Information
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Purpose
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Department
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Employee Name:
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Company:
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Employee Position:
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Conducted on
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Evaluation Conducted By:
EMPLOYEE REVIEW
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Does the employee operate a spud unit as part of their regular duties?
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Is the person performing this evaluation an experienced spud unit operator?
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Name and signature of qualified spud unit operator performing evaluation. (if other than evaluator)
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PHYSICAL OBSERVATION. Can the employee effectively describe the required PPE for spud unit operation?
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PHYSICAL OBSERVATION. Can the employee effectively demonstrate proper spud unit inspection?
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PHYSICAL OBSERVATION REQUIRED. Can the employee effectively demonstrate proper unit startup?
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PHYSICAL OBSERVATION REQUIRED. Does the employee operate the spud unit smoothly?
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VERBAL QUIZ, Is the employee aware of the major hazards associated with spud unit operation (ex. backlash, striking underwater lines, improper spud pin insertion, etc.)
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STOP EVALUATION - Re-start the evaluation once you obtain the assistance of an experienced certified rigger.
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Does the employee perform rigging as part of his/her regular duties?
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Is the person performing this evaluation a certified and experienced rigger?
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Name and signature of certified and qualified rigger (if other than evaluator)
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Has the employee attended and passed an approved rigger training class?
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PHYSICAL OBSERVATION. Can the employee effectively describe the required PPE for rigging?
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PHYSICAL OBSERVATION. Can the employee effectively demonstrate proper rigging inspection?
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PHYSICAL OBSERVATION REQUIRED. Can the employee effectively demonstrate proper rigging techniques?
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PHYSICAL OBSERVATION REQUIRED. Can the employee effectively demonstrate proper hand signals?
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VERBAL QUIZ. Can the employee identify rigging by name?
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STOP EVALUATION - Re-start the evaluation once you obtain the assistance of an experienced certified rigger.
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Does the employee perform deck hand duties as part of his/her regular duties?
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Is the evaluator experienced in deck hand duties and responsibilities?
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STOP EVALUATION, only resume once assistance is obtained from an experienced and qualified deck or a person of greater qualifications.
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Name and signature of experienced deck hand consulted (if other than evaluator)
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PHYSICAL EVALUATION, Can employee effectively describe the minimum PPE required for deck hands?
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PHYSICAL EVALUATION, Can employee effectively demonstrate deck rigging inspection?
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PHYSICAL EVALUATION, Can employee effectively demonstrate proper body positioning while handling rigging?
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PHYSICAL EVALUATION, Can employee effectively demonstrate proper line handling?
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PHYSICAL EVALUATION, Can employee effectively demonstrate required knots and vessel securing?
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Has employee completed the new hire orientation and all required training mandated by the position held?
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Employee must complete all training prior to graduation.
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Is the employee familiar with the company Stop Work Authority policy and process?
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Employee must be re-educated on the process before completion of the review.
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Is the employee familiar with the Behavior Based Safety Process?
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Can they demonstrate the correct completion of an observation or have cards previously completed by the employee been determined to be complete and correct?
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Employee must be re-educated on the process before completion of the review.
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Employee must be re-educated on the process before completion of the review.
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Is the employee familiar with the JSEA Process?
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Can they demonstrate the correct completion of a JSEA or has a previous JSEA completed by the employee been determined to be complete and correct?
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Employee must be re-educated on the process before completion of the review.
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Employee must be re-educated on the process before completion of the review.
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Regardless of the results of the above questions, is there any reason that the evaluator feels that he employee should remain in the SSE program?
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Please state your reason here:
HSE REVIEW
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Was the employee involved in any accidents during the SSE period?
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Was the employee determined to be in violation of company or customer policies or procedures resulting in the accident?
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STOP REVIEW: Employee must remain in SSE status for 90 days before review may be completed. Have employee sign the review and explain that he or she must remain accident and violation free during the 90 day period to be re-considered for SSE graduation.
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Has employee received any warning citations resulting from HSE policy violations?
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Has the employee demonstrated his/her ability to adjust properly to corrective action?
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Stop review and consult with employee's supervisor.
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Consult with the employee's supervisor. Did the employees supervisor provide any reason why he felt that the employee should remain in the SSE program?
CLOSING
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Is employee cleared for SSE graduation?
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Final comments:
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Evaluator signature:
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Employee signature: