically relating to the safety management at this organisation?

  Yes

  No

  N/A

• Can you tell me how many times if any in that period of time have you received formal instructions in relation to safety management in general or safety management as a Senior Manager?

  Yes

  No

  N/A

• Have you had cause to discuss with any of your staff the specifics in relation to the online induction program or for that matter any safety related program other than to direct them to complete the induction training program?

  Yes

  No

  N/A

• Have you ever had a discussion with your fellow general managers or the Chief Executive regarding the resources and the costs associated with the safety aspects of this organisation?

  Yes

  No

  N/A

• Are you in a position to share any of those discussions?

  Yes

  No

  N/A

• Do you ever have cause to question an initiative by a fellow Executive or the CEO based on safety reasons?

  Yes

  No

  N/A

• When was the last time you as a senior manager undertook a safety specific task other than when reminded to by either the safety manager or an upcoming safety systems audit?

  Yes

  No

  N/A

Commentary

• General Comments

  Yes

  No

  N/A

• Do you know the cost anticipated for the Worker's Compensation Insurance premium for the next 12 months?

  Yes

  No

  N/A

• Are you aware of any of your staff members receiving either a work-related injury or illness? Discuss

  Yes

  No

  N/A

• Do you believe you have any role with respect to your staff member's injuries?

  Yes

  No

  N/A

• if so can you give me the circumstances about the injury or illness and what you subsequent we did as the manager of an employee?

  Yes

  No

  N/A

• Do you know if the organisation has a well documented Safety Management System? If so what do you know about it?

  Yes

  No

  N/A

• What do you believe to be the reason for having an SMS?

  Yes

  No

  N/A

• Tell me what you understand the SMS contains. Nominate which policies it contains?<br>OHS Policy<br>Drug and Alcohol<br>Consultation<br>RTW & Injury Management<br>

  Yes

  No

  N/A

• Have you ever had cause to look up anything in the SMS? Discuss circumstances.

  Yes

  No

  N/A

• Do you know of any situations where safety was managed very well? And what were the circumstances?

  Yes

  No

  N/A

• Do you know of any situation where safety could have been managed better? And what were the circumstances?

  Yes

  No

  N/A

• What do you think of safety this organisation?

  Safe

  At Risk

  N/A

• With finances so tight at the moment do you think you spend too much on safety?

  Yes

  No

  N/A

• Do you have any suggestions regarding this question that the organisation is either over resourced or under resourced or just the right amount of resource?

  Yes

  No

  N/A

• Do you have regular staff meetings with your team?

  Yes

  No

  N/A

• Do you compile an agenda for these meetings?

  Yes

  No

  N/A

• Is safety a standard agenda item?

  Yes

  No

  N/A

• If not is safety discussed at all? Details...

  Yes

  No

  N/A

• Have you received information regarding safety that you may pass on to the members of your team on a regular basis? Discuss

  Yes

  No

  N/A

• Do you have any suggestions on how the organisation could address some of the safety related matters discussed today or do you think the you could contribute further in the areas of safety improvement?

  Yes

  No

  N/A

• General commentary and discussion regarding safety

  Yes

  No

  N/A

• Overall, what do you believe the level of the organisation's safety performance in relation to employee safety management to be?

  Excellent

  Good

  Fair

  Poor

  Don't Know

• Overall, what do you believe the level of organisation's safety performance in relation to employee injury prevention and management to be?

  Excellent

  Good

  Fair

  Poor

  Don't Know

• I will now explore some specifics according to your role

• Interviewee's Signature

  Sign

• Interviewer's Signature

  Sign

• Witness Signature

  Sign