SAFETYANDHEALTHPROGRAMAUDITTOOLCOMPANY/SITE:________________________________ADDRESS:______________________________________________________________________________________________________________________________AUDITORNAME:________________________________AUDITORPHONE#_________________________________AUDITORSIGNATURE:_________________________DATE:_______________________________________________SECTION1:MANAGEMENTLEADERSHIPActionItemNotImplementedPartiallyImplementedImplementedwithonlyMinorDeficienciesFullyImplementedEvidenceofImplementationManagementimplementsandcommunicatesawritten,signedpolicysupportingthesafetyandhealthprogram.Managementroutinelydemonstratesvisiblecommitmenttotheprogram.Managementdefinesspecificgoalsandexpectationsfortheprogram,alongwithplansforachievingthegoals.Managementallocatesappropriateresources(fundsandtime)toaccomplishgoalsandmanagetheprogram.Managementassignsresponsibilityandaccountabilityforimplementingandmaintainingtheprogram.Managementencourages,recognizes,andrewardsworkercontributionstoworkplacesafetyandhealth.1December2017SECTION2:WORKERPARTICIPATIONRequirementNotImplementedPartiallyImplementedImplementedwithonlyMinorDeficienciesFullyImplementedEvidenceofImplementationWorkersareencouragedtoparticipateintheprogram,havethemeanstoparticipate,andfeelcomfortableparticipatingandgivinginputonsafetyandhealthissues.Workersaretrainedonhowtoreportaninjury,illness,hazard,orconcern,includinggoodcatches/nearmisses.Workersreportinjuries,illnesses,hazards,andconcernswithoutfearofreprisal.Reportsofinjuries,illnesses,hazards,orotherconcernsareacknowledgedpromptly.Reportsofinjuries,illnesses,hazards,orotherconcernsareresolvedpromptly,afterworkerinputissought,andaretrackedtocompletion.Workershaveaccesstoinformationtheyneedtounderstandsafetyandhealthhazardsandhazardcontrolmeasuresintheworkplace.Workersareassignedrolesinorareotherwiseinvolvedinallaspectsoftheprogram.Workerscanparticipatewithoutencounteringlanguage,skill,oreducationbarriers;restrictionsonparticipatingduringworktime;orfearofretaliationordiscrimination.2December2017RequirementNotImplementedPartiallyImplementedImplementedwithonlyMinorDeficienciesFullyImplementedEvidenceofImplementationWorkershaveauthoritytoinitiateorrequestatemporarysuspensionorshutdownofanyworkactivityoroperationtheybelievetobeunsafe.3December2017SECTION3:HAZARDIDENTIFICATIONANDASSESSMENTRequirementNotImplementedPartiallyImplementedImplementedwithonlyMinorDeficienciesFullyImplementedEvidenceofImplementationWrittenmaterialssuchasinjury/illnesslogs,SafetyDataSheets,medicalreports,workplaceinspectionresults,incidentinvestigationreports,andmanufacturers’literaturearereviewedtohelpidentifyhazards.Theworkplaceisinspectedregularlytoidentifyconditionsthatposeorcouldposeasafetyorhealthconcern.Inspectionscoverallareasandactivitiesandincludeplantandtransportationvehicles.Beforemakingchangestooperations,workflow,physicalplant,equipment,ormaterials,workersandmanagersconductareviewtoidentifyanysafetyorhealthissues.Theworkplaceisevaluatedtoidentifyworkerexposuretohealthhazards.Trendsininjuryandillnessdata,reportsofhazards,incidents,etc.areanalyzedtoidentifycommonhazards.4December2017RequirementNotImplementedPartiallyImplementedImplementedwithonlyMinorDeficienciesFullyImplementedEvidenceofImplementationIncidents(includingclosecalls/nearmisses)an...
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