Health and Safety Program Verification Possible Score Technique Employed Points Awarded D O I 5.0 Company 5.1 Are the rules clearly stated in writing? 2 5.2 Are the rules prominently posted or provided to each worker? 1 OR 5.3 Do workers understand company and site specific rules? 2 5.4 Does the program address non-conformance and progressive disciplinary actions? 2 5.5 Are the rules applied / enforced consistently with all personnel? 2 AND Total Points Possible 9 Total Points Awarded Auditor’s Comments
Health and Safety Program Verification Possible Score Technique Employed Points Awarded D O I SS2 Harassment Policy SS2.1 Is a written policy, signed and dated by current senior management? 2 SS2.2 Are employees aware of the policy objectives? 2 SS2.3 Is the policy posted on all worksites? 2 OR SS2.4 Does the policy and procedure conform to government standards? 2 Points Possible 8 Total Points Awarded Auditor’s Comments Comments are mandatory for all deficient Label comments with the appropriate reference number SS3.1 The auditor must confirm that an OH Committee has been established or a Representative appointed as required. SS3.2 The of committee members must be posted, usually on the report form. The auditor must confirm that workers and management are represented in appropriate numbers. SS3.3 Committee reports must confirm that meetings are held at the required minimum frequency. SS3.4 Committee Co-chairs or the Representative must have received training in relation to their responsibilities as committee members or the Representative. This training is typically provided by OH&S in Saskatchewan and is referred to as Level 1 and Level 2 Committee Training. SS3.5 Committee reports must be posted. SS3.6 Committee reports should indicate the recommendations that are made and if the appropriate action has been taken. If the company chooses not to act as requested then written and reasonable justification must be provided. SS3.7 to current legislation.
Evaluation Summary Company Auditor Date Section Number Section Title Possible Points Actual Points Minimum Standard Auditor Comments 1 Health and Safety Policy 27 14 2 Hazard Assessment, Analysis and Control 42 21 3 Safe Work Practices 17 9 4 Safe Job Procedures 15 8 5 Company 9 5 6 Personal Protective Equipment (PPE) 21 11 7 Preventative Maintenance Program 12 6 8 Training and Communication 42 21 9 Inspections 30 15 10 Investigations and Reporting 30 15 11 Emergency Preparedness 27 14 12 Statistics and Records 18 9 13 Legislation 12 6 Total 302 Minimum standard = 80% overall and 50% minimum in each of sections 1 through 13. SCSA Supplemental Section Actual Points X 100 = Possible Points Standard Achieved % Yes No Section # Section Name Possible Points Actual Points Standard Achieved SS1 Physical Conditions 18 Yes No SS2 Harassment Policy 8 Auditor Signature SS3 Committees / Representative 12 Auditor Comments Senior Company Officer Name SS1 Senior Company Officer Signature SS2
Auditor Executive Summary Audit Interviews 1 The interview sample size is based on the number of workers associated with the auditee at the time of the audit. Include workers and supervisors in service to other employers under contract to the auditee at the time of the audit. Use the chart below as a guide to determine the minimum number of workers and supervisors to interview. Total number of workers Worker Interviews Required Management Interviews Required Total Interviews Required Approximate % of Workforce 200+ 75% of 25% of total 10% of workforce 10% 100 – 199 15 5 20 20% 50 – 99 9 3 12 25% 25-49 6 2 8 35% 10 to 24 3 2 5 50% 1 to 9 All All All 100% 2 Select interview candidates with the intent to sample a broad range of worker and supervisor experience. Employee rosters can be useful in selecting candidates. Auditors may wish to select some candidates based on worksite observations or entries and references found in safety program documentation.
Question Manager and Supervisor Interview Questions Interview Response No. Reference # Negative Positive 15 5.2 How are the communicated to your workers? 16 5.5 What is the procedure for non-compliance? 17 6.2 How do you inform your workers of the requirements for using PPE? 18 6.3 How do your workers get access to basic PPE? 19 6.4 When your workers need specialized PPE where do they get it? 20 6.7 What type of training or instruction do you give your workers to help them understand the proper use, care, maintenance and limitations of PPE? 21 6.8 What guidelines are used to select PPE? 22 7.2 What are some of the maintenance activities that you carry out specifically to meet manufacturers’ recommendations or the requirements of legislation? 23 7.6 What is the procedure for handling defective equipment on this site such as hand tools, equipment or machinery? 24 7.7 Explain how the individuals that perform maintenance are competent to do that type of work. 25 8.2 Is orientation to all site personnel including clerical, supervisory staff and sub- contractors? 26 8.5 How do you confirm that mandatory training requirements have been completed? 27 8.7 Give some examples of job specific training this company provides and documents. 28 8.9 What formal training have you received to help you lead the company safety program? Notes:
Interview Summary Sheets Worker Interviews Management/Supervisor Interviews Result Reference # Negative Positive Question # Negative Positive Question # 1.6 1 1.7 2 1 1.9 3 2 2.1 4 3 2.2 5 4 2.3 6 5 2.9 7 6 2.11 8 7 3.3 9 3.4 10 8 3.5 11 9 3.6 12 10 4.1 13 11 4.3 14 4.4 15 12 4.5 16 13 4.6 17 14
5.2 18 15 5.3 19 5.5 20 16 6.2 21 17 6.3 22 18 6.4 23 19 6.7 24 20 6.8 25 21 7.2 22 7.5 26 7.6 27 23 7.7 28 24 8.2 29 25 8.5 30 26 8.7 31 27 8.9 28 8.10 32 29 8.11 33 30 8.12 34 31 8.14 35 9.5 32 9.6 36 33
9.8 37 34 9.9 38 35 9.10 39 36 10.2 40 37 10.4 41 10.5 38 10.7 42 39 10.8 43 40 10.9 44 11.2 45 41 11.7 46 42 11.9 47 11.10 48 53 12.8 44 13.1 49 45 13.2 50 13.3 51 46 13.4 47 SS2.2 52 SS3.1 53 48 SS3.2 54 49 SS3.3 55 50
SS3.6 56 51 SS3.7 57 52 Optional Sections OP1, OP2 & OP3 – Not Required for SCSA COR Certification OP1.2 1 OP1.3 2 OP1.4 1 3 OP1.5 2 4 OP2.2 5 OP3.1 6 OP3.2 3 7 OP3.3 4 8 OP3.4 5 9
Auditor’s Comments: Health and Safety Program Verification Possible Score Technique Employed Points Awarded D O I OP1 WCB Claims Management OP1.1 Is a WCB Claims Management Policy in place, signed and dated? 2 OP1.2 Is there an active WCB claims management program in place? 1 AND OP1.3 Have key personnel received WCB Claims Management training? 2 AND OP1.4 Is pre-employment / placement screening performed? 2 AND OP1.5 Are alternate work programs in place? 1 AND Total Points Possible 8 Total Points Awarded OP2 Environmental Protection Policy OP2.1 Is an environmental policy in place, signed and dated? 2 OP2.2 Is there an environmental protection program in place? 1 AND Total Points Possible 3 Total Points Awarded OP3 Miscellaneous Programs OP3.1 Is a system in place to pre-qualify sub-contractors? 3 AND OP3.2 Are incentive / recognition programs in for safety? 1 AND OP3.3 (Specify) AND OP3.4 (Specify) AND Total Points Possible Total Points Awarded