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1.1 Does the company have a written health and safety policy? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
1.4 Have health and safety responsibilities been developed for each applicable level within the company? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
1.6 Is there a policy for addressing workforce non-compliance with safety requirements? Is the process being followed as outlined? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
1.7 Does the company encourage employees to maintain a healthy lifestyle? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
2.1 Does the company have a written Emergency Response Plan (ERP) specific to their operation to guide the emergency response actions in the case of an emergency? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
2.2 Does the ERP outline the steps to be taken in the event of an emergency? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
2.4 Has training been provided to the employees given specific responsibilities in the Emergency Response Plan? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
2.5 Have emergency response drills been conducted periodically to test the effectiveness of the ERP and to enhance employee awareness? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
3.1 Does the safety orientation include the necessary information and instruction to ensure health and safety at work? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
3.2 Are all newly hired, returning, and/or transferred workers, contractors provided with a safety orientation on/or before starting work? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
3.3 Has training been provided to employees at all levels with respect to their duties and responsibilities? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
3.4 Are required employee certifications maintained and do they meet legislative requirements? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
3.5 Is worker competency and knowledge of safe performance standards within their assigned tasks evaluated periodically? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.1 Is there a written policy or procedure outlining the requirements of formal hazard assessments? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.2 Have all company positions or disciplines been inventoried for formal hazard assessment purposes? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.3 Have the potential hazards and required risk controls associated with each job task been identified and documented? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.4 Have all the relevant identified hazards and risks been communicated to all affected workers? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.5 Are written safe work procedures and rules established based on the results of the risk assessment? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.6 Is there a process to create, review and revise formal hazard assessments as required? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.7 Is there a system in place that allows all levels to participate in the development, review, reporting or revision of the formal hazard assessments in their position? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.9 Does the company have a written program to control slip, trip, and fall injuries? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.10 Has an assessment been conducted to identify risks associated with musculoskeletal injuries (MSI) in the workplace? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.11 Does the company have a written program to control musculoskeletal injuries? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.12 Does the company have a written PPE Policy developed that is appropriate to the nature of the tasks performed? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.14 Does the company communicate and provide training on PPE that includes the care, use and maintenance of any required PPE? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.15 Does the employer ensure hazard controls are used by employees? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.16 Is there a preventative maintenance or pre-use program to ensure equipment and machinery are in safe condition? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.17 Is the preventative maintenance or pre-use program being implemented as outlined? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
4.18 Does the company have a written bullying and harassment prevention plan with policies, procedures and training? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
5.1 Does the company have a workplace inspection program? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
5.2 Are inspection checklists developed based on the operating risks of the company? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
5.3 Has inspection training been provided to employees with inspection duties and responsibilities? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
5.4 Are inspections being carried out according to the required frequency? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
5.5 Are identified deficiencies corrected according to established time frames and with regard to the risk level of the hazard? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
6.1 Does the company have a written incident investigation program outlining the process of reporting and investigation of incidents and near misses? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
6.2 Is there an investigation process or procedure which includes: * Choose One Not Applicable Nonconformity Partial Conformity Conformity
6.3 Has incident investigation training been provided to employees with incident investigation duties and responsibilities? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
6.4 Are investigations being carried out according to the established investigation program? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
6.5 Are recommendations generated from the investigation implemented according to established time frames and implemented with respect to the risk level of the hazards? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
7.1 Does the company have a written process to administer the health and safety management system and to evaluate its effectiveness? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
7.2 Are health and safety issues discussed regularly with all staff? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
7.3 Have incident statistics been maintained and analyzed to identify trends and improvement areas? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
7.4 Have corrective actions been identified based on the results of incident statistical analysis? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
7.5 Does the company have a process to review and update its health & safety program documents? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
8.1 Is an Corrective Action plan being developed to address deficiencies and continual improvement opportunities identified by the annual audit? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
8.2 Are corrective actions being followed up to ensure completion? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
8.3 Are corrective actions being reviewed and signed off by company owner / senior management? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
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9.1 As a prime contractor, are specific health and safety responsibilities written for other contractors and visitors? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
9.2 Have criteria been established for selecting, monitoring, and evaluating contractors? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
9.3 Is there a process to ensure site-specific orientations are completed for other employers/contractors and visitors? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
9.5 Does the company include contractors in ongoing safety management by ensuring that they are consistently aware of changes in applicable procedures, hazards and/or other safety initiatives? * Choose One Not Applicable Nonconformity Partial Conformity Conformity
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