Basic Safety Program Audit Instrument

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					Basic Safety Program Audit Instrument


         General Information



           Effective Date January 1, 2003
                         Basic Safety Program Audit Instrument

                                      General Information

Dates of Audit:                              Previous Audit Information:

   Start:                                       Date:                      Score:
   Last Date of Audit:                          Date:                      Score:
   Completed Report:


Type of Audit:

         Baseline               Internal                     External               One Year COR
         Limited Scope          Student                      Renewal                Six Month COR


Company Data:

   Legal Name:

   Address:

   City/Town:

   Province:                                  Postal Code:

   Key Contact:

   Phone #:

   Fax #:


Auditor Data:

   Company:

   Name:

   Certification:                          Renewal:

   Phone #:                                   Office #:
   Cell./Page #:                              Fax #:
   Address:

   City/Town:                                  Province:

   Postal Code:

Revised: February 2003
                         Basic Safety Program Audit Instrument

                                   General Information

Locations Visited:                                                No. Of Workers at Site:

     1.                                                              1.

     2.                                                              2.

     3.                                                              3.

     4.                                                              4.

     5.                                                              5.

     6.                                                              6.

                                                          Total


WCB Account Number(s)              WCB Industry Code(s)




Revised: February 2003
Basic Safety Program Audit Instrument


          Audit Instrument



           Effective Date January 1, 2003
                                 Basic Safety Program Audit Instrument




                                                                                                               Documentation

                                                                                                                               Observation
                                                                                        Maximum




                                                                                                                                             Interview
                                                                                                    Awarded
                                                                                                      Points
                                                                                           Points
A. Management Involvement and Commitment
1. Company Safety Policy

        a) Does the company have a written safety policy?                               0, 5                        5              0         0

        b) Does the safety policy contain:

                 1 - the signature of the chief operating officer?                      0, 3                        0              3         0

                 2 - reference to management responsibility?                            0, 2                        0              2         0

                 3 - a requirement to comply with government regulations?               0, 3                        0              3         0

                 4 - reference to supervisor's responsibilities?                        0, 2                        0              2         0

                 5 - reference to workers' responsibilities?                            0, 2                        0              2         0

        c) Does the company inform employees about the policy by:

                 1 - distributing copies of the policy?                                0-5                          0              2         3

                 2 - posting it at worksites?                                          0 - 10                       0           10           0

                 3 - discussing the policy with employees?                             0-5                          0              0         5

2. Guiding Principles

        a) * Does the company post the Petroleum Industry Guiding Principles          Yes / No                      0              0         0
            in prominent locations at worksites? (Yes, No)
        b) *Are the guiding principles reviewed as part of employee and               Yes / No                      0              0         0
            contractor orientations, training programs and safety meetings? (Yes,
            No)
3. Safety Responsibilities

        a) Are specific safety responsibilities written and distributed to the:

                 1 - management function?                                              0-2                          1              0         1

                 2 - supervisory function?                                             0-2                          1              0         1

                 3 - workers?                                                          0-2                          1              0         1

                 4 - contractors?                                                      0-2                          1              0         1

                 5 - visitors?                                                         0-2                          1              0         1

        b) Is there a method or system in place to ensure safety responsibilities      0-5                          2              0         3
            are carried out?
        c) Are there adequate resources available to managers, supervisors and         0-5                          0              0         5
            employees to be able to perform their assigned safety responsibilities?




Revised February 2003
                               Basic Safety Program Audit Instrument




                                                                                                            Documentation

                                                                                                                            Observation
                                                                                     Maximum




                                                                                                                                          Interview
                                                                                                 Awarded
                                                                                                   Points
                                                                                        Points
A. Management Involvement and Commitment
4. Management Communication

        a) Does management communicate to employees, contractors and
            subcontractors, at least annually:
                 1 - why safety is important and who it affects?                   0 - 10                        2              5         3

                 2 - the company's commitment to safety?                           0 - 10                        2              5         3

        b) How often does management tour worksites to observe work practices
            and discuss safety issues with workers?
                    1. Senior management (2 or 5 or 10)                            0 - 10                        4              0         6

                                (0 - 10) - quarterly

                                (0 - 05) - semi-annually

                                (0 - 02) - annually

                    2. Middle management (2 or 5 or 10)                            0 - 10                        4              0         6

                                (0 - 10) - monthly

                                (0 - 05) - quarterly

                                (0 - 02) - semi-annually

                    3. Front line supervisors (2 or 5 or 10)                       0 - 10                        4              0         6

                                (0 - 10) - daily

                                (0 - 05) - weekly

                                (0 - 02) - bi-weekly


                                                                              Type of Audit preformed:



                                        Element A Scoring Summary
                 Total points awarded
                                                                          =
                 Points available (107) - n/a              107

                 Start date:                         Last date on site:           Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

      A1a

      A1b1

      A1b2

      A1b3

      A1b4

      A1b5

      A1c1

      A1c2

      A1c3

      A2a

      A2b

      A3a1

      A3a2

      A3a3

      A3a4

      A3a5

      A3b

       A3c

      A4a1

      A4a2

      A4b1

      A4b2

      A4b3



Revised: February 2003
                               Basic Safety Program Audit Instrument




                                                                                                               Documentation

                                                                                                                               Observation
                                                                                        Maximum




                                                                                                                                             Interview
                                                                                                    Awarded
                                                                                                      Points
                                                                                           Points
B. Hazard Identification and Control
 1. Inspections

        a) Is there a written standard or procedure for the Inspection program?        0 - 10                    10                0         0

        b) Is there a formal inspection program in place that:

                 1 - has pre-determined frequency?                                     0-5                          5              0         0

                 2 - is assigned to positions?                                         0-5                          5              0         0

        c) Are there appropriate inspection checklists available for use by the        0 - 10                       5              0         5
            inspectors?
        d) Is there a system to ensure that deficiencies identified by inspections     0 - 20                       5           10           5
            are transferred to 'action lists' or 'work orders'?
        e) Is training available for those who are expected to perform the             0-5                          2              0         3
            inspections?
 2. Hazard Reporting

        a) Is there a system to identify hazards associated with the job, before the   0 - 15                       5              5         5
            job starts?
        b) Is there a system to identify, and communicate report hazards when          0 - 15                       5              5         5
            changes are made to operations?
        c) Is there training provided for the identification/recognition of            0 - 10                       5              0         5
            hazards?
 3. Risk Assessment

        a) Is there a system or procedure to assess and prioritize risk related to     0 - 30                    20             10           0
            each hazard and the assigning of responsibility for corrective action?
        b) Is there a process in place that ensures the risk associated with new       0 - 15                       5              5         5
            hazardous products are determined before purchasing them?
        c) Is there a system to assess risk associated with the hazards of new or      0 - 15                       5              0         10
            modified operations?
 4. Risk Control

        a) Is there an adequate maintenance program in place to satisfy                0 - 10                       5              5         0
            legislation requirements and industry practices?
        b) Is there evidence that manufacturers maintenance guidelines are             0-5                          2              0         3
            followed?
        c) Do employees utilize the risk controls in place?                            0-5                          0              3         2

        d) Is there evidence that management enforces the use of risk controls by      0-5                          2              0         3
            employees?
        e) Are there industry-standardized engineering codes and standards             0-5                          5              0         0
            available within the company?


Revised February 2003
                               Basic Safety Program Audit Instrument
                                                                         Type of Audit preformed:



                                        Element B Scoring Summary
                 Total points awarded
                                                                     =
                 Points available (185) - n/a         185

                 Start date:                    Last date on site:           Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

       B1a

      B1b1

      B1b2

       B1c

      B1d

       B1e

       B2a

      B2b

       B2c

       B3a

      B3b

       B3c

       B4a

      B4b

       B4c

      B4d

       B4e




Revised: February 2003
                               Basic Safety Program Audit Instrument




                                                                                                           Documentation

                                                                                                                           Observation
                                                                                    Maximum




                                                                                                                                         Interview
                                                                                                Awarded
                                                                                                  Points
                                                                                       Points
C. Rules and Work Procedures
 1. Safety Rules

        a) Does the company have standards or written rules for:

                 1 - the reporting of hazardous conditions, acts and behaviors?     0, 5                        5              0         0

                 2 - alcohol and drug abuse?                                        0, 5                        5              0         0

                 3 - personal protective equipment?                                 0, 5                        5              0         0

        b) Have health and safety rules been communicated to each employee         0 - 10                       2              5         3
            and posted as appropriate?
        c) Does the company have a method to ensure compliance with the rules?     0 - 10                       2              5         3

 2. Legislative Compliance

        a) *Does the company comply with Industry Standards for: (Yes, No)        Yes / No                      0              0         0

                 1 - jobsite conditions

                 2 - working environment

                 3 - supplies/storage

                 4 - equipment

                 5 - worker compliance

                 6 - emergency response systems

                 7 - label/signs.

        b) Is the company aware of and have copies of all legislation that is      0-5                          2              0         3
            applicable to their operation?
 3. Standard Work Procedures

        a) Is there a Task Inventory for each discipline?                          0 - 10                    10                0         0

        b) Is there a method of identifying the highest risk jobs?                 0 - 10                    10                0         0

        c) Have standard work procedures and/or Codes of Practice been written     0-5                          2              0         3
            for jobs found on the Hazardous Job Inventory?
        d) Are employees involved in the development and maintenance of             0, 5                        5              0         0
            procedures?
        e) Are the employees familiar with and making use of the standard work     0 - 10                       0           10           0
            procedures and codes of practice?




Revised February 2003
                               Basic Safety Program Audit Instrument




                                                                                                            Documentation

                                                                                                                            Observation
                                                                                     Maximum




                                                                                                                                          Interview
                                                                                                 Awarded
                                                                                                   Points
                                                                                        Points
C. Rules and Work Procedures
 4. Personal Protective Equipment

        a) Do employees have access to appropriate personal protective and          0-5                          0              3         2
            safety equipment?
        b) Are the employees wearing PPE when required?                             0 - 10                       0           10           0

        c) Are employees trained in the fitting of their PPE?                       0-5                          2              0         3

        d) Are employees trained in the proper care of their PPE?                   0-5                          2              0         3

 5. Enforcement

        a) Are there procedures in place for disciplining individuals who violate   0-5                          2              0         3
            company safety rules?
        b) Are the rules posted in each work area?                                  0-5                          0              5         0

 6. Emergency Procedures

        a) Are the appropriate number of employees trained in first aid as          0-5                          2              0         3
            required by occupational health and safety regulations?
        b) Are appropriate first aid equipment and supplies available at every      0 - 20                       0           20           0
            worksite in accordance with occupational health and safety
            regulations?
        c) Are there written emergency response plans for the following
            emergencies?
                 1 - Fire                                                            0, 5                        5              0         0

                 2 - Injury/death                                                    0, 5                        5              0         0

                 3 - Spills, leaks, and other releases of hazardous substances       0, 5                        5              0         0

                 4 - Natural disasters                                               0, 5                        5              0         0

        d) Are the emergency response plans communicated to all employees?          0 - 10                       5              5         0

        e) Is the training for emergency response plans communicated to all         0 - 10                       5              0         5
            employees?
        f) Are employees familiar with their ERP responsibilities?                  0 - 10                       0              0         10

        g) Are there drills and exercises held to test the ERP?                     0-5                          5              0         0

        h) Are drills and exercises evaluated to update the ERP?                     0, 5                        0              0         5




Revised February 2003
                               Basic Safety Program Audit Instrument
                                                                         Type of Audit preformed:



                                        Element C Scoring Summary
                 Total points awarded
                                                                     =
                 Points available (200) - n/a         200

                 Start date:                    Last date on site:           Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

      C1a1

      C1a2

      C1a3

      C1b

       C1c

      C2a

      C2b

      C3a

      C3b

       C3c

      C3d

       C3e

      C4a

      C4b

       C4c

      C4d

      C5a

      C5b

      C6a

      C6b

      C6c1

      C6c2

      C6c3

      C6c4

Revised: February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

      C6d

       C6e

       C6f

      C6g

      C6h




Revised: February 2003
                                 Basic Safety Program Audit Instrument




                                                                                                          Documentation

                                                                                                                          Observation
                                                                                   Maximum




                                                                                                                                        Interview
                                                                                               Awarded
                                                                                                 Points
                                                                                      Points
D. Training
 1. Safety Orientation

        a) Are appropriate orientations given to:

                 1 - employees ?                                                  0-5                          2              0         3

                 2 - contractors?                                                 0 - 15                       2           10           3

                 3 - subcontractors?                                              0-5                          2              0         3

                 4 - visitors?                                                    0-5                          2              0         3

        b) Does the orientation include a review of :

                 1 - company policies and procedures?                              0, 2                        0              0         2

                 2 - specific job hazards?                                         0, 2                        0              0         2

                 3 - safety precautions?                                           0, 2                        0              0         2

                 4 - job responsibilities?                                         0, 2                        0              0         2

                 5 - regulatory requirements?                                      0, 2                        0              0         2

                 6 - company enforcement policy?                                   0, 2                        0              0         2

                 7 - management's commitments towards workers right to know?       0, 2                        0              0         2

                 8 - procedure for workers to refuse unsafe work?                  0, 2                        0              0         2

                 9 - the role of supervisor when unsafe work is reported?          0, 2                        0              0         2

        c) Is the orientation conducted before the individual begins his or her   0-5                          5              0         0
            new job?
        d) Are critical issues (e.g., emergency evacuation procedures, alarm      0 - 10                       5              0         5
            systems, hazard reporting, etc.) addressed on the first day of
            employment?
 2. On-The-Job Training

        a) Is there evidence of an On-the-Job Training Program that covers        0-5                          2              0         3
            job-specific hazards?
        b) Is there a system that ensures that appropriate qualifications are     0 - 10                       5              0         5
            obtained by employees before they are allowed to perform their job?
        c) Is there a system to ensure that refresher training is provided to     0 - 10                    10                0         0
            employees?




Revised February 2003
                               Basic Safety Program Audit Instrument
                                                                        Type of Audit preformed:



                                        Element D Scoring Summary
                 Total points awarded
                                                                    =
                 Points available (88) - n/a          88

                 Start date:                   Last date on site:           Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

      D1a1

      D1a2

      D1a3

      D1a4

      D1b1

      D1b2

      D1b3

      D1b4

      D1b5

      D1b6

      D1b7

      D1b8

      D1b9

       D1c

      D1d

      D2a

      D2b

       D2c




Revised: February 2003
                                 Basic Safety Program Audit Instrument




                                                                                                              Documentation

                                                                                                                              Observation
                                                                                       Maximum




                                                                                                                                            Interview
                                                                                                   Awarded
                                                                                                     Points
                                                                                          Points
E. Communication
1. Communication Systems

        a) Is there a system in place to ensure employees are provided               0 - 10                        5              0         5
            communication and the opportunity to provide feedback on health and
            safety issues?
2. Safety Meetings

        a) Are there guidelines for conducting safety meetings with all               0-5                          2              0         3
            personnel?
        b) Are regular, scheduled meetings held with employees, contractors and      0 - 20                        5           10           5
            subcontractors to discuss current safety issues?
        c) *Is there a procedure to ensure the follow-up of significant items       Yes / No                       0              0         0
            identified during safety meetings? (Yes, No)
        d) Does senior management review significant items identified during          0-5                          0              0         5
            the safety meetings?
        e) Are minutes and attendance records for safety meetings kept?               0-5                          5              0         0

3. Safety Records

        a) Is there a system to retain essential safety documents for:

                 1 - training?                                                        0-5                          5              0         0

                 2 - inspections?                                                     0-5                          5              0         0

                 3 - incident reports?                                                0-5                          5              0         0

                 4 - investigations?                                                  0-5                          5              0         0

                 5 - safety meeting minutes?                                          0-5                          5              0         0

        b) Is there a system to evaluate the safety program?                         0 - 15                     15                0         0


                                                                                Type of Audit preformed:



                                         Element E Scoring Summary
                 Total points awarded
                                                                          =
                 Points available (85) - n/a             85

                 Start date:                     Last date on site:                 Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

       E1a

       E2a

      E2b

       E2c

      E2d

       E2e

      E3a1

      E3a2

      E3a3

      E3a4

      E3a5

      E3b




Revised: February 2003
                               Basic Safety Program Audit Instrument




                                                                                                                  Documentation

                                                                                                                                  Observation
                                                                                           Maximum




                                                                                                                                                Interview
                                                                                                       Awarded
                                                                                                         Points
                                                                                              Points
F. Incident and Accident Reporting and Investigation
 1. Incident and Accident Reporting

        a) Is there a written procedure for reporting and investigating incidents         0, 5                         5              0         0
            and accidents?
        b) Does the company have an incident/accident report form which guides            0-5                          5              0         0
            the investigator towards root cause?
        c) Does the procedure include a senior management review process?                 0-5                          2              0         3

        d) Are workers required to report all incidents and accidents?                   0 - 10                        5              0         5

        e) Are incidents and accidents being reported?                                   0 - 15                        2           10           3

 2. Incident and Accident Investigation and Follow-up

        a) Are all persons investigating incidents and accidents trained in              0 - 10                        5              0         5
            investigation techniques?
        b) Do investigations focus on collecting evidence and identifying root           0 - 10                        5              0         5
            causes?
        c) Is there a procedure for documenting and implementing investigator             0-5                          2              0         3
            recommendations?
        d) Is there a verification process to ensure corrective action is taken?         0 - 10                        5              0         5

        e) Is there a designated manager or supervisor who is responsible for the         0-5                          2              0         3
            coordination of the investigation process?
        f) Are statistics analyzed to identify trends?                                    0, 5                         5              0         0


                                                                                    Type of Audit preformed:



                                        Element F Scoring Summary
                 Total points awarded
                                                                          =
                 Points available (85) - n/a             85

                 Start date:                      Last date on site:                    Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

       F1a

       F1b

       F1c

       F1d

       F1e

       F2a

       F2b

       F2c

       F2d

       F2e

       F2f




Revised: February 2003
Basic Safety Program Audit Instrument


               Element G



           Effective Date January 1, 2003
                               Basic Safety Program Audit Instrument




                                                                                                                    Documentation

                                                                                                                                    Observation
                                                                                             Maximum




                                                                                                                                                  Interview
                                                                                                         Awarded
                                                                                                           Points
                                                                                                Points
G. Onsite-Audit Module (Optional)
  On-site Audit Module (Optional)

        1. Have all contractor and sub-contractors now on-site met the selection           0 - 20                     20                0         0
        criteria?
        2. Does every contractor company on-site have a valid Certificate of               0 - 10                        5              0         5
        Recognition (COR)?
        3. Have all contractors employees received a site-specific orientation             0 - 10                     10                0         0
        prior to starting work?
        4. Have all of the contract employees participated in a 'pre-job' meeting          0 - 10                        5              0         5
        today?
        5. Has a valid work permit been issued for the contractor for today's              0 - 10                        5              0         5
        work?
        6. Are there designated supervisors to supervise the contractor                    0 - 10                        0              0         10
        employees?
        7. Has there been an inspection for general conditions within the last five        0 - 10                        0              0         10
        (5) working days on this site?
        8. Has there been a formal site inspection within the last thirty (30) days        0 - 10                        5              5         0
        on this site, conducted by the Prime Contractor?
        9. Are the observable conditions of the contractors equipment meeting              0 - 10                        0           10           0
        the Prime Contractors equipment standards?
        10. Are there provisions for contract employees to report unsafe                   0 - 10                        0              0         10
        conditions on site?


                                                                                      Type of Audit preformed:



                                        Element G Scoring Summary
                 Total points awarded
                                                                          =
                 Points available (110) - n/a           110

                 Start date:                     Last date on site:                       Report completed:




Revised February 2003
                                  Basic Safety Program Audit Instrument


                                     Client being audited                     Date of audit


   Question              Points                             Auditor's Notes

       G1

       G2

       G3

       G4

       G5

       G6

       G7

       G8

       G9

      G10




Revised: February 2003
Basic Safety Program Audit Instrument


          Jobsite Evaluation

         Calculative Form for Question C2a


             Effective Date January 1, 2003
                     Basic Safety Program Audit Guidelines

Jobsite Evaluation

Use the attached jobsite evaluation form to determine how well the company being audited meets
company and regulatory requirements. In the first column, items to be evaluated at the worksite are
listed under groupings. All these items may not be present at every worksite and in some instances
new items may need to be added to the checklist.

Below is the procedure for calculating the jobsite evaluation score. The final score will be a
percentage of compliance with company and regulatory requirements.

1. For Every item evaluated, place a tick mark "|" on the appropriate line of the "Evaluated"
   column.

2. For every item evaluated, but found deficient, place a tick mark "|" on the appropriate line
   of the "Deficient" column.



        A. Jobsite Conditions                                Evaluated                Deficient
             1. Working surfaces                       |||| |||                ||
             2. Hallways / aisles                      |
             3. Stairways                              |||| |||| ||||          |
             etc.


3. Add the number of items evaluated. In the Score Calculation box at the end of this
   element, put that total in both of the "Total Evaluated" lines. Add the number of items
   found deficient. Put that total in the "Total Deficient" line. Subtract the Total Deficient
   from the Total Evaluated. Then divide that total by the Total Evaluated. Multiple by 100
   to get the percentage.

These observations exceed the Partnerships Standards, but are very important to the Petroleum
Industry. Therefore, the scoring of this section will produce a Yes or No answer to be entered into
Element C, question 2a.

80% and above = Yes
79% and below = No




Revised: February 2003
                            Basic Safety Program Audit Instrument


                          Client audited                                 Audit date


                                           Jobsite Evaluation
A. Jobsite Conditions                               Evaluated       Deficient
      1. Working surfaces
      2. Hallways / aisles
      3. Stairways
      4. Doorways
      5. Educational training rooms
      6. Lunchrooms / housekeeping
      7. Climbing devices
      8. Roadways
      9. Power line proximity
      0. Working platforms
B. Working Environment                              Evaluated       Deficient
      1. Lighting
      2. Energy sources
      3. Indoor air quality
      4. Floor design
C. Supplies / Storage                               Evaluated       Deficient
      1. Storage rooms
      2. Waste collections
      3. Material storage
      4. Fuels / hazardous chemicals
      5. Compressed gas cylinders
      6. Securing of loads / transportation
D. Equipment                                        Evaluated       Deficient
      1. Workstation
      2. Chairs
      3. Keyboard / mouse trays
      4. Monitor height
      5. Document holder
Revised: February 2003
                             Basic Safety Program Audit Instrument


                           Client audited                                 Audit date


                                            Jobsite Evaluation
      6. Footrests
      7. Printers
      8. Photocopiers
      9. Overhead filing cabinets
      0. Filing cabinets
      1. Electrical safety
      2. Guards and barriers
E. Worker Compliance                                 Evaluated       Deficient
      1. Compliance with work practices
      2. Compliance with legislation
      3. Compliance with work procedures
F. Emergency Response                                Evaluated       Deficient
      1. Emergency evacuation instructions
      2. Fire protection
      3. First aid supplies
      4. First aid attendants workstation signs
      5. Emergency telephones
      6. Eye wash / showers
G. Labels / Signs                                    Evaluated       Deficient
      1. Fire extinguisher MSDS
      2. Exits / evacuation
      3. Photocopiers / printers toner MSDS
      4. Lock-out systems
      5. Hazard Signs
      6. Alarms
      7. Noise Level Warning




Revised: February 2003
                                 Basic Safety Program Audit Instrument


                                 Client audited                              Audit date


                                                   Jobsite Evaluation



                                             SCORE CALCULATION


      Total                             - Total
  Evaluated                            Deficient
                                                                =       %=
                         Total
                     Evaluated                                                Score for
                                                                                C2a




Revised: February 2003
Basic Safety Program Audit Instrument


          Audit Guidelines



           Effective Date January 1, 2003
                               Basic Safety Program Audit Guidelines




                                                                                                             Documentation

                                                                                                                             Observation
                                                                                                 Maximum




                                                                                                                                           Interview
                                                                                                    Points
A. Management Involvement and Commitment
1. Company Safety policy
A written company safety policy can effectively convey management’s commitment
and positive attitude toward safety. When distributed, communicated and
consistently reinforced as important, it represents that on the most fundamental and
basic level, the company believes in preventing injury and loss. It demonstrates an
underlying philosophy and standard by which the remainder of the safety program
stems, and promotes accountability by assigning basic safety responsibilities.
Management must promote the policy and philosophy actively throughout the
company to be effective.

        a) Review the company's safety policy. If there is no policy, or the company is          0, 5             5              0         0
            unable to produce the policy during the time you are there, allocate 0 points.
            (Doc. 0, 5)
        b) Ensure policy contains:

                 1 - signature(s) of the most senior management, current within one year.        0, 3             0              3         0
                      (Obs. 0, 3)
                 2 - references to management responsibility. (Obs. 0, 2)                        0, 2             0              2         0

                 3 - requirement to comply with government regulations. (Obs. 0, 3)              0, 3             0              3         0

                 4 - reference to supervisor's responsibilities. (Obs. 0, 2)                     0, 2             0              2         0

                 5 - reference to workers' responsibilities. (Obs. 0, 2)                         0, 2             0              2         0

        c) Check to see if the policy is distributed to employees through handbooks, safety
            training programs, policy/program manuals, or new employee orientation.
            Interview workers to determine if they were given copies of the policy.
                 1. Confirm distribution of the policy. (Obs. 0 - 2) Employees confirm          0-5               0              2         3
                     distribution of the policy. (Int. 0 - 3)
                 2. Policy is posted in locations visible to the majority of employees on a     0 - 10            0           10           0
                     daily basis. Subtract one point for each failure to post at any critical
                     site. (remote sites, lunchrooms, main buildings, etc.) (Obs. 0 - 10)
                 3. When management carries out policy discussions, do the majority of          0-5               0              0         5
                     interviewees understand their responsibilities. Create interview
                     questions by verifying with meeting minutes, orientation records etc.
                     (Int. 0 - 5)




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                                                                                                                                        Interview
                                                                                                 Points
A. Management Involvement and Commitment
2. Guiding Principles
The extent to which a company is deemed to be acting to prevent injury and loss
among its workers and facilities is often measured by how well they measure up to
the standards set by their industry sector. The Petroleum Industry's Guiding
Principles on safety were developed by industry associations to promote the
importance of the safety function among their member companies. Adopting,
promoting, and exercising the industry guiding principles helps to demonstrate a
company’s willingness to align themselves with an accepted minimum standard of
conduct.

        a) Confirm that the guiding principles are posted in locations where employees      Yes / No           0              0         0
            and contractors are most likely to see them, along with the policy statement.
        b) Ensure management is committed to the philosophy stated in the guiding           Yes / No           0              0         0
            principles. Does the company live by the philosophy? Review training
            records, safety meeting minutes, and indoctrination handbook to ensure
            guiding principles are reviewed and contained within.




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                                                                                                                                          Interview
                                                                                                   Points
A. Management Involvement and Commitment
3. Safety Responsibilities
Assigning safety responsibilities is an important component of translating a safety
program from philosophy to functionality. Safety responsibilities establish
specifically who does what and when for activities identified in the safety program.
Responsibilities must be quantifiable in the safety program so that performance can
be measured or evaluated. Managers cannot control what they cannot measure. To
meet the intent of this element, the task or responsibility must be clearly stated, the
position responsible for performing the task must be identified, and the frequency of
the task performed must be included. Ensure that responsibilities are identified for
every position that may have an impact on safety within the company. This should
include managers, supervisors, employees, contractors and visitors.

        a) Review the written responsibilities and ensure they are measurable (who does
            what and when). Do responsibilities exist for all of the required positions in
            the company and are they specific to the positions in the company? Are the
            responsibilities complete for all elements of the program? Can the majority of
            employees produce or identify the location of a copy of their responsibilities?
            Are the responsibilities generally understood? Indicate 'n/a' if supervisors and
            contractors are non-existent in this organization. All companies should be
            prepared for visitors such as government agencies. If the responsibility is not
            developed, or if it is developed but not distributed, allocate 0 points. Insure
            individuals interviewed are given their responsibilities.

                 1. (Doc. 0, 1 + Int. 0, 1) - The Management function                           0-2              1              0         1

                 2. (Doc. 0, 1 + Int. 0, 1) - The Supervisory function                          0-2              1              0         1

                 3. (Doc. 0, 1 + Int. 0, 1) - Workers                                           0-2              1              0         1

                 4. (Doc. 0, 1 + Int. 0, 1) - Contractors                                       0-2              1              0         1

                 5. (Doc. 0, 1 + Int. 0, 1) - Visitors                                          0-2              1              0         1

        b) Ensure that a process for measuring performance of established safety goals          0-5              2              0         3
            and objectives are in place. At least annually, supervisors and their employees
            review the written responsibilities, goals and objectives to measure
            performance. Formal or informal systems of review exist. An informal system
            lacks documentation but can be verified through interviews. A formal system
            has consistent documentation and can be verified through interviews.
            1. If objectives are written with confirmation in writing of meeting these
            objectives. (Doc. 0, 2)
            2. If majority of interviews confirm worker knowledge of the system. (Int. 0 - 3)


        c) Resources and support should be available to managers, supervisors, and              0-5              0              0         5
            employees in the form of:
            1. Health and Safety resource person. (Int. 0 - 3)
            2. Budgetary support. (Int. 0 - 1)
            3. Training. (Int. 0 - 1)




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                                                                                                                                             Interview
                                                                                                      Points
A. Management Involvement and Commitment
4. Management Communication
Management communication activities help to unify all levels within a company
hierarchy towards a common goal by reinforcing the importance and rationale of
safety objectives. Management can only ensure long-term success in controlling
accidents and loss by influencing standards of behavior. Managers should
demonstrate their commitment to safety by communicating with employees at all
levels, contractors, clients, and suppliers on the importance of safety, safety
responsibilities and safety performance expectations.

        a) Review methods of communication (e.g. Newsletters, memo's, etc.). If no
            evidence of communication, insufficient evidence or senior management is not
            involved in the communication, allocate 0 points. Verify that communication
            occurred in the last 12 months, there is supporting documentation,
            documentation post / distributed and interviews confirm: Determine if
            communication specifically addresses:

                 1. why safety is important and who it affects. (Doc. 0, 2), (Obs. 0 - 5),        0 - 10            2              5         3
                     (Int. 0 - 3)
                 2. the company's commitment to safety. (Doc. 0, 2), (Obs. 0 - 5), (Int. 0 - 3)   0 - 10            2              5         3


        b) Review any documentation, e.g. log books, tour sheets and inspection records.
            Interview management, supervisors and workers to verify frequency and
            content of tours. Positions may not be applicable to all organizations. Tours
            must be verifiable and must include safety specific observations and
            discussions with workers. For each level of the organization, allocate either 2,
            5 or 10 points depending on frequency.

                 1. Senior management (2 or 5 or 10)                                              0 - 10            4              0         6

                         (Doc. 0, 4 + Int. 0 - 6) - quarterly

                         (Doc. 0, 2 + Int. 0 - 3) - semi-annually

                         (Doc. 0, 1 + Int. 0 - 1) - annually

                 2. Middle management (2 or 5 or 10)                                              0 - 10            4              0         6

                         (Doc. 0, 4 + Int. 0 - 6) - monthly

                         (Doc. 0, 2 + Int. 0 - 3) - quarterly

                         (Doc. 0, 1 + Int. 0 - 1) - semi-annually

                 3. Front line supervisors (2 or 5 or 10)                                         0 - 10            4              0         6

                         (Doc. 0, 4 + Int. 0 - 6) - daily

                         (Doc. 0, 2 + Int. 0 - 3) - weekly

                         (Doc. 0, 1 + Int. 0 - 1) - bi-weekly



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                                                                                                                                           Interview
                                                                                                    Points
B. Hazard Identification and Control
 1. Inspections
 Routine planned inspections are an effective pre-loss method of identifying
 hazardous conditions and acts, and are one way in which a company can act to
 satisfy the legislated requirement to prevent all reasonably foreseeable incidents and
 accidents. They involve a systemic review of a company's facilities, equipment, tools
 and the employees who use them. Inspections can ensure that company and
 legislative standards are being followed, and hazards are identified before they result
 in accidents.

        a) Verify that a formal standard (how, who, what, where, when) exists that sets         0 - 10         10                0         0
            the criteria for inspections. (Doc. 0 - 10)
        b) A formal inspection program will identify what needs to be inspected and the
            frequency. Review the company's requirement for conducting inspections.
            Use
            manufacturer's recommendations as a minimum standard for comparison: for
            example, log books for hoisting equipment. Ensure legislative requirements
                      d      d      k
               1. Determine if the intended frequency of the formal inspection program is       0-5               5              0         0
                   met. (Doc. 0 - 5)
                 2. Determine that positions are assigned for inspections. Verify that the      0-5               5              0         0
                     designated positions are performing the inspections. Inspections may
                     be performed by any of the following.
                     1. Safety committee members (Doc 0, 2)
                     2. Supervisors (Doc 0, 1)
                     3. Workers (Doc 0, 1)
                     4. Managers (Doc 0, 1)

        c) Review the company's inspection checklists. Ensure checklists are available for      0 - 10            5              0         5
            all applications including:
            1. Facilities (Doc 0, 1)
            2. Systems (Doc 0, 1)
            3. Equipment (Doc 0, 1)
            4. Job sites (Doc 0, 1)
            5. Actions/behavior of workers (Doc 0, 1)
            Interview workers to determine if they are using the appropriate checklist.
            (Int. 0 - 5)

        d) Review action lists or work orders to verify follow-up on identified deficiencies.   0 - 20            5           10           5
            (Doc. 0 - 5) Observe a sample of corrections. (Obs. 0 - 10) Interview
            supervisors to determine how deficiencies get corrected. (Int. 0 - 5)
        e) Training for inspections may be formal (documented) or informal                      0-5               2              0         3
            (on-the-job-training). Training records indicate formal inspection training.
            Review training records and inspection reports. (Doc. 0, 2) Interview
            employees who perform inspections to determine if training was provided.
            Verify that more than one person is participating. (Int. 0 - 3)




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                                                                                                                                        Interview
                                                                                                 Points
B. Hazard Identification and Control
 2. Hazard identification
 Hazard identification and risk control is the ongoing process of identifying
 hazardous conditions or acts and minimizing the associated risks. Hazard
 identification and risk control involves four steps: (1) identifying the hazard, (2)
 reporting the hazard, (3) evaluating the risks associated with the hazard, and (4)
 controlling the risks associated with the hazard. The hazard reporting process fills
 in the gaps between regularly scheduled inspections. This process can be informal
 and effective, although it is a little more difficult to prove the informal system's
 effectiveness.

        a) Look for methods used to identify hazards of any kind and communicated            0 - 15            5              5         5
            before the job starts (Hazard reporting, job planning, work permit, pre-job
            meetings, etc.). System exists. (Doc. 0, 5) Look for any type of hazard
            identification or information posting. (Obs. 0 - 5) Are hazards
            communicated? (Int. 0 - 5)
        b) Review the written procedure for identifying and reporting hazards when there     0 - 15            5              5         5
            are changes to the operation. (Doc. 0, 5) Observation of work areas for access
            to reporting system. (Obs. 0 - 5) Verify knowledge of the systems by
            interviewing workers and supervisors concerning their familiarity with the
            communication of the hazard reporting system. (Int. 0 - 5)
        c) Verify the workers have had exposure to training in hazard recognition. Check     0 - 10            5              0         5
            if the hazards are identified.
            1. OJT records and or training records (Doc 0 - 5)
            2. Interview (Int. 0 - 5)




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                                                                                                                                        Interview
                                                                                                 Points
B. Hazard Identification and Control
 3. Risk Assessment
 Performance of risk assessments is an important component of the employer’s duty to
 take all reasonable precautions to prevent injury or illness of their employees.
 Before hazards can be controlled, they must first be identified. Proper risk
 assessments consist of determining the potential for harm by physical, chemical or
 biological means from each task, process or product in use, and assigning a
 corresponding rating according to the severity potential of each hazard identified.
 Additionally, determining the risks associated with new processes or products before
 they are utilized can allow substitutions or modifications to be made that would
 eliminate or minimize the potential hazards identified. All identified risks must be
 scheduled for corrective action, and responsibility assigned.

        a) Review the procedure(s) in place for assessing risk (e.g. 'Task Inventory').      0 - 30         20             10           0
            (Doc. 0 - 10)
            1. Confirm that identified hazards are prioritized according to risk (e.g.
            'Frequency/severity ranking'). (Doc. 0 - 10)
            2. Verify that each identified risk has assigned responsibility for corrective
            action (e.g. posting hazard notices, ease of access to 'Job Hazard Analysis'
            etc.). (Obs. 0 - 10)

        b) Review procedure(s) for the purchasing of hazardous products. (Doc. 0 - 5)        0 - 15            5              5         5
            Ensure that hazard assessments are performed before purchases are made.
            (Obs. 0 - 5) Interview workers and supervisors to verify the procedure(s) are
            used. (Int. 0 - 5)
        c) Review procedure(s) requiring hazard assessments to be performed on all new       0 - 15            5              0         10
            or modified operations. (Doc. 0 - 5) Interview workers and supervisors to
            verify familiarity with the system. (Int. 0 - 10)




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                                                                                                                                          Interview
                                                                                                   Points
B. Hazard Identification and Control
 4. Risk Control
 Controls must be implemented for all identified risks so that the potential for harm
 to employees is reduced. In order of preference, risks can be controlled by the usage
 of engineering controls, administrative controls, or personal protective equipment. It
 is the responsibility of the employer to ensure that appropriate risk controls are in
 place and that the controls meet all legal requirements and industry standards.
 Management must monitor the use of implemented controls, employee knowledge of
 these controls, and must consistently create consequences to employees for
 non-compliance. Upkeep and maintenance of all company equipment according to
 legislated requirements, manufacturer’s guidelines and industry practices is an
 important part of the risk control program. The company must be aware of all
 applicable standards and engineering codes that apply to the equipment and work
 processes used at their worksites, and meet or exceed these standards.

        a) Review documents on equipment controlled by legislation (e.g. pressure relief       0 - 10            5              5         0
            valves, rig masts, etc.). (Doc. 0 - 5) Observe equipment to determine the
            effectiveness of the maintenance program by their appearance. (Obs. 0 - 5)
        b) Look for a maintenance library for reference materials from the manufacturer.       0-5               2              0         3
            (Doc. 0, 2) Interview maintenance staff to verify the use of those references.
            (Int. 0 - 3)
        c) Observe the conditions of those controls on site(s), such as, but not limited to:   0-5               0              3         2
            (Obs. 0 - 3)
            1. appropriate guards.
            2. appropriate signs.
            3. use of lifting devices.
            4. isolating/purging.
            5. lock out.
            Interview employees concerning the variety of controls at their disposal. (Int.
            0 - 2)

        d) Review records of non-compliance and action on them. (Doc. 0 - 3) Interview         0-5               2              0         3
            employees to determine familiarity. (Int. 0 - 2)
        e) Look for appropriate available information, such as:                                0-5               5              0         0
            1. CSA Standards
            2. ASME Standards
            3. IMS Standards
            4. IRP Guides
            5. API Standards
            6. Manufacturer Specifications.
            Award points for the use of appropriate standard guides. (Doc. 0 - 5)




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                                                                                                                                          Interview
                                                                                                   Points
C. Rules and Work Procedures
 1. Safety Rules
 Detailed rules and procedures identify company and legislative requirements and
 expectations of all employees and contractors. They serve as a reference and the
 minimum standard by which business is conducted. Most importantly, rules and
 procedures ensure consistency in the performance of tasks by all employees. They
 ensure that jobs are performed correctly every time, which results in the reduction of
 mistakes, accidents and loss. The auditor needs to know something about the work
 process to access whether rules and work procedures are complete. The auditor
 must review the process and be provided with a tour of the operations.

        a) Review written rules, assess whether they are appropriate for the
            operation/facility, employees, etc. Do the rules address the hazards associated
            with the critical work task performed by the company?
                 1. Confirm the reporting of hazards. (Doc. 0, 5)                              0, 5              5              0         0

                 2. Confirm the existence of an effective drug and alcohol rule. (Doc. 0, 5)   0, 5              5              0         0

                 3. Ensure rules exist for personal protective equipment. These rules          0, 5              5              0         0
                     should address what type of equipment is required, when and where it
                     is to be worn and the care and maintenance of the equipment. (Doc. 0,
                     5)
        b) Review documentation to determine if rules are referred to during orientation,      0 - 10            2              5         3
            safety meetings and training sessions. (Doc. 0, 2) Observe if rules are posted
            around equipment or in areas requiring the use of personal protective
            equipment (eye protection at grinders and drill presses, hearing protection for
            high noise level areas, etc.). (Obs. 0 - 5) During interviews determine if the
            rules have been distributed and if they have been effectively communicated to
            each employee and contractor. (Int. 0 - 3)

        c) Check for a system that will promote compliance to safety rules. This may be        0 - 10            2              5         3
            in the form of positive reinforcement program. Check for the existence of
            written employee responsibilities / accountabilities regarding the compliance to
            safety rules. (Doc. 0, 2) Observe if rules are posted and how the workers
            follow these rules. (Obs. 0 - 5) Interview workers to determine the level of
            understanding with respect to the intent and compliance with these rules. (Int.
            0 - 3)




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                                                                                                                                            Interview
                                                                                                     Points
C. Rules and Work Procedures
 2. Legislative Compliance
 To answer this question you must use Jobsite Evaluation. Legislative compliance
 should be considered the minimum basic standard by which the company operates.
 Rules and work procedures must follow or exceed the intent of the legislation. In
 order to assess legislative compliance, the Auditor must know what acts and
 regulations affect the company/industry and possess a good understanding of the type
 of requirements contained within.

        a) Follow the 'Jobsite Evaluation' instructions in the Basic Safety Program Audit.      Yes / No           0              0         0
            Using the Jobsite Evaluation Form, conduct an evaluation of the work site(s).
            Notes must be made of any deficiencies found during the evaluation. Each
            deficiency may be an indication of a Basic Safety Program element which is
            not functioning properly.

                 1 - jobsite conditions

                 2 - working environment

                 3 - supplies/storage

                 4 - equipment

                 5 - worker compliance

                 6 - emergency response systems

                 7 - label/signs.

        b) Verify that the company has access to all applicable legislation (Federal,            0-5               2              0         3
            Provincial, Municipal, etc.). (Doc. 0, 2) Interview managers and supervisors
            to verify the level of knowledge they have of the legislation that applies to the
            company. (Int. 0 - 3)




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                                                                                                                                          Interview
                                                                                                   Points
C. Rules and Work Procedures
 3. Standard Work Procedures
 The intent of a procedure is to ensure consistency in the performance of hazardous
 work and to form the minimum standard by which a specific task is performed. All
 procedures should be written in an easily referenced format and readily available to
 the worker performing the tasks. Workers must have a clear understanding of the
 procedures they are required to follow. A system for periodic review of procedures
 should exist. Workers should be observed to determine if they are following
 procedures. All employees involved in the work task should be given the opportunity
 to suggest steps that would provide for improved work procedures.

        a) Hazardous jobs should have been identified by discipline (maintenance,              0 - 10         10                0         0
            operations, drilling, etc.). The list should indicate the jobs which have the
            potential to injure competent workers. Deduct proportionately for each
            discipline found without a Task Inventory (e.g. if four disciplines are
            identified, and only two Task Inventories are written, deduct 50%). (Doc. 0 -
            10)

        b) Confirm that a ranking system has been developed to identify high risk for          0 - 10         10                0         0
            hazardous work (e.g. Frequency / Severity). (Doc. 0 - 10)
        c) Confirm that procedures and/or Codes of Practice (e.g. Confined Space Entry)        0-5               2              0         3
            have been developed for hazardous work and must satisfy applicable
            legislation. (Doc. 0, 2) Interview workers to determine if they are aware of the
            applicable task procedures, and the content and location of these procedures.
            (Int. 0 - 3)
        d) Confirm that procedures and/or Codes of Practice have been developed with            0, 5             5              0         0
            input from employees. (Doc. 0, 5)
        e) Review records to ensure that employees receive training on hazardous work          0 - 10            0           10           0
            procedures and Codes of Practice. Where practical, observe employees
            performing critical tasks to confirm use of Standard Work, Procedures and
            Codes of Practice. (Obs. 0 - 10)

 4. Personal Protective Equipment
 Procedures and rules for the use of personal protective equipment (PPE) should be
 written and known by all employees. Adequate and appropriate equipment should
 be readily available to all employees for their use. The auditor must be familiar with
 the fitting, use, cleaning, maintenance and application of PPE. Special attention
 should be given to items such as the type of condition of cartridges and respirators;
 the operability and use of safety belts, harness and fall arrest devices.

        a) Verify that there is an adequate supply that is readily available. (Obs. 0 - 3)     0-5               0              3         2
            Confirm that the employees know where the PPE is stored. (Int. 0 - 2)
        b) Confirm that employees are wearing PPE when required. (Obs. 0 - 10)                 0 - 10            0           10           0

        c) Confirm through documentation that records are available for the fitting of PPE     0-5               2              0         3
            where applicable. (Doc. 0, 2) Interview workers to confirm they have been
            trained in the use of PPE and safety equipment. (Int. 0 - 3)
        d) Confirm through documentation that records are available for training on the        0-5               2              0         3
            care of PPE. (Doc. 0, 2) Interview workers to confirm if they know where to
            find information on the care of their PPE. (Int. 0 - 3)

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                                                                                              Points
C. Rules and Work Procedures
 5. Enforcement
 An enforcement policy should be based on positive reinforcement which recognizes
 safety behaviors and correcting violations immediately. The employees must have a
 clear understanding of the intent of the rules, and training must be provided
 regarding what behavior's are expected. Corrective actions to prevent recurrence
 with non-compliance to rules should be consistent with guidelines that have been
 established by the company. The reason why the rule was not followed should always
 be considered in order to alter sub-standard behavior. A written discipline policy
 that provides supervisors with a step-by-step guide on how to administer discipline in
 a consistent manner should be available and communicated to all employees

        a) Review the disciplinary policy, training and orientation records to confirm     0-5              2              0         3
            communication. (Doc. 0, 2) Confirm that the enforcement policy is effective.
            Interview employees to confirm that the policy has been communicated, and
            have general knowledge of the policy. (Int. 0 - 3)
        b) Verify that appropriate rules are posted in work areas. Rules would include     0-5              0              5         0
            such items as smoking and PPE, etc. Subtract one point for each area without
            posted rules. (Obs. 0 - 5)




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                                                                                                                                          Interview
                                                                                                   Points
C. Rules and Work Procedures
 6. Emergency Procedures
 Emergency procedures should identify specific tasks and the personnel assigned
 those tasks in the event of an emergency. The individual in charge of coordinating
 the emergency actions must be identified. All emergency scenarios should be
 identified. The procedures must be easily referenced, concise and understandable.
 All employees must be aware of content and location of the procedures. The contact
 lists associated with the procedures must be current. The procedures must be
 updated and tested on a regular basis.

        a) Check training records to verify that employee first aid training is current, and   0-5               2              0         3
            the appropriate level and number for the work site. Confirm that peak
            employment periods such as shutdowns, construction, etc. are in compliance.
            Include subcontractors. (Doc. 0, 2) Confirm by interviewing employees. (Int.
            0 - 3)
        b) Confirm that the required equipment is available and easily accessible to           0 - 20            0           20           0
            workers. Verify that the equipment functions properly and that it is in clean
            condition. (Obs. 0 - 20)
        c) A plan may consist of procedures, postings, training, testing and drills.
            Procedure details would include safe areas, search and rescue, emergency
            response provisions, medical transportation, notification of next of kin, etc.
                 1. Fire (Doc. 0, 5)                                                            0, 5             5              0         0

                 2. Injury / death (Doc. 0, 5)                                                  0, 5             5              0         0

                 3. Spills, leaks, and other releases of hazardous substances (Doc. 0, 5)       0, 5             5              0         0

                 4. Natural disasters (Doc. 0, 5)                                               0, 5             5              0         0

        d) Determine that the ERP call system includes personnel contacts, sequence and        0 - 10            5              5         0
            timing. (Doc. 0, 5) Observer posting / availability of call down list and
            availability of some sort of communication system. (Obs. 0 - 5)
        e) Verify ERP training has been provided. Confirm records of drills. (Doc. 0 - 5)      0 - 10            5              0         5
            Interview employees to determine familiarity of the ERP plan. (Int. 0 - 5)
        f) Interview employees concerning their responsibilities for emergency response.       0 - 10            0              0         10
             Award points for ability to describe. (Int. 0 - 10)
        g) Review the ERP and records of drills to determine if drills are being held at       0-5               5              0         0
            least annually. (Doc. 0, 5)
        h) Look at revision date on the ERP. Verify through interviews that the plan is         0, 5             0              0         5
            updated based on feedback from drills. (Int. 0, 5)




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                                                                                                                                         Interview
                                                                                                  Points
D. Training
 1. Safety Orientation
 Initial safety training is one of the most important aspects of any safety program. All
 employees and contractors must receive some level of basic safety training, specific to
 the facility / process / company prior to starting work. IRP 16 will be the standard
 for minimum level of generic information needed to complete an orientation not
 including site-specific information.

        a) Check the company policies and interview workers to verify the requirements
            for safety orientations. Confirm who is responsible for conducting the
            orientation and what worker acknowledgement is required. Are appropriate
            orientations given to:
                 1) newly-hired or transferred employees? (Doc. 0, 2) (Int. 0 - 3)            0-5               2              0         3

                 2) contractors? (Doc. 0, 2), (Int. 0 - 3) As the Auditor, you are still      0 - 15            2           10           3
                     required to have an orientation whether you are viewed as a contractor
                     or visitor. This observation must include all sites visited during the
                     audit process. Does the orientation cover the basic requirement of IRP
                     16? (Obs. 0 - 10)

                 3) sub-contractors? (Doc. 0, 2), (Int. 0 - 3)                                0-5               2              0         3

                 4) visitors? (Doc. 0, 2), (Int. 0 - 3)                                       0-5               2              0         3

        b) Interview workers based on the review of the company policies and procedures.
            Are all appropriate elements included? Does the orientation include a review
            of:
                 1. company policies and procedures? (Int. 0, 2)                               0, 2             0              0         2

                 2. specific job hazards? (Int. 0, 2)                                          0, 2             0              0         2

                 3. safety precautions? (Int. 0, 2)                                            0, 2             0              0         2

                 4. job responsibilities? (Int. 0, 2)                                          0, 2             0              0         2

                 5. regulatory requirements? (Int. 0, 2)                                       0, 2             0              0         2

                 6. company enforcement policy? (Int. 0, 2)                                    0, 2             0              0         2

                 7. management's' commitments towards workers right to know? (Int. 0, 2)       0, 2             0              0         2

                 8. procedure for workers to refuse unsafe work? (Int. 0, 2)                   0, 2             0              0         2

                 9. the role of supervisor when unsafe work is reported? (Int. 0, 2)           0, 2             0              0         2

        c) Review documentation to determine if safety orientation is an integral part of     0-5               5              0         0
            the training program. Verify that the orientation takes place at the earliest
            possible stage of employment (usually within the first week on the job). (Doc.
            0, 5)




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D. Training
        d) Interview and verify with documentation that critical issues are addressed on        0 - 10            5              0         5
            the first day of the job, or the first day on a new job site. Critical issues may
            include emergency procedures, alarm systems, near miss/hazard reporting, etc.
            (Doc. 0 - 5), (Int. 0 - 5)

 2. On-The-Job Training
 On-The-Job Training (OJT) provides workers with ongoing training after the initial
 orientation. This relates to task-specific training provided at the work place, that
 provides the knowledge and motivation to perform a task the right way each time. It
 can be used in conjunction with an evaluation program, to ensure that workers are
 competent in a position and ready to move on to another. OJT should be provided to
 all workers who are new to a work site, or when procedures or processes change, etc.
 The program must also identify when someone is required to be trained or required
 to demonstrate competency levels and who is responsible for providing the training.

        a) OJT may be formal (documented) or informal (no documentation). Award                 0-5               2              0         3
            points only if OJT is provided consistently. Check for training records,
            responsibilities, training requirements and required competency levels. (Doc.
            0, 2) Interview new employees to determine what OJT has been provided and
            what hazards were identified during the training. (Int. 0 - 3)

        b) Determine the process of competence verification (e.g. checking certification        0 - 10            5              0         5
            and licenses, use of a job log, planned job observation, worker pairing, etc).
            Award points based on application of the OJT. (Doc. 0 - 5) Interview workers
            to determine if they were required to obtain appropriate qualifications prior to
            beginning work. Example: H2S Alive, Driver training, PST, etc. (Int. 0 - 5)

        c) Review training records and certification requirements. Award points based on        0 - 10         10                0         0
            the percentage that is up-to-date (e.g. H2S, First Aid, Confined Space,
            WHMIS). (Doc. 0 - 10)




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E. Communication
1. Communication Systems
Communication between the employer and employee is very important. Formal
communication systems take the form of safety meetings, health and safety
committees, suggestion boxes, newsletters, health and safety tours, etc. To be
effective, the system must allow the workers to freely provide input into the system
and receive feedback on the issues without fear of reprisals.

        a) Review policies and procedures to verify that there is a communication system.       0 - 10            5              0         5
            Ensure the system allows for two-way communication, and includes a feedback
            loop. An action log or similar system must be in place which assigns
            responsibility and timing for action items. (Doc. 0 - 5) Interview employees to
            determine if they are given the opportunity to provide input and receive
            feedback. (Int. 0 - 5)

2. Safety Meetings
Safety meetings are intended as group communication sessions to provide
information on new company programs, initiatives and procedures. This is an
important part of training and refresher training. Input of safety suggestions and
practical recommendations should be sought from employees.
        a) Review safety meeting guidelines. Determine if they include schedules,               0-5               2              0         3
            responsibilities, key topics, and standards for attendance. (Doc. 0, 2)
            Interview employees to verify that they are given the opportunity to attend.
            (Int. 0 - 3)
        b) Review meeting minutes to verify that meetings are being scheduled on a              0 - 20            5           10           5
            regular basis. (Doc. 0, 5) Attend a safety meeting to observe first hand that
            safety issues are being discussed on a timely basis. (Obs. 0 - 10) Interview
            workers to verify that the meetings are occurring on some sort of regular basis.
            (Int. 0 - 5)

        c) Review the procedure(s) to ensure that action items are addressed. Interview        Yes / No           0              0         0
            employees to test effectiveness of safety meeting follow-up. (Yes, No)
        d) Interview senior management to verify the review of both unresolved and              0-5               0              0         5
            significant items identified during safety meetings. (Int. 0 - 5)
        e) Verify that meeting minutes with attendees are on file. (Doc. 0 - 5)                 0-5               5              0         0




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E. Communication
3. Safety Records
Retaining detailed records of safety-related activities provides a valuable tool for
program evaluation. These records allow for the identification of safety system
deficiencies, measurement of progress, analysis of trends, and provide a written
account of prior safety activities in the event of a serious incident. Internal and
external audits performed at the appropriate frequency are a means of evaluating
the level of program functionality and effectiveness, and provide the company with
an ongoing opportunity to correct identified deficiencies before they lead to incidents
or accidents.

        a) Look at the document handling or document management system. Award
            points based on the percentage of documents for each set in the system.
                 1. Training (Doc. 0 - 5)                                                    0-5               5              0         0

                 2. Completed inspection forms (Doc. 0 - 5)                                  0-5               5              0         0

                 3. Completed incident reports (Doc. 0 - 5)                                  0-5               5              0         0

                 4. Completed investigation reports (Doc. 0 - 5)                             0-5               5              0         0

                 5. Safety meeting minutes (Doc. 0 - 5)                                      0-5               5              0         0

        b) Verify that the safety program is being evaluated (audited) both internally and   0 - 15         15                0         0
            externally. Determine the required frequency of the evaluations and confirm
            the last two evaluations were performed on time:
            1. External audit. n/a if this is the first audit.
            2. Maintenance audit. n/a if this is the first audit.
            3. 2nd Maintenance audit completed on or before the anniversary
            4. Renewal audits completed on or before the anniversary date of the COR.
            (Doc 0 - 15)




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F. Incident and Accident Reporting and Investigation
 1. Incident and Accident Reporting
 All types of accidental loss or near loss should be reported, either verbally or in
 writing. Loss reporting includes but is not limited to injury, property damage,
 equipment failure, environmental damage, security-related loss, vehicular damage or
 near-misses. All employees should know of the requirement to report accidents and
 incidents and how this process works. Written guidelines should be provided that
 identify the responsibilities and requirements for notification, reporting,
 investigation, and follow-up.

        a) Review the procedure and confirm that it outlines a company-specific process          0, 5             5              0         0
            for reporting incidents and accidents. (Doc. 0, 5)
        b) Review a copy of the incident/accident report form. Does it guide the                0-5               5              0         0
            investigator to a root cause? (Doc. 0 - 5)
        c) Review the procedure and confirm that it includes a senior management review         0-5               2              0         3
            process. (Doc. 0, 2) Interview senior management to verify that they review
            incident/accident reports. (Int. 0 - 3)
        d) Review the written policy and verify that employees are required to report all       0 - 10            5              0         5
            types of loss and potential loss (near miss reporting). (Doc. 0, 5), (Int. 0 - 5)
        e) Review documents to verify written reporting as per company policy. (Doc. 0,         0 - 15            2           10           3
            2) Observe equipment for unreported damage. (Obs. 0 - 10) Interview
            employees to verify all incidents and accidents are being reported. (Int. 0 - 3)




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F. Incident and Accident Reporting and Investigation
 2. Incident and Accident Investigation and Follow-up
 All accidents and near-miss incidents should be investigated to determine the cause
 and the action required to prevent a recurrence. Employees required to perform
 investigations should be trained in accident investigation techniques. Investigation
 reports should concentrate on determining the root causes, what management
 system failed, and what the company can do to prevent another similar loss. This
 should be a 'fact finding' exercise rather than 'fault finding'.

        a) Review training records and establish whether the appropriate persons have         0 - 10            5              0         5
            been trained. Confirm that the level of training is adequate. Confirm that the
            required knowledge provided enables the investigators to adequately
            investigate accidents. (Doc. 0 - 5) Interview designated investigators to
            determine if they have been trained. (Int. 0 - 5)

        b) Review completed incident/accident forms. Confirm that sufficient evidence         0 - 10            5              0         5
            was collected and that the identified root causes are appropriate. (Doc. 0 - 5)
            Interview investigators to determine if they focus on evidence collection and
            understand what a root causes is. (Int. 0 - 5)
        c) Review the procedures for incident/accident investigation. There may be a          0-5               2              0         3
            separate procedure for implementing recommendations. Confirm that a
            procedure exists that clearly defines how recommendations are to be
            documented. Confirm that procedures exists for assigning accountability for
            the implementation of those documented recommendations. (Doc. 0, 2)
            Interview investigators and confirm that they are aware of the procedures for
            documenting recommendations and the assigned accountability. (Int, 0 - 3)

        d) Determine if there is an established process for confirming that corrective        0 - 10            5              0         5
            action has been taken once the recommendations have been implemented.
            Typically, this would be a follow-up inspection by the safety committee or a
            joint worker/management review of the problem area to ensure that the
            incident/accident cannot reoccur. (Doc. 0, 5) Interview workers to confirm an
            effective verification process is in place. Determine if workers are content
            with the incident/accident follow-up process. (Int, 0 - 5)

        e) Review the accident investigation procedure for a designated                       0-5               2              0         3
            manager/supervisor that coordinates the investigation. (Doc. 0, 2) Interview
            investigators to determine if they are aware of who is responsible for
            coordination of investigations. (Int. 0 - 3)
        f) Verify that documentation exists which confirms internal or external statistics     0, 5             5              0         0
            are analyzed for trends. (Doc. 0, 5)




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G. Onsite-Audit Module (Optional)
 On-Site Module (Optional)
 The intent for this element is to be used on medium and large companies that hire out
 to contractors to be Prime Contractor Representatives for them. When doing an
 Audit (External / Maintenance / Renewal)) ask your client if they have contracted
 representatives in the field. The client has the option of you completing this element
 to see how their contracted person(s) are doing. This element stands alone from the
 main protocol and the score achieved within, does not reflect on the overall score of
 the protocol.

        1. Verify by documentation. Records should indicate pre-qualification criterion.       0 - 20         20                0         0
            Award points proportionately for the documents covering contractors. (Doc. 0
            - 20)

        2. Confirm COR documentation is available and valid. (Doc. 0 - 5) Interview the        0 - 10            5              0         5
            manager responsible for hiring the contractor. (Int. 0 - 5)
        3. Verify by reviewing attendance sheets. Award points for percentage of               0 - 10         10                0         0
            contractor's employees orientated. (Doc. 0 - 10)
        4. Verify by reviewing pre-job meeting minutes. (Doc. 0 - 5) Interview                 0 - 10            5              0         5
            employees and award points for the percentage of positive confirmation. (Int.
            0 - 5)
        5. Verify by obtaining a copy of the permit. (Doc. 0 - 5) Interview contractors for    0 - 10            5              0         5
            general knowledge of the terms of the permit. Award points for positive
            indicators. n/a if not applicable. (Int. 0 - 5)
        6. Interview contractor's employees. Continuous supervision should be available.       0 - 10            0              0         10
            Award points based on positive confirmation. (Int. 0 - 10)
        7. Verify by interviewing contractor employees/supervisors to determine who            0 - 10            0              0         10
            performed the inspections. Award points for the percentage of sites that have
            been inspected. (Int. 0 - 10)

        8. Verify by reviewing inspection reports and determine if deficiencies have been      0 - 10            5              5         0
            corrected. If no deficiencies are indicated, compare the auditor's report with a
            visual inspection of your own to determine the completeness of the auditor's
            inspection. Award points for positive indicators. (Doc. 0 - 5), (Obs. 0 - 5)

        9. Verify by documentation and observation of equipment on site. Award points          0 - 10            0           10           0
            for the percentage of positive indicators. (Obs. 0 - 10)
        10. Verify by interviewing employees. Award points for the percentage of positive      0 - 10            0              0         10
            indicators. (Int. 0 - 10)




Revised February 2003
                                        Recommendations

                                                                            Date of audit


                         Element A. Management Involvement and Commitment
      Possible Points            107    Actual Points           Score




Revised: February 2003
                                     Recommendations

                                                                        Date of audit


                         Element B. Hazard Identification and Control
      Possible Points        185     Actual Points              Score




Revised: February 2003
                                 Recommendations

                                                                   Date of audit


                         Element C. Rules and Work Procedures
      Possible Points     200     Actual Points            Score




Revised: February 2003
                              Recommendations

                                                            Date of audit


                              Element D. Training
      Possible Points    88   Actual Points         Score




Revised: February 2003
                                 Recommendations

                                                                 Date of audit


                              Element E. Communication
      Possible Points    85      Actual Points           Score




Revised: February 2003
                                    Recommendations

                                                                           Date of audit


                 Element F. Incident and Accident Reporting and Investigation
      Possible Points        85      Actual Points              Score




Revised: February 2003
                                   Recommendations

                                                                      Date of audit


                         Element G. Onsite-Audit Module (Optional)
      Possible Points       110     Actual Points             Score




Revised: February 2003