SPRS To Go

HOA To Go

 

Reviewed by ________________________________________

 

Date: _______/_______/20_____

Comments:

 

 

 

 

 

Section

Reference

Applicable

Criteria

Score

Comment

Section 1: Management Leadership & Employee Participation

PRESIDENT / OWNER STATEMENT IS WRITTEN

 

01. IS PART OF THE SAFETY MANUAL

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

02. SIGNED BY PRESIDENT

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

03. PART OF EMPLOYEE ORIENTATION TRAINING

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

SAFETY & HEALTH GOALS & OBJECTIVES ARE DEFINED

 

01. COMPANY HAS DEVELOPED WRITTEN SAFETY & HEALTH GOALS

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

02. MEASURES ARE USED TO TRACK AND UPDATE GOAL PROGRESS ON AN ANNUAL BASIS

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

03. STATED GOALS ARE COMMUNICATED TO EMPLOYEES

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

MANAGEMENT SAFETY RESPONSIBILITIES ARE DEFINED

 

01. DEFINED GENERAL SAFETY RULES ARE STATED

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. SAFETY RESPONSIBILITIES ARE IN WRITING

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. A SAFETY BUDGET IS BUILT INTO EACH BID

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. HOW THE COMPANY WILL EVALUATE SAFETY PERFORMANCE RESPONSIBILITIES

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. SAFETY RESPONSIBILITIES ARE SUMMARIZED FOR EACH JOB DESCRIPTION

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. THIS SUMMARY INCLUDES DETEAILED RESPONSIBILITIES OF MANAGEMENT, SAFETY DIRECTOR, AND JOB SUPERINTENDENT / FOREMAN

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

EMPLOYEE SAFETY RESPONSIBILITIES ARE DEFINED

 

01. METHOD FOR EMPLOYEES TO COMMUNICATE SAFETY HAZARDS

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. EMPLOYEE SAFETY RESPONSIBILITIES ARE DEFINED AND IN WRITING

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. EMPLOYEES SHOULD NOT CONDUCT TASKS IN WHICH THEY HAVEN'T BEEN TRAINED

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. PROCEDURES EXIST TO FOLLOW IF AN EMPLOYEE IS ASKED TO DO SOMETHING THEY CONSIDER UNSAFE

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. METHOD FOR EMPLOYEES TO COMMUNICATE SAFETY IMPROVEMENT SUGGESTIONS

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

SUBCONTRACTOR SAFETY RESPONSIBILITIES ARE DEFINED

 

01. SUBCONTRACTORS ARE REQUIRED TO DESIGNATE AN ONSITE SAFETY REPRESENTATIVE

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. SUBCONTRACTORS TO PROVIDE A MSDS FOR ALL HAZARDOUS MATERIALS BROUGHT ONSITE

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. A CENTRAL LOCATION FOR MSDS' IS ESTABLISHED AT EACH JOBSITE

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. SUBCONTRACTORS TO PROVIDE A PROJECT SPECIFIC SAFETY PLAN

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. SUBCONTRACT AGREEMENT CONTAINS PROVISIONS REGARDING SAFETY

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. WEEKLY TOOL BOX TALKS WILL BE GIVEN BY SUBCONTRACTORS

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. THE DEPARTMENT SAFETY REPRESENTATIVE HAS OSHA 10-HOUR CONSTRUCTION TRAINING

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

SAFETY DIRECTOR / COORDINATOR IS DESIGNATED

 

01. THE SAFETY DIRECTOR REPORTS DIRECTLY TO UPPER MANAGEMENT

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. A DEFINED WRITTEN POLICY REFLECTS THE SAFETY ROLE, AUTHORITY, AND RESPONSIBILITY OF THE SAFETY DIRECTOR

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. THE SAFETY DIRECTOR HAS RECEIVED OSHA 10-HOUR CONST. TRAINING

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. SAFETY DIRECTOR HAS A PERSONAL "SAFETY MANAGEMENT STATEMENT"

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. SAFETY DIRECTOR'S PERFORMANCE IS REVIEWED ANNUALLY & BASED ON SPECIFIC CRITERIA (EG. SPECIFIC GOALS)

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. SAFETY DIRECTOR RECEIVES TRAINING NECESSARY TO ACCOMPLISH DESIGNATED TASKS AS DETAILED IN THEIR JOB RESPONSIBILITIES (EG. CONFINED SPACE ENTRY, NOISE MONITORING, FORKLIFT TRAINING, ETC.)

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. SAFETY DIRECTOR HAS RECEIVED OSHA CONST. 30-HOUR TRAINING OR OSHA 500 TRAINING

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

Section 2: Workplace Analysis

A SELF INSPECTION PROGRAM IS DEFINED

 

01. CORRECTIVE ACTION IS REQUIRED TO BE DOCUMENTED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. SAFETY DIRECTOR OR OTHER DESIGNATED COMPETENT PERSON PERSONALLY CONDUCTS RANDOM INSPECTIONS (E.G., MONTHLY TO SUPPORT INSPECTION REQUIREMENT.)

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. SAFETY INSPECTION ITEMS ARE REVIEWED USING A SPECIFIC SELFINSPECTION FORM (PROVIDED IN SAFETY PROGRAM.)

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. A DESIGNATED PERSON TO CONDUCT JOBSITE SAFETY INSPECTIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. BEHAVIORAL BASED INSPECTIONS ARE PERFORMED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. SAFETY INSPECTION TRAINING IS REQUIRED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. A DATABASE OF INSPECTION RESULTS IS ESTABLISHED AND REQUIRED TO BE GIVEN TO THE SAFETY DIRECTOR.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. TARGET DATES FOR CORRECTIVE ACTIONS ARE REQUIRED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. ALL SAFETY INSPECTION RESULTS ARE SENT TO UPPER MANAGEMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. A DESIGNATED PERSON TO CONDUCT WEEKLY JOBSITE SAFETY INSPECTIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

JOB HAZARD ANALYSIS (JHA) PROCEDURES ARE DEFINED

 

01. CORRECTIVE ACTION OR PREVENTIVE ACTION PLANS ARE CALLED TO MANAGEMENTS ATTENTION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. JHAS ARE REQUIRED ON A SET SCHEDULE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. JOBS/ACTIVITIES ARE ANALYZED WHEN AN ACCIDENT OCCURS AND REVIEWED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. JHAS ARE COMPLETED ON A COMPANY "JHA FORM".

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. SAFE TO WORK PROCESSES ARE USED TO REVIEW THE PURCHASE OF ANY NEW EQUIPMENTTO ENSURE ADEQUATE PROCEDURES ARE ESTABLISHED AND TRAINING IS CONDUCTED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. PRIOR TO BIDDING NEW JOBS, THE COMPLETION OF A PRE-JOB PLANNING PROCESS IS USED TO EVALUATE UNIQUE SAFETY ISSUES ON THE JOB.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. INDIVIDUALS CONDUCTING THE JHAS ARE TRAINED IN HOW JHAS ARE DONE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

ACCIDENT REPORTING PROCEDURES ARE DEFINED

 

01. REPORTING PROCEDURES ARE DESIGNED TO FIND THE ACCIDENT (INCIDENT) CAUSE AND PROMPT CORRECTIVE MEASURES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. ALL DOCUMENTATION IS FORWARDED TO MGMT. TO CONDUCT AN ACCIDENT ANALYSIS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. ALL PERSONNEL ARE TO BE FAMILIAR WITH THE ACCIDENT (INCIDENT) REPORTING PROCEDURE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. ALL INCIDENTS ARE REPORTED USING A COMPANY SPECIFIC FORM AND THEN FORWARDED TO MANAGEMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. PROCEDURES TO FOLLOW IN CASE OF PERSONAL INJURY, PROPERTY DAMAGE, OR CHEMICAL SPILL.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. INJURED EMPLOYEE AND WITNESS STATEMENTS ARE TAKEN.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. THE SAFETY DIRECTOR IS RESPONSIBLE FOR OSHA RECORDKEEPING (E.G., OSHA 300 LOG).

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. ALL INCIDENT INFORMATION WILL BE IN A COMPANY DATABASE TO SORT FOR TRENDS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. CORRECTIVE ACTION IS TAKEN AND "LESSONS LEARNED" REPORTED TO ALL LEVELS OF MANAGEMENT, AFFECTED EMPLOYEES AND SAFETY COMMITTEE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. ALL INCIDENTS (INCLUDING NEAR MISSES) ARE INVESTIGATED BY A TRAINED INDIVIDUAL THE SAME DAY OF OCCURRENCE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

Section 3: Hazard Prevention

DISCIPLINARY POLICIES & PROCEDURES ARE DEFINED

 

01. VIOLATIONS OF SAFETY POLICIES WILL RESULT IN DISCIPLINARY ACTIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. ALL DISCIPLINARY ACTIVITY IS NOTED IN EMPLOYEES PERSONNEL FILE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. DISCIPLINARY POLICIES ARE PART OF NEW HIRE ORIENTATION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. ALL DISCIPLINARY ACTIVITIES WILL BE DOCUMENTED ON COMPANY FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. AUTHORITY AND RESPONSIBILITY FOR DISCIPLINARY ACTION (E.G., WHO CAN DISCIPLINE, ETC.).

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. MANAGEMENT WILL REVIEW DISCIPLINARY DATA (TRENDS) AND USE THIS INFORMATION TO UPGRADE EMPLOYEE TRAINING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. CONSEQUENCES ARE BASED ON THE SEVERITY AND/OR FREQUENCY OF INFRACTION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

SUBSTANCE ABUSE PROGRAM MEETS OR EXCEEDS THE MICCS SUBSTANCE ABUSE PROGRAM PROTOCOL

 

01. ADHERENCE TO THE MICCS SUBSTANCE ABUSE POLICY WHEN REQUIRED BY OWNER.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. A BASIC POLICY OF COMPANYS POSITION ON SUBSTANCE/ALCOHOL ABUSE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. A SUBSTANCE ABUSE POLICY INCORPORATES ALL GUIDELINES STATED IN THE MICCS SUBSTANCE ABUSE POLICY.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. ADHERENCE TO THE MICCS SUBSTANCE ABUSE GUIDELINES THROUGHOUT COMPANY.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. MEASURES TO BE TAKEN IN CASE OF SPECIMENS THAT ARE DILUTED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. EMPLOYEE ASSISTANCE PROGRAM IS AVAILABLE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. REASONABLE CAUSE TESTING WITH DOCUMENTATION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. JOB SUPERINTENDENT AND FOREMAN ARE TRAINED IN DRUG AND ALCOHOL AWARENESS ON THE JOBSITE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. RANDOM DRUG TESTING CONDUCTED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. ALL INJURED EMPLOYEES WHO ARE PROVIDED WITH MEDICAL ASSISTANCE AT THE DESIGNATED HOSPITAL/CLINIC WILL BE DRUG AND ALCOHOL TESTED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

AN OCCUPATIONAL MEDICAL FACILITY IS DESIGNATED

 

01. POSTING OF MEDICAL FACILITY INFORMATION FOR EACH JOBSITE.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

02. AN OCCUPATIONAL MEDICAL FACILITY HAS BEEN DESIGNATED FOR EACH JOBSITE.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

03. DISCIPLINARY ACTION FOR FAILURE TO COMPLY WITH OCCUPATIONAL MEDICAL REQUIREMENTS.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

04. EMPLOYEE MEDICAL RESTRICTIONS ARE COMMUNICATED TO MANAGEMENT, JOB SUPERINTENDENT AND WORKERS COMPENSATION PROVIDER.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

05. THE FACILITY TO PROVIDE CONTRACTOR WITH LOSS DATA AND COORDINATION OF RETURN TO WORK & JOB RESTRICTIONS.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

LIGHT / RESTRICTED DUTY POLICIES & PROCEDURES ARE DEFINED

 

01. AN EARLY RETURN-TO-WORK (LIGHT DUTY) PROGRAM IS PRESENT.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

02. FUNCTIONAL JOB DESCRIPTIONS FOR EACH JOB CLASSIFICATION.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

03. PROCEDURES TO FOLLOW IN COORDINATION BETWEEN INJURED, SAFETY DIRECTOR, AND HEALTH CARE PROVIDER.

N/A

Fails (0)

Min Criteria (4 of 4)

Exceeds Min Criteria (4 of 4)

Best Practices (4 of 4)

PERSONAL PROTECTIVE EQUIPMENT POLICIES & PROCEDURES ARE DEFINED

 

01. WHAT PPE THE COMPANY WILL PROVIDE EMPLOYEES AND WHAT (IF ANY) THE EMPLOYEE WILL PROVIDE (E.G., WORK BOOTS, HARD HATS, SAFETY GLASSES, GLOVES, ETC.)

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. PPE IS PROVIDED, TRAINING ON THE PROPER USE OF PPE WILL BE PROVIDED

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. JOBSITE PERSONNEL ARE REQUIRED TO WEAR AND MAINTAIN THE PPE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. VIOLATIONS OF THE USE OF PPE RESULTS IN DISCIPLINARY ACTION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. EMPLOYEES TO PROVIDE FEEDBACK ON THE USEFULNESS OF PPE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. RESPONSIBILITY OF THE PPE PROGRAM IS WITH THE SAFETY DIRECTOR.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. A PPE PROGRAM IS AUDITED EVERY YEAR.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. WRITTEN WORKPLACE HAZARD ASSESSMENTS TAKE PLACE FOR ALL JOBS, PROCESSES OR PHASES OF ACTIVITY THAT APPLIES TO ASSIGNED WORK.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A HAZARD COMMUNICATION PROGRAM IS DETAILED & INCLUDES MSDS INSTRUCTIONS

 

01. LOCATION OF MSDSS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. REQUIREMENT FOR LABELING SECONDARY CONTAINERS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. MSDSS ARE REQUIRED FOR EACH HAZARDOUS CHEMICAL, WHICH ARE USED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. ALL EMPLOYEES RECEIVE TRAINING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. WHO HAS THE RESPONSIBILITY FOR THE AD#MINISTRATION OF THE HAZCOM PROGRAM AND TRAINING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. A WRITTEN HAZCOM PRGM. IS PRESENT ON ALL JOBSITES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM. .

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. THE SAFETY DIRECTOR HAS THE RESPONSIBILITY FOR THE AD#MINISTRATION OF THE HAZCOM PROGRAM AND TRAINING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. PROCEDURES TO FOLLOW TO ENSURE THAT ANY NEW MATERIAL PURCHASED WILL HAVE A MSDS AND HOW THE MSDS BINDER WILL BE UPDATED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. ALL EMPLOYEES RECEIVE COMPREHENSIVE TRAINING INCLUDING - METHODS & OBSERVATIONS TO BE USED TO DETECT HAZARDOUS CHEMICALS ON THE WORK SITE. - THE PHYSICAL & HEALTH HAZARDS OF THE CHEMICALS ON THE WORK SITE. - PROTECTION MEASURES FOR THE EMPLOYEE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

11. WORK SITE LABELING SYSTEM FOR NEW/ MISSING LABELS ON CONTAINERS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

AN EMERGANCY ACTION PLAN (EAP) IS DEFINED

 

01. JOB SPECIFIC EAP PROCEDURES & EQUIPMENT ARE DEVELOPED PRIOR TO THE START OF A PROJECT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. EAP IS IN WRITING AND PERSONNEL RESPONSIBILITIES ARE DEFINED AND DISCUSSED AT ORIENTATION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. AN EAP MOCK DRILL IS CONDUCTED ON ALL JOBSITES EVERY SIX (6) MONTHS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. ANNUALLY EAP PROCEDURES ARE REVIEWED AND CHANGES DOCUMENTED. .

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. DESIGNATED EMPLOYEES (IF ANY) ARE TRAINED ANNUALLY IN THE PROPER USE OF A FIRE EXTINGUISHER.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. EAP CHECKLIST AND TRAINING IS PROVIDED TO ALL JOB SUPERINTENDENTS TO ASSURE PROPER EAPS ARE FOLLOWED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON ASBESTOS AWARENESS IS WRITTEN

 

01. INSTRUCTIONS ON HOW TO AVOID CONTACT OR DISTURBING ACM AND REPORT TO SUPERVISION

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. EXAMPLES OF AS#BESTOS CONTAINING MATERIALS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. HEALTH HAZARDS OF AS#BESTOS

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. PHYSICAL PROPERTIES OF AS#BESTOS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. PRE JOB PLANNING INCLUDES A REVIEW OF POSSIBLE ACM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON ASBESTOS HANDLING / REMOVAL IS DETAILED

 

01. HOUSEKEEPING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. HYGIENE FACILITIES AND PRACTICES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. COMPETENT PERSON OBLIGATIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. RECORDKEEPING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. PROVISION OF PROTECTIVE CLOTHING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. PROVISION OF RESPIRATORY PROTECTION INCLUDING SELECTION, FIT TESTING AND MEDICAL EVALUATION.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. MEASURES TAKEN TO MONITOR EMPLOYEE EXPOSURE LEVELS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. MEASURES TAKEN TO NOTIFY OTHER EMPLOYERS ONSITE OF REGULATED AREAS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. EXPLANATION OF ENGINEERING CONTROLS AND WORK PRACTICES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. ESTABLISHMENT OF REGULATED AREAS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

11. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

12. MAINTENANCE OF TRAINING DATABASE TO TRACK REFRESHER OBLIGATIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON BLOODBORNE PATHOGENS IS DETAILED

 

01. HEPATITIS B VACCINATION, POSTEXPOSURE EVALUATION AND FOLLOW-UP.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. CLEAN-UP AND DISPOSAL OF INFECTIOUS MATERIALS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. MEDICAL RECORDKEEPING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. TRAINING OF EMPLOYEES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. COMMUNICATION OF HAZARDS TO EMPLOYEES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. PPE (CLOTHING OR EQUIPMENT WORN BY EMPLOYEE FOR PROTECTION AGAINST HAZARD).

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. PROVISIONS FOR OCCUPATIONAL EXPOSURE TO BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM. .

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. EXPOSURE CONTROL PLAN IS ACCESSIBLE TO EMPLOYEES AND UPDATED AT LEAST ANNUALLY (OR CHANGES DICTATE).

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. USE AND POSTING OF BLOOD BORNE PATHOGEN KITS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON COMPRESSED CYLINDER HANDLING / STORAGE IS DETAILED

 

01. REFERENCE TO GENERAL SAFE HANDLING AND TRANSPORTING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. PROPER SEPARATION OF FUEL GAS CYLINDERS FROM OXYGEN IN STORAGE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. PROPER STORAGE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. DETAILED EXPLANATION OF PROPER USE, STORAGE AND HANDLING OF CYLINDERS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. CYLINDER LABELING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. PRECAUTIONS FOR RELEASING UNWANTED PRESSURE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. PROPER USE OF GAUGES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON CONFINED SPACE ENTRY IS DETAILED

 

01. SYSTEM FOR THE PREP., ISSUANCE, USE, AND CANCELLATION OF ENTRY PERMITS

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. CERTIFIED TRAINING OF ALL ENTRY TEAM MEMBERS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. PROPER MAINTENANCE OF INJURY DOCUMENTATION FOR ONE YEAR.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. MEASURES TO PROVIDE NECESSARY RESCUE & PERSONAL EQUIPMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. PROVISIONS OF PPE EQUIPMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. PROVISIONS OF COMMUNICATIONS EQUIPMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. PROVISIONS OF VENTILATING EQUIPMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

08. PROVISIONS OF AIR TESTING EQUIPMENT.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

09. PROCEDURES AND PRACTICES NECESSARY FOR SAFE ENTRY OPERATIONS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

10. MEASURES TO IDENTIFY AND EVALUATE THE HAZARDS BEFORE ENTERING.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

11. MEASURES TO PREVENT UNAUTHORIZED ENTRY.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

12. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

13. MEASURES TO COORDINATE WITH OTHER EMPLOYERS WHEN WORKING SIMULTANEOUSLY.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

14. DUTIES AND RESPONSIBILITIES OF A CONFINED SPACE ENTRY TEAM MEMBER.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON ELECTRICAL SAFETY IS DEFINED

 

01. GENERAL REQUIREMENTS REGARDING THE USE OF TEMPORARY WIRING & GROUNDFAULT CIRCUIT INTERRUPTERS.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

02. USE OF PROPER PPE.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

03. GENERAL ELECTRICAL SAFETY RULES.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

04. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

A FALL PROTECTION PLAN IS DETAILED

 

01. INSPECTION OF EQUIPMENT AND MATERIALS USED FOR FALL PROTECTION

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

02. TRAINING PROVISIONS INCLUDING WRITTEN CERTIFICATION FOR ALL EMPLOYEES EXPOSED

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

03. REQUIREMENTS FOR FALL PROTECTION ON WALKING/WORKING SURFACES GREATER THAN 6.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

04. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

05. DEVELOPMENT OF SITE SPECIFIC FALL PROTECTION PLANS.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

06. MEASURES TO PROVIDE RETRAINING AS NEEDED.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

07. PERFORMANCE CRITERIA OF EQUIPMENT USED.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

08. EXPLANATION OF FALL PROTECTION OPTIONS: GUARDRAILS, NETS OR PERSONAL FALL ARREST.

N/A

Fails (0)

Min Criteria (6 of 12)

Exceeds Min Criteria (9 of 12)

Best Practices (12 of 12)

A POLICY ON FIRE PREVENTION IS DETAILED

 

01. PROPER STORAGE, LABELING, CONTAINMENT, AND USE OF FLAMMABLE AND COMBUSTIBLE LIQUIDS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. MEASURES TO INSPECT ALL PORTABLE EXTINGUISHERS ON A MONTHLY BASIS AND CERTIFICATION ONCE PER YEAR.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. PROVISIONS FOR PORTABLE FIRE EXTINGUISHERS WHERE NEEDED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. TRAINING INVOLVING FIRE EXTINGUISHER USE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. PRE JOB PLANNING INCLUDES A REVIEW OF POSSIBLE FIRE HAZARDS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. MEASURES FOR MAINTAINING CLEARANCE OF OUTSIDE FIRE HYDRANTS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A POLICY ON HAND / POWER TOOL SAFETY IS DETAILED

 

01. ALL TOOLS WILL BE DOUBLE INSULATED OR PROPERLY GROUNDED.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

02. PROVISION FOR IDENTIFICATION AND REMOVAL FROM SERVICE OF ANY DEFECTIVE TOOL.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

03. GUARDING REQUIREMENTS.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

04. TOOLS INSPECTED PRIOR TO USE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

05. EQUIPMENT AND PROCEDURES ARE ELEMENTS OF THE SELF INSPECTION FORM.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

06. HAZARD ASSESSMENT SHALL DICTATE PROPER PPE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

07. DETAILED PROCEDURE FOR TAGGING DEFECTIVE TOOLS AND VERIFICATION OF REPAIR PRIOR TO RETURNING TOOL TO SERVICE.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)

A HEARING CONSERVATION PLAN IS DETAILED

 

01. ALL TEST RESULTS MADE AVAILABLE TO EFFECTED EMPLOYEES.

N/A

Fails (0)

Min Criteria (4 of 8)

Exceeds Min Criteria (6 of 8)

Best Practices (8 of 8)