Information
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Contractor
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Work Area
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Date and Time
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Survey completed by
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Superintendent
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Foreman
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Crew size in work area
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Number of workers on site
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Contractor's Safety Representitive
Administrative:
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Is their JHA covering the scope of work being preformed?
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Was a PTP filled out for scope of work and did it cover the hazards of their work?
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Are there any additional hazards found not noted on the PTP/JHA?
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Is employee knowledge of GHS and hazards noted on the SDS of products being used?
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Was an equipment inspection preformed by the operator before using the equipment?
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Does the operator have proof that he has been trained to operate the equipment?
Conditions
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Are tools being used in a proper and safe manner?
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Are safe work practices in material handling being used?
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For the work being preformed is the correct PPE being used?
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Are there less than two employees working together in any one area or task?
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What training has employee received from his employer before performing this task or scope of work?
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Are any conditions present found to be in violation of the OSHA 1926 standards?
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How long have you been on this site?
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How long have you been in the construction industry?
Employee's perception of their role in safety and their perception of management
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What would be the most likely cause or condition for something to go wrong within your task today?
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In this mornings Daily Huddle what hazard did you become most aware of?
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Did you do your stretch and flex this morning or after lunch?
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Did the meeting wake you up for the day?
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Have you ever identified something that was not on the PTP/JHA or that was missed by the crew?
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Has anyone given you praise for working safely?
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Do you feel that you have the correct PPE and tools for the task or job you are performing?
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If you saw a hazard in the work place would you do something?
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Is near miss reporting encouraged within your company?
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Have you ever reported a near miss?
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Does reporting an accident/incident cause you to worry about what your employer would do or say to you?
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If you were involved in an incident would you feel like you could lose your job?
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What would you like tho see more of that would help you do your job?
Foreman's perception of their role in safety and providing a work area free of recognized hazards
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Have you ever made a safety suggestion to your management or site management?
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Have you ever reported a near miss?
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What safety conversation did you have with your crew today?
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What risks do other trades pose to your employees in the area?
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When hazards are identified do you feel that BARC or your company's management will address the hazard noted?
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Who many times has your crew been stopped today/this week for this safety survey?
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How many subcontractors do you have working under you?
Additional Comments
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Additional comments:
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Signature of foreman, superintendent, or crew leader
