1.1 Is a current, written Health and Safety Policy signed and dated by the owner? (0 or 2) Review the written health and safety policy. The policy must state: management’s commitment to health and safety (HS) overall and objectives general HS responsibilities of employees & contractors requirement to comply with relevant legislation & company HS standards D 1.2 Do employees know what the Workplace Health and Safety Policy states? (0 - 3) Interview employees and explain how employees are made of the policy. Score based on percentage of positive responses from interviews. I Notes: 1.3 Have specific health and safety responsibilities been written for: Manager(s)? (0 or 2) Review the written responsibilities documents (e.g. job descriptions, HS manual, contracts). Depending on the size or nature of the company, one or more of these categories may not be applicable. Indicate with n/a. Where the company has no workers, the owner will be considered the Manager. D Supervisor(s)? (0 or 2) D Worker(s)? (0 or 2) D Notes: Sub-contractor(s) (others)? (0 or 2) D Notes: 1.4 Are all of the following knowledgeable about their health and safety responsibilities? Manager(s)? (0 -2) I Notes:
3.1 Have controls (Engineering, Administrative and Personal Protective Equipment) been identified for health and safety hazards? (0 or 3) Review prioritized hazard assessment documents (2.1c), and compare with hazard controls. Points are awarded based on the percentage of hazards for which controls have been identified. D Notes: 3.2 Are Health and Safety Hazards controlled using the following methods? Engineering (0 - 3) Review documentation and observe the identified controls methods. Points are awarded for positive observations of implemented controls. O Notes: Administration (0 - 3) O Notes: Personal Protective Equipment (PPE) (0 - 3) O Notes: 3.3 Are employees controls developed for identified health and safety hazards? (0 - 3) Observe employees controls. Verify by interview. Compare/observe employee performance against hazard controls developed in 3.1 and 3.2. Assign points based on the percentage of controls used by employees. O Notes: 3.4 Does the owner ensure health and safety policies and control methods are followed? (0 or 3) Review documentation and interview workers. 90% positive response is required in interviews to award points. DI Notes: 3.5 Is a scheduled Preventative Maintenance program for equipment, machinery and vehicles in place? (0 or 3) Review documentation. D Notes:
3.6 Where personal protective equipment is required, are workers trained in use, care and maintenance of the protective equipment? (0 or 3) Review PPE policy and training records. (Where the company has no workers, describe how the owner is trained.) D Notes: 3.7 Has a plan been developed, in consultation with the contracting organization(s), for ensuring workplace health and safety? (0 - 6) Review the written plan. The plan must address: Identification of site specific hazards and controls Ongoing field-level hazard assessment Reporting of changes to work site conditions Review of emergency response plans Process for dealing with worker non-compliance On-site supervision of contract workers Points awarded based number of sub-points addressed. D Is the plan communicated to all employees? (0 or 2) Interview workers. All workers interviewed must be aware of the plan to score points. I Notes: PIR I AUDIT SCORE – Element 3 Audit element score possible 32 – Points not applicable (N/A) = Total points possible Points scored on this element / Total points possible = x 100 = %