Report VCA 1 English by Sm5dWLv

VIEWS: 2 PAGES: 45

									This file contains the mandatory format for the initial and repeat audit reports for SCC* version 2008/5.1

The sole valid and correct version of this report is the version available at the beginning of the audit via the websites
'www.ssvv.nl' and 'www.vca-besacc.be'. A revised version can be identified by the amended date at the bottom of each sheet

General information:
                                            All entry cells are set to automatic wrap, i.e. when the text in the cell fits on more than 1 line the
                                            height of the cell is automatically increased (to accommodate more lines). A hard return (begin
                                            on a new line) can be entered in the cells by pressing the Alt key together with Enter while the
                                            cell is open

                                            CBs can create extra sheets (for example, by completing 'sheet 1' after 'SCC Coordinator' or
                                            creating additional sheets). As an example, a separate sheet is enclosed for closed non-
                                            compliances


This file is comprised of 10 tabs, including this sheet.

1. Explanation                              Current sheet with an explanation of the file
(protected, data cannot be entered in
cells)

2. CB's sheet                               Cover sheet that each CB can complete with information such as CB numbers, logos, etc.
(entirely unprotected, data may be          However, no parts of the other sheets may be moved to or pasted in this sheet
entered in all cells)


3. General
                                           Most sheets are partially protected, solely the cells in which data can be entered are
(in part protected, data can be entered in
                                           accessible. Always begin by completing the type of audit!!
some cells)

4. Audit data                              No particulars
(in part protected, data can be entered in
some cells)


5. Audit plan                               Sheet that can be completed by each CB and which indicates the agenda that is followed and
(entirely unprotected, data may be          the auditees who are interviewed. However, no parts of the other sheets may be moved to or
entered in all cells)                       pasted in this sheet


6. Questionnaire
(in part protected, data can be entered in Data can be entered solely in cells with the following frame:
some cells)


                                            Checkbox per minimum requirement/document => the auditor clicks on the relevant checkbox
                                            when the auditor is of the opinion that a minimum requirement is met or a document is
                                            satisfactory. When not all checkboxes for a question can be checked then - irrespective of the
                                            substantiation - the question has not been satisfied, with the exception of the information cited
                                            under 'Complete, see note'

                                            Drop-down menu => the default option of the drop-down menu for each question is
                                            'Incomplete'. This needs to be set manually to:

                                            (1) 'Complete' => all minimum requirements have been met, all documents are satisfactory and
                                            the substantiations are also satisfactory

                                            (2) 'Complete, see note' => this option has been included for those instances in which a
                                            question is satisfied even though a minimum requirement has not been met or a document is
                                            not satisfactory.
                                            Example for Question 2.1: a new company drew up an RIE 3 months ago that has yet to be
                                            subjected to an annual assessment. In this instance the checkbox for the relevant minimum
                                            requirement should not be checked: select the 'Complete, see note' option in the drop-down
                                            menu and enter the reason that the question is satisfied while the minimum requirement is not
                                            met or the document is not satisfactory




SHE Checklist for contractors, version 2008/5.1                  SCC* Report: 1-06-10                                             Explanation Page 1 of 45
                                          (3) 'Complete, see NB' => this option in the drop-down menu is intended solely for situations in
                                          which the relevant question cannot be tested because the NB accompanying the question is
                                          applicable to this company. Consequently, this option is available for questions 3.6 and 3.8
                                          When the 'Complete, see NB' option is selected from the drop-down menu then the question
                                          does not need to be completed further! The number of minimum requirements and documents
                                          on the Result sheet changes to '0'


                                          Substantiation => the substantiation should:
                                          - be as specific as possible to the company
                                          - include sufficient observations/verifications
                                          The auditor's substantiation endorses the auditor's opinion that the company is in full
                                          compliance with the objective or minimum requirement




                                          Exp => opportunity to provide an explanation. This entry option is not mandatory. It serves 2
                                          purposes:
                                          a) this cell can be used to state which of the options available for a minimum requirement
                                          (Question 1.2) is applicable
                                          b) this cell can be used to give an explanation, where applicable, why a minimum requirement
                                          needs to be verified in the field, i.e. during a project / construction-site visit
                                          for example Question 1.1, 3rd minimum requirement: "The policy statement is made known to
                                          the entire company." Verification can be carried out by questioning, for example, employees at
                                          the site. The employees who are questioned and the findings can then be entered in this cell.



                                          Note => Auditor's comments about the entire question!
                                          a) This entry option is mandatory when the assessment of the question is 'Complete see note'.
                                          This cell must then state why the relevant question is satisfied while not all minimum
                                          requirements have been met or not all documents are satisfactory
                                          b) This entry option is not mandatory in other situations. However, the auditor can then use this
                                          cell to enter all the relevant particulars, for example when the auditor is of the opinion that the
                                          structuring of the data made available by the company exhibits room for improvement



7. Result
(protected, data cannot be entered in     The following information is provided for each question:
cells)                                    - the actual question
                                          - the notes made by the auditor (under the question)
                                          - the nature of the question, i.e. a compulsory question or a supplementary question
                                          - the number of minimum requirements, the number of scored minimum requirements and a
                                          field that displays exclamation marks until all minimum requirements have been checked
                                          - the number of documents, the number of scored documents and a field that displays
                                          exclamation marks until all documents have been checked
                                          - the ultimate assessment of the question as 'Incomplete', 'Complete' or 'Complete, see note.'
                                          Consequently, for example, when exclamation marks are displayed next to the minimum
                                          requirements or documents for a question then the note to that question must in any case
                                          contain a satisfactory explanation of the reason



8. Analysis
(protected, data cannot be entered in     This sheet contains an analysis of the result of the audit. The analysis includes a statement of
cells)                                    the requirements that have been met as determined by the number of scored questions and
                                          substantiations. Please note: this is quantitative!! The analysis is not an assessment of the
                                          results.


9. Findings and authorisation              To be completed by the SCC auditor: the auditor's name is displayed automatically once the
(in part protected, data can be entered in auditor's name has been entered in the Audit data sheet
some cells)


10. SCC coordinator                        To be completed by the SCC coordinator: the coordinator's name is displayed automatically
(in part protected, data can be entered in once the coordinator's name has been entered in the Audit data sheet
some cells)




SHE Checklist for contractors, version 2008/5.1                SCC* Report: 1-06-10                                          Explanation Page 2 of 45
CB's sheet




SHE Checklist for contractors, version 2008/5.1   SCC* Report: 1-06-10   CB's sheet Page 3 of 45
                                                               GENERAL
                         Audit on the basis of the checklist for:                                            Audit type:

                                      SCC*
                                                                                               Enter

Particulars about the company:
  • the name of the company




  • registered offices

  • address
  • telephone number                                                 • web address


  • name of contact person                                           • e-mail address of contact person


  • the name of the organisational unit that has received certification (if other than the name of the company)




  • the names of the members of the management board, the name of the officer with the final responsibility for the company (or
    organisational unit)
      name                                                           name




  • name of the SH officer of the company (or organisational unit)


  • the scope of the work (framework of the activities) that fall under the assessed SHE management system




  • change in scope compared to previous audits




Employees
  • number of permanent operational employees
  • number of temporary operational employees
  • number of supervisors of the operational employees
  • number of other (administrative) employees
  • number of other (temporary) employees
                                                      Total number of employees

Relevant changes in the organisation
  •
  •

Relevant changes in documentation




SHE Checklist for contractors, version 2008/5.1                 SCC* Report: 1.06.10                                          General Page 4 of 45
  •




Details about the main branch and sub-branches:
                                                                                                                                   Number of    Number
                                                                                                                                   employees*   Projects/
No Name of main branch                                                       Town/city
                                                                                                                                                construction
                                                                                                                                                sites**
  1
                                                                                                                                   Number of    Number
                                                                                                                                   employees*   Projects/
No Name of sub-branch(es)                                                    Town/city
                                                                                                                                                construction
                                                                                                                                                sites**
  2
  3
  4
  5
  6
  7
  8
  9
 10
 11
 12
* encompasses all categories of employees specified above under the 'employees' heading at each branch
** the average number of projects in progress / construction sites where work is being carried out simultaneously by each branch


Accident statistics
                                                Last year for which data are available:



  1 Number of employees (including temporary employees)
  2 Number of hours worked
  3 Lost-time accidents/ accidents resulting in absenteeism
  4 Accidents resulting in fatalities (a)
  5 Number of occupational accidents (3+4)
  6 Injury Frequency Rate, IF (b)

(a) Fatality: death within 30 days whereby the cause of death is (in part) the result of the injury incurred in the accident
                               number of lost-time/absenteeism accidents (3+4) x 1,000,000
(b) Injury Frequency Rate, IF
                                                number of hours worked (2)


NACE Code (rev.2)*
* the NACE code applicable to the scope of the work (framework of the activities) that fall under the assessed SHE management system



IF of the sector (B)
(see www.vca-besacc.be)




SHE Checklist for contractors, version 2008/5.1                         SCC* Report: 1.06.10                                               General Page 5 of 45
                                                    AUDIT DATA
Company


Time to be assigned to audit/time spent on audit                             Date / dates of audit
   • Time to be assigned to
     audit in accordance with
     Annex F
    • Actual time spent on audit

CB's particulars
    • Name/branch of CB
    • SCC Auditor
    • SCC Coordinator

Phase 1; Audit findings




Non-compliances / observations from previous audits
    • Non-compliances dealt with adequately?

Note




    • Observations dealt with?

Note




Assessment of the sub-branches' internal audits (where relevant)
   •




Number of branches / projects / construction sites
    • Sub-branches visited
                                                                          Visited
 No Name of main branch
                                                                    Yes             No
    1
                                                                          Visited
 No Name of sub-branch(es)
                                                                    Yes             No
    2
    3
    4
    5
    6
    7
    8
    9
   10
   11
   12
                                         Total number visited




SHE Checklist for contractors, version 2008/5.1                 SCC* Report: 1.06.10                 Audit data Page 6 of 45
     • Projects/construction sites visited

          name                                                    location               Falls under main branch or
                                                                                             sub-branch number
                                                                                              (see above table)

      i
          Activities scope of work on project/construction site



     ii
          Activities scope of work on project/construction site



    iii
          Activities scope of work on project/construction site



   iv
          Activities scope of work on project/construction site



    v
          Activities scope of work on project/construction site



   vi
          Activities scope of work on project/construction site



   vii
          Activities scope of work on project/construction site



  viii
          Activities scope of work on project/construction site



     • Interviewed persons

          Name                                                    Job/position              main or sub-branch
                                                                                             number/project-
                                                                                             construction site
                                                                                             (see tables above)




SHE Checklist for contractors, version 2008/5.1                   SCC* Report: 1.06.10                   Audit data Page 7 of 45
To be completed/created by CB




SHE Checklist for contractors, version 2008/5.1   SCC* Report: 1-06-2010   Audit plan Page 8 of 45
                                                     QUESTIONNAIRE
Assessment on the basis of:
                                                                  SCC*
Company



1.1         Has the company drawn up a SHE policy statement?                                                                    Comp.
Objective:                                                                                                        Incomplete
            The specification and implementation of a company SHE policy pertaining to the company
            staff, the employees of contractors and temporary employees.

                                                              Substantiation


Minimum requirements

            The policy statement must at least devote attention to:
            - the prevention of personal injury
            - the prevention of material and environmental damage
            - endeavours to achieve continual improvements in the SHE performance

            The policy statement is made known to the entire company (to all employees) (by repeated announcements of
            the policy) and is implemented.

      Exp
            Signed by the person with the most senior position in the company

            3-yearly evaluation and, when necessary, updating of the policy


Documents

            Policy statement
  Note


1.2         Has the company appointed a Safety and Health Officer?                                                              Comp.

Objective                                                                                                         Incomplete
            The coordination of H&S issues within the company during its everyday operations and
            a guarantee that the necessary expertise is available for those issues.
                                                              Substantiation


Minimum requirements

            The H&S Officer reports directly to the Management Board, and is incorporated by name in the
            organisation chart.

            The job description of the H&S Officer incorporates an explicit specification of the concomitant duties,
            responsibilities, and powers

            The H&S Coordinator is in the possession of the necessary expertise, or has demonstrable recourse to
            internal/external experts

      Exp
            The H&S Coordinator is known within the organisation, inclusive of at the workplace
      Exp


Documents

            Organisation chart: the H&S Officer reports directly to the Management Board

            Job description of the H&S Coordinator




SHE Checklist for contractors, version 2008/5.1                   SCC* Report: 1.06.10                                   Questionnaire Page 9 of 45
        Diploma, testimonial, or certificate
Note


1.6     Does the Management Board carry out assessments of compliance with the SCC requirements?
                                                                                                                            Comp.

Objective:                                                                                                  Incomplete
        The Management Board’s involvement in compliance with the SCC requirements
                                                          Substantiation


Minimum requirements

        Annual Management Board assessments of internal audits in three years covering the entire system

        Determination and follow-up of improvement measures


Documents

        Internal audit reports

        Annual Management Board assessments
Note


1.7     Is an objective formulated and followed up with respect to the IF for lost-time/absenteeism accidents?
                                                                                                                            Comp.

Objective:                                                                                                  Incomplete
        Reduction of the IF of lost-time/absenteeism accidents and the Management Board's involvement.
                                                          Substantiation


Minimum requirements

        Adoption of the annual target for the IF of lost-time/absenteeism accidents
                                                          Substantiation


        Plan of action, comprised of:
        - points for action arising from the target
        - the persons responsible for the implementation and assessment
        - the scheduling


        Periodic – at least yearly – evaluation of the achievement of the target and the implementation of the measures


        Specification and implementation of corrective measures on the basis of the evaluation
                                                          Substantiation




Documents

        Summary of the actions

        Evaluation reports
Note


2.1     Is the company in the possession of an up-to-date SHE risk inventory and evaluation?
                                                                                                                            Comp.

Objective:                                                                                                  Incomplete
        The determination and control of SHE risks.




SHE Checklist for contractors, version 2008/5.1               SCC* Report: 1.06.10                                 Questionnaire Page 10 of 45
                                                           Substantiation


Minimum requirements

        Up-to-date SHE risk inventories and evaluations are available for all positions within the company which have
        been specified as jobs with associated risks
                                                           Substantiation



        SHE risk inventories and evaluations take place by carrying out the following:
        - an inventory of the hazards
        - determining the risks
        - evaluating the risks

        SHE risk inventories and evaluations are carried out:
        - by means of a prescribed methodology
        - with the active participation of the H&S Officer as referred to in Question 1.2

        Risks determined during the evaluation are controlled by implementing effective measures , whereby
        preference is given to tackling the risks at source (prevention principles)
                                                           Substantiation



        Plan of action, comprised of:
        - points for action arising from the SHE risk inventories and evaluations
        - the persons responsible for the implementation and assessment
        - the scheduling

        Periodic assessment of the plan of action (plan of approach), at least once a year, inclusive of the corrective
        measures

        SHE risk inventories and analyses are evaluated at least once every three years, and amended as necessary
        with the active participation of the H&S Officer

        SHE risk inventories and evaluations are evaluated at least once a year on the basis of accidents/SHE incidents,
        and amended as necessary


Documents

        Method for SHE risk inventories and analyses

        Plan of action

        Reports of assessments

        Summary of corrective measures

        Summary of SHE risk inventories and analyses

        Detailed SHE risk inventories and analyses
Note


2.2     Do task-risk analyses take place?                                                                                      Comp.
Objective:                                                                                                     Incomplete
        The determination and control of the SHE risks associated with the work to be
        carried out by the company in specific circumstances and environments (workplaces).
                                                           Substantiation


Minimum requirements

        Guidelines for the determination of the work/situations/environments in need of the performance of a task-risk
        analysis




SHE Checklist for contractors, version 2008/5.1                SCC* Report: 1.06.10                                   Questionnaire Page 11 of 45
            Task-risk analyses are performed by means of a specification of:
            - duties (in the specific environment)
            - the associated risks
            - the measures that have been implemented

            Task-risk analyses are performed:
            - by means of a prescribed methodology
            - under the responsibility of a line officer involved in those tasks, and who
              X is in the possession of sufficient knowledge, expertise and experience about safety
              X is responsible for the communications with all those carrying out the work at the workplace

            Risks determined during the evaluation are controlled by implementing effective measures , whereby preference
            is given to tackling the risks at source
                                                             Substantiation



            Subsequent to every accident resulting in lost time/absenteeism (Section 12) the task-risk analysis is subjected
            to an evaluation and amended where necessary


Documents

            Guidelines/methodology applicable to task-risk analyses

            Summary of current task-risk analyses

            Task-risk analyses
Note


2.3         Are LMRAs carried out before commencing work?                                                                        Comp.
Objective:                                                                                                       Incomplete
            The employees carry out a check at the workplace to verify that all risks have been
            recognised and that adequate control measures have been implemented. The approach is based on the principle
            that employees start high-work risk only once adequate measures have been implemented.


                                                             Substantiation


Minimum requirements

            Procedure / instructions for the employees’ performance of LMRAs before starting work

            Performance of LMRAs
      Exp


Documents

            Procedure / instructions
Note


2.4         Is the appropriate personal protective equipment issued, maintained and replaced free of charge?
                                                                                                                                 Comp.

Objective:                                                                                                       Incomplete
            The provision of the appropriate personal protective equipment to staff so as to prevent injury and occupational
            disease.
                                                             Substantiation


Minimum requirements




SHE Checklist for contractors, version 2008/5.1                  SCC* Report: 1.06.10                                   Questionnaire Page 12 of 45
            The issue of personal protective equipment is based on the control measures specified in the risk inventory and
            evaluation and the TRA

            The employees possess the appropriate personal protective equipment
      Exp
            The issue, inclusive of maintenance/exchange, is free of charge
      Exp
            Guideline for the provision of instructions for use
      Exp


Documents

            List of personal protective equipment that is available / has been made available

            Guidelines for instructions for use
Note


3.1         Are all employees in the possession of vocational training and experience relating to the work they are to
                                                                                                                                Comp.
            carry out?
Objective:                                                                                                     Incomplete
            All employees are in the possession of the vocational knowledge and expertise required
            to carry out their duties within the company.
                                                             Substantiation


Minimum requirements
            A summary of the vocational training and experience requirements applicable to each position

            Procedures providing assurance for workplace compliance with the stipulated training and experience
            requirements
      Exp


Documents
            List of required vocational training and experience

            Procedure for assured integration
Note


3.2         Are all operational employees in the possession of a “Basic Elements of Safety (SCC)” diploma,
                                                                                                                                Comp.
            testimonial, or certificate?
Objective:                                                                                                     Incomplete
            All operational employees are in the possession of basic SHE knowledge.
                                                                  Substantiation


Minimum requirements

            Operational employees employed by the company for a period in excess of three months are in the possession of
            a valid “Basic elements of safety (SCC)” diploma, testimonial, or certificate bearing the SCC logo

      Exp


Documents
            Diplomas, marks of conformity, certificates
Note


3.3         Are all operational supervisors in the possession of a “Safety for Operational Supervisors (SCC)”
                                                                                                                                Comp.
            diploma, testimonial, or certificate”?




SHE Checklist for contractors, version 2008/5.1                      SCC* Report: 1.06.10                              Questionnaire Page 13 of 45
Objective:                                                                                                       Incomplete
            All operational supervisors are in the possession of SHE knowledge.
                                                               Substantiation


Minimum requirements

            Operational supervisors employed by the company for a period in excess of three months are in the possession
            of a valid ‘Safety for operational supervisors (SCC)’ diploma, testimonial, or certificate bearing the SCC logo

      Exp


Documents
            Organisation chart / list of operational supervisors

            Diplomas, marks of conformity, certificates
Note


3.4         Are all employees in the possession of specific knowledge and expertise pertaining to high-risk tasks or
            work in a high-risk environment to be performed by them within the company?                                          Comp.


Objective:                                                                                                       Incomplete
            All employees are in the possession of the specific knowledge and expertise they require
            to perform high-risk tasks and/or work in a high-risk environment to be performed by them
            within the company (see Section 2).
                                                               Substantiation


Minimum requirements

            Summary of specific training and experience requirements classified according to position (for Belgium, see the
            Register van Risicovolle Taken [‘Register of high-risk tasks’])


            For work in the petrochemical sector: compliance with the requirements specified in the SSVV Opleidingengids
            (‘SSVV Training Guide’) or (in Belgium) in the Register van Risicovolle Taken (‘Register of high-risk tasks’) as
            demonstrated by a summary of specific training and experience requirements classified according to position


            Procedures to assure compliance with the stipulated specific training and experience requirements
      Exp


Documents
            List of specific training and experience requirements classified according to position

            Procedure for assured integration
Note


3.5         Does the company provide specific in-house SHE information and instructions?                                         Comp.
Objective:                                                                                                       Incomplete
            All employees are cognisant of the SHE regulations and instructions, as well as the
            SHE instructions governing the work they are assigned to carry out in their customary
            work environments.
                                                               Substantiation


Minimum requirements




SHE Checklist for contractors, version 2008/5.1                    SCC* Report: 1.06.10                                 Questionnaire Page 14 of 45
            The information provided to the employees devotes attention to:
            - the company’s SHE policy
            - the general risks associated with the work
            - the general safety regulations and instructions
            - personal protective equipment
            - the notification of unsafe situations and the actions to be taken
            - the procedure in the event of (serious) injury
            - the procedure in the event of emergency
            - the action to be taken in the event of complaints

            Determination of the content of the SHE instructions (inclusive of the frequency and the manner in which the
            instructions are given) that govern which work/work environments

            Procedures providing assurance for compliance with the stipulated instruction requirements
      Exp


Documents
            Documentation relating to the provision of SHE information

            Summary of the SHE instructions, inclusive of the frequency

            Procedure for assured integration
Note


3.6         Is there an adequate procedure for the correct management and completion of the Personal Safety
                                                                                                                                      Comp.
            Logbook (where relevant)?
Objective:                                                                                                            Incomplete
            Correct management and completion of the Personal Safety Logbook.
                                                                Substantiation


Minimum requirements

            Procedure for the registration of training courses/instructions and the stipulated certificates of medical suitability
            in the Personal Safety Logbook

            An official document must be included in the personnel file for each notification/note relating to training/in-house
            instruction incorporated in the Personal Safety Logbook

            Specification of the person responsible for the completion of the Personal Safety Logbook

            Records of the issue of Personal Safety Logbooks
      Exp


Documents
            Procedure for the completion of the Personal Safety Logbook

            Records of the issue of Personal Safety Logbooks
Note
            N.B.: the question is answered in the affirmative when the company does not use Personal Safety Logbooks.



3.7         Can communications pertaining to SHE issues be effected without language impediments?
                                                                                                                                      Comp.

Objective:                                                                                                            Incomplete
            Communications pertaining to SHE issues can be effected without language impediments.
                                                                Substantiation


Minimum requirements

            Employees who speak other languages are deployed in a manner providing for the effective communication of
            relevant SHE issues (see, in particular, questions 3.5, 5.2 and 7.1)




SHE Checklist for contractors, version 2008/5.1                     SCC* Report: 1.06.10                                     Questionnaire Page 15 of 45
                                                                Substantiation



Documents
        • (none)
Note


3.8         Are the employees cognisant with the internal regulations/procedures at the clients where they will work,
            such when this requirement is explicitly specified and the necessary information is made available by the          Comp.
            clients?
Objective:                                                                                                      Incomplete
            The employees' knowledge of the client's internal regulations and procedures governing
            their work.
                                                             Substantiation


Minimum requirements
            Assurances for compliance with the objective
      Exp


Documents
            Procedure for assured integration
Note
            N.B.: the question is answered in the affirmative when the client does not request this knowledge


6.1         Are sufficient preventive environmental-protection measures implemented which are focused on the
                                                                                                                               Comp.
            prevention of soil pollution and waste management?
Objective:                                                                                                      Incomplete
            The prevention of soil pollution and the effective management of waste.
                                                                Substantiation


Minimum requirements

            Inventory of the risks relating to soil pollution and waste (related to the company’s activities)
                                                                Substantiation


            The implementation of the necessary preventive measures
                                                                Substantiation


            A waste-management procedure specifying:
            - the manner in which the wastes shall be collected and stored
            - the manner in which and by whom the waste shall be removed and transported to which approved
              processors
            - assurances that the waste management is carried out in accordance with the procedure

      Exp


Documents
            Inventory of the relevant risks/waste

            Procedure for waste management

            List of approved processors contracted by the company
Note


7.1         Is the company prepared for an effective response to emergency situations?                                         Comp.
Objective:                                                                                                      Incomplete




SHE Checklist for contractors, version 2008/5.1                     SCC* Report: 1.06.10                              Questionnaire Page 16 of 45
            An effective response to emergency situations on the client’s site.
                                                              Substantiation


Minimum requirements

            Procedure for the issue of notification, warning, giving the alarm, and evacuation in connection with emergency
            situations

            The employees’ cognisance with the procedure
      Exp

            The necessary First-Aid equipment at the workplace/project, inclusive of any specific equipment required in
            connection with possible extraordinary exposure to materials
      Exp

            The necessary fire-extinguishing equipment at the workplace/project, inclusive of any specific equipment
            required in connection with potential hazards
      Exp

            The aforementioned equipment is always:
            - available in sufficient quantities
            - maintained in the correct condition

      Exp

            The organisation (persons, equipment and procedures) required to maintain control in emergency situations



Documents

            Procedure for the issue of notification, warning, giving the alarm, and evacuation in connection with emergency
            situations
Note


8.1         Are periodic workplace inspections carried out by the operational supervisors?                                         Comp.
Objective:                                                                                                      Incomplete
            The maintenance and furtherance of a safe working environment and working methods.
                                                              Substantiation


Minimum requirements
            Procedure, with specifications of:
            - the performance of inspections
            - the follow-up subsequent to the observation of any non-compliances
            - the use of a check-list

            Inspections of each workplace are carried out at least once a month by the operational
            supervisor
      Exp

            Inspection reports which incorporate a list of the non-compliances that were observed, the improvements to be
            implemented, the person(s) responsible for the implementation, and the scheduling for the implementation
                                                              Substantiation


            Plan of action, comprised of:
            - points for action arising from the inspections
            - the persons responsible for the implementation and assessment
            - the scheduling


Documents
            Procedure pertaining to the performance of workplace inspections, and the inspection programme

            Reports of inspections that have been carried out, and the follow-up




SHE Checklist for contractors, version 2008/5.1                   SCC* Report: 1.06.10                                    Questionnaire Page 17 of 45
Note


9.1         Are employees in given positions and/or employees to be deployed at specific workplaces subjected to
                                                                                                                                   Comp.
            an examination of their medical suitability (see Question 2.1)?
Objective:                                                                                                          Incomplete
            The deployment of employees who are medically suitable for the performance of the duties
            associated with their position and/or for assignment to specific workplaces.
                                                              Substantiation


Minimum requirements

            Summary of the positions subject to medical suitability requirements and, where relevant, the frequency of the
            examinations on the basis of the SHE risk inventory and evaluation

            Assessment of the medical suitability, where applicable, by a qualified medical expert (a company medical officer
            in the Netherlands or an occupational health physician in
            Belgium)

      Exp
            Register of medical suitability for the various positions/workplaces


Documents
            Summary of the positions subject to medical suitability requirements

            Agreement with a qualified medical expert (a company medical officer in the
            Netherlands or an occupational health physician in Belgium) that includes the
            aforementioned medical examination as a specific duty

            Register of medical suitability for the various positions/workplaces
Note


9.2         Have specifications been drawn up of the employees in given positions who are required to undergo
            periodic medical examinations in view of the exposure risks associated with those positions?                           Comp.


Objective:                                                                                                          Incomplete
            The prevention of detrimental effects on the health of employees due to exposure during
            the performance of duties associated with their position.
                                                              Substantiation


Minimum requirements

            Inventory of positions accompanied by specific medical risks on the basis of the risk inventories and
            evaluations

            Summary of the relevant employees
      Exp

            The involvement of and provision of advice by a qualified medical expert (a company medical
            officer in the Netherlands or an occupational health physician in Belgium) relating to the
            determination of exposure

            The involvement of and provision of advice by a consultant. e.g. a labour hygienist, relating to
            exposure risks

            The implementation of suitable measures on the transgression of exposure limits
      Exp
            Determination and specification of the frequency of medical examinations


Documents




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         Inventory of positions accompanied by specific medical risks (inclusive of the content of
         the examinations and the frequency of the examinations)

         Summary of the relevant employees

         Agreement with a qualified medical expert (a company medical officer in the
         Netherlands or an occupational health physician in Belgium) that includes the periodic
         aforementioned medical examination as a specific duty

Note


10.1     Does the company purchase materials, work equipment and personal protective equipment that are
                                                                                                                              Comp.
         justifiable from a SHE perspective?
Objective:                                                                                                    Incomplete
         The use of materials, work equipment and personal protective equipment that is justifiable from a SHE
         perspective.
                                                        Substantiation


Minimum requirements

         Inventory of materials, work equipment and personal protective equipment accompanied by potential risks

                                                           Substantiation


         SHE requirements to be met by the above to preclude the potential risks.
                                                           Substantiation


         Procedures providing for the assurance of the purchase solely of materials, work equipment and personal
         protective equipment which comply with the SHE
         requirements
   Exp

         Periodic updates of SHE requirements on the basis of risk inventories and evaluations, inspections
         and assessments


Documents
         Inventory of materials, work equipment and personal protective equipment accompanied by potential risks,
         including the governing SHE
         requirements
         Procedure for assured integration
Note


10.2     Are the work equipment and personal protective equipment inspected at periodic intervals?
                                                                                                                              Comp.

Objective:                                                                                                    Incomplete
         The work equipment and personal protective equipment comply with the specified SHE requirements at all times.

                                                           Substantiation


Minimum requirements

         Inventory of the work equipment and personal protective equipment to be subjected to periodic examination

                                                           Substantiation


         Inspection requirements
                                                           Substantiation




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         Frequency of the inspections: at least once a year, with reasons for any departures from the frequency
         if lower

         Expertise of the persons carrying out the inspections

         Procedures providing for the assurance that non-approved work equipment and personal protective equipment
         tools will not be used


         Identification of the expiry date of the period of approval on work equipment and personal protective equipment

                                                             Substantiation



Documents

         Inventory of the work equipment and personal protective equipment to be subjected to periodic examination


         Register of inspections

         Procedure for assured integration
Note


12.1     Is the company in the possession of a procedure for the notification and registration of employee
                                                                                                                              Comp.
         accidents resulting/not resulting in lost time/absenteeism?
Objective:                                                                                                     Incomplete
         Insight into the current SHE performance.
                                                             Substantiation


Minimum requirements
         Notification procedure / notification form

         The employees are familiar with the procedure
   Exp

         Registration of accidents classified into the categories:
         - lost-time accident/ accident resulting in absenteeism
         - accidents resulting in modified duties
         - accidents not resulting in lost time/absenteeism

         (Internal) publication – periodic, at least annually – of accident figures.


Documents
         Notification procedure

         Current (examples of) publications or summaries
Note


12.2     Does the company investigate accidents resulting/not resulting in lost time/absenteeism?
                                                                                                                              Comp.

Objective:                                                                                                     Incomplete
         To learn from accidents.
                                                             Substantiation


Minimum requirements

         Investigation procedure commensurate with the (potential) severity of the accident which specifies:
         - the period within which the investigation is to be completed
         - the designation of the person responsible for the investigation
         - the investigation method




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                                                           Substantiation


        Improvement measures:
        - the specification of improvement measures (follow-up of (task) risk analysis; see Section 2)), inclusive of the
        designation of the person responsible for the scheduling and implementation
        - the implementation of improvement measures
        - the follow-up of immediate corrective and preventive measures to be implemented

                                                           Substantiation


        Plan of action, comprised of:
        - points for action arising from the investigation
        - the persons responsible for the implementation and assessment
        - the scheduling

        (Internal) publication/communications of the lessons learnt


Documents
        Procedure

        Investigation of accidents

        Reports pertaining to improvement measures
Note




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RESULT                       It is possible that a number of notes added on the 'Questionnaire' sheet are not completely legible because they are comprised of a number of lines. If this is the
                             case:
                             - click the mouse in the top left corner (junction of rows and columns) of this sheet to select all cells


Company
List   SCC*
No     Question                                                                                                          Type of    minimum requirements      Documents              Assessment
       Note to question                                                                                                  question   Total / appr.   /CK Total / appr.   /CK           question        CK
1.1    Has the company drawn up a SHE policy statement?
                                                                                                                          Comp.        4   /   0     !!!     1   /     0     !!!      Incomplete      !!!
1.2      Has the company appointed a Safety and Health Officer?
                                                                                                                          Comp.        4   /   0     !!!     3   /     0     !!!      Incomplete      !!!
1.6      Does the Management Board carry out assessments of compliance with the SCC requirements?
                                                                                                                          Comp.        2   /   0     !!!     2   /     0     !!!      Incomplete      !!!
1.7      Is an objective formulated and followed up with respect to the IF for lost-time/absenteeism accidents?
                                                                                                                          Comp.        4   /   0     !!!     2   /     0     !!!      Incomplete      !!!
2.1      Is the company in the possession of an up-to-date SHE risk inventory and evaluation?
                                                                                                                          Comp.        8   /   0     !!!     6   /     0     !!!      Incomplete      !!!
2.2      Do task-risk analyses take place?
                                                                                                                          Comp.        5   /   0     !!!     3   /     0     !!!      Incomplete      !!!
2.3      Are LMRAs carried out before commencing work?
                                                                                                                          Comp.        2   /   0     !!!     1   /     0     !!!      Incomplete      !!!
2.4      Is the appropriate personal protective equipment issued, maintained and replaced free of charge?
                                                                                                                          Comp.        4   /   0     !!!     2   /     0     !!!      Incomplete      !!!
3.1      Are all employees in the possession of vocational training and experience relating to the work they are to
         carry out?                                                                                                       Comp.        2   /   0     !!!     2   /     0     !!!      Incomplete      !!!
3.2      Are all operational employees in the possession of a “Basic Elements of Safety (SCC)” diploma, testimonial,
         or certificate?                                                                                                  Comp.        1   /   0     !!!     1   /     0     !!!      Incomplete      !!!
3.3      Are all operational supervisors in the possession of a “Safety for Operational Supervisors (SCC)” diploma,
         testimonial, or certificate”?                                                                                    Comp.        1   /   0     !!!     2   /     0     !!!      Incomplete      !!!
3.4      Are all employees in the possession of specific knowledge and expertise pertaining to high-risk tasks or work
         in a high-risk environment to be performed by them within the company?                                           Comp.        3   /   0     !!!     2   /     0     !!!      Incomplete      !!!
3.5      Does the company provide specific in-house SHE information and instructions?
                                                                                                                          Comp.        3   /   0     !!!     3   /     0     !!!      Incomplete      !!!
3.6      Is there an adequate procedure for the correct management and completion of the Personal Safety Logbook
         (where relevant)?                                                                                                Comp.        4   /   0     !!!     2   /     0     !!!      Incomplete      !!!




SHE Checklist for contractors, version 2008/5.1                                                SCC* Report: 1.06.10                                                                      Result Page 34 of 45
No       Question                                                                                                         Type of    minimum requirements      Documents       Assessment
         Note to question                                                                                                 question   Total / appr.   /CK Total / appr.   /CK    question       CK
3.7      Can communications pertaining to SHE issues be effected without language impediments?
                                                                                                                           Comp.        4
                                                                                                                                        1   /   0    !!!    1
                                                                                                                                                            0   /   0    !!!
                                                                                                                                                                          -    Incomplete      !!!
3.8      Are the employees cognisant with the internal regulations/procedures at the clients where they will work, such
         when this requirement is explicitly specified and the necessary information is made available by the clients?
                                                                                                                           Comp.        1   /   0    !!!    1   /   0    !!!   Incomplete      !!!

6.1      Are sufficient preventive environmental-protection measures implemented which are focused on the
         prevention of soil pollution and waste management?                                                                Comp.        3   /   0    !!!    3   /   0    !!!   Incomplete      !!!
7.1      Is the company prepared for an effective response to emergency situations?
                                                                                                                           Comp.        6   /   0    !!!    1   /   0    !!!   Incomplete      !!!
8.1      Are periodic workplace inspections carried out by the operational supervisors?
                                                                                                                           Comp.        4   /   0    !!!    2   /   0    !!!   Incomplete      !!!
9.1      Are employees in given positions and/or employees to be deployed at specific workplaces subjected to an
         examination of their medical suitability (see Question 2.1)?                                                      Comp.        3   /   0    !!!    3   /   0    !!!   Incomplete      !!!
9.2      Have specifications been drawn up of the employees in given positions who are required to undergo periodic
         medical examinations in view of the exposure risks associated with those positions?
                                                                                                                           Comp.        6   /   0    !!!    3   /   0    !!!   Incomplete      !!!

10.1     Does the company purchase materials, work equipment and personal protective equipment that are
         justifiable from a SHE perspective?                                                                               Comp.        4   /   0    !!!    2   /   0    !!!   Incomplete      !!!
10.2     Are the work equipment and personal protective equipment inspected at periodic intervals?
                                                                                                                           Comp.        6   /   0    !!!    3   /   0    !!!   Incomplete      !!!
12.1     Is the company in the possession of a procedure for the notification and registration of employee accidents
         resulting/not resulting in lost time/absenteeism?                                                                 Comp.        4   /   0    !!!    2   /   0    !!!   Incomplete      !!!
12.2     Does the company investigate accidents resulting/not resulting in lost time/absenteeism?
                                                                                                                           Comp.        4   /   0    !!!    3   /   0    !!!   Incomplete      !!!
                                                                                                                                       89       0          55       0




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                                                       ANALYSIS
Company



Analysis of number of substantiations, minimum requirements met and documents approved

Score for questions
                                                    Max. number            Scored   Consequence
                                                                                    When not all compulsory questions have been
                                                          25                 0
Compulsory questions                                                                scored => no nomination
On the basis of the number of scored compulsory questions the company should
 NOT BE       nominated for certification



Substantiations
                                                    Max. number            Scored   Consequence
Substantiation for targets                               25                  0      If not all substantiations have been entered then
Substantiation for minimum requirements                  16                  0      the report cannot be accepted
On the basis of the number of entered substantiations the company should
 NOT BE       nominated for certification



Minimum requirements and documents 'not approved' for questions awarded a score
                                              Compulsory
                                               questions
Number of minimum requirements not approved          0
                                                                            Sound substantiation (under notes) must be
Number of documents not approved                     0
                                                                            enclosed for any minimum
                                                                            requirements/documents that are not approved
                                                                            AND the SCC coordinator must give explicit
                                                                            approval (see SCC coordinator's authorisation)




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                                 FINDINGS AND AUTHORISATION
                                                           SCC Auditor

Company
       Company name
       Organisational unit


Non-compliances, current audit
        Number
                                                         Status    enter
        of NC's


       Verification of non-compliances by                          Document study

                                                                   Follow-up study on site




Observations / points for attention for the next audit

       no         question no. Observation / point for attention




Auditor's final conclusion

On the basis of the audit I conducted and the results/analyses as included in this report my recommendation for the issue / continuation of
certification on the basis of SCC 2008/5.1 is:


                                                               enter



SCC Auditor's name                                                                       Signature




Date




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                                             SCC COORDINATOR
Company
    • Company name
    • Organisational unit


Coordinator's final conclusion

On the basis of the audit that was conducted as included in this report and, specifically,
- the results/analyses
- the substantiations and notes
- the status and verification of non-compliances
- the auditor's findings, authorisation and final conclusion
my recommendation for the issue/continuation of certification of the basis of SCC 2008/5.1 is:


                                                          enter




SCC Coordinator's name                                                                Signature




Date




SHE Checklist for contractors, version 2008/5.1              SCC* Report: 1-06-2010               SCC Coordinator Page 45 of 45

								
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