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					                                     JHSC
                               Workplace Inspection
                                             (Checklist Template)




           June 2002
           Corporate Services
           Human Resources
           Occupational Health, Safety and Workers’ Compensation Unit



…/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                              Page 1 of 17
                                                 JHSC Workplace Inspection Checklist Template
               Attached is a Joint Health & Safety Committee (JHSC) Workplace Inspection Checklist template. This
               checklist is provided to support JHSC in the development of their specific workplace inspection checklist.
               It is up to individual committees to determine the level of detail that is necessary for their respective
               workplaces (for assistance contact your local Health & Safety Consultant).
               This template can be saved as a Word document and sections can be added or deleted as applicable for the
               specific workplace. Links to related Resources are provided in the live document posted on the Health &
               Safety Intranet site. If you require assistance with accessing or manipulating this document contact the
               Occupational Health, Safety and Workers’ Compensation Unit at 2-5497.

               Checklist Content

AIR SAMPLING SYSTEM ............................................................................................................................................................................... 4
   GENERAL VENTILATION (I.E. HEATING VENTILATION AIR CONDITIONING SYSTEM) ........................................................................................ 4
   LOCAL EXHAUST VENTILATION (E.G. FUMEHOODS, PAINT BOOTHS, HOODS, DUST COLLECTION EQUIPMENT, ETC.) .......................................... 4
AISLES & PASSAGEWAYS, ACCESS & EGRESS, FLOORS & STAIRWAYS ...................................................................................... 4
   AISLES AND PASSAGEWAYS ............................................................................................................................................................................... 4
   ACCESS AND EGRESS ......................................................................................................................................................................................... 4
   FLOOR AND STAIRWAYS .................................................................................................................................................................................... 4
CONFINED SPACE (AS DEFINED BY THE OHSA AND WORK PRACTICE)........................................................................................... 4

ELECTRICAL .................................................................................................................................................................................................... 4
   ELECTRICAL POWER SYSTEMS........................................................................................................................................................................... 4
ELEVATING DEVICES (FOR MOVEMENT OF PERSONS) ..................................................................................................................... 5

EMERGENCY EQUIPMENT AND PROCEDURES ..................................................................................................................................... 5
   FIRST AID KITS/STATIONS/EQUIPMENT ............................................................................................................................................................. 5
   EYE WASH/BATH & DELUGE SHOWERS ............................................................................................................................................................. 5
   FIRE PREVENTION AND FIRE PROTECTION ......................................................................................................................................................... 5
   EMERGENCY LIGHTING ...................................................................................................................................................................................... 5
EXCAVATION ................................................................................................................................................................................................... 6

FALL PROTECTION ........................................................................................................................................................................................ 6

HAZARDOUS / DESIGNATED SUBSTANCES............................................................................................................................................. 6
   BATTERY ROOMS............................................................................................................................................................................................... 6
   CHEMICALS/SOLVENTS/CLEANERS.................................................................................................................................................................... 6
   FUELS/FLAMMABLES/COMBUSTIBLES ............................................................................................................................................................... 6
   COMPRESSED GASES (CONSIDER ALL PRESSURE CYLINDERS: SCBA, O2, WELDING, SPRAY CANS, ETC.) .......................................................... 7
   TANK STORAGE SYSTEMS .................................................................................................................................................................................. 7
DESIGNATED SUBSTANCES ......................................................................................................................................................................... 7
   ASBESTOS .......................................................................................................................................................................................................... 7
   ACRYLONITRILE, ARSENIC, BENZENE, COKE OVEN EMISSIONS, ISOCYANATES, LEAD, MERCURY, SILICA, VINYL CHLORIDE .......................... 7
GENERAL HOUSEKEEPING ......................................................................................................................................................................... 7
   EMPLOYEE FACILITIES (KITCHENS/WASHROOMS/SHOWER/ CHANGE ROOMS) .................................................................................................. 7
LADDERS & SCAFFOLDS .............................................................................................................................................................................. 8
   LADDERS ........................................................................................................................................................................................................... 8
   SCAFFOLD & PLATFORMS .................................................................................................................................................................................. 8
LIGHTING .......................................................................................................................................................................................................... 8
   GENERAL LIGHTING........................................................................................................................................................................................... 8
   OFFICE LIGHTING .............................................................................................................................................................................................. 8
LOCKOUT/BARRICADES ............................................................................................................................................................................... 8

MACHINERY AND MACHINE GUARDING ................................................................................................................................................ 8
   CONVEYORS ...................................................................................................................................................................................................... 9
   HYDRAULIC SYSTEMS........................................................................................................................................................................................ 9
   GRINDING WHEELS ............................................................................................................................................................................................ 9
MATERIAL HANDLING & STORAGE ....................................................................................................................................................... 10
   MATERIAL HANDLING (MECHANICAL) ............................................................................................................................................................ 10
   MANUAL MATERIAL HANDLING (REFER TO RESOURCES FOR THOROUGH CHECKLIST ON MANUAL MATERIAL HANDLING).............................. 10
   STACKING AND STORAGE ................................................................................................................................................................................ 10
   LABELLING ...................................................................................................................................................................................................... 10
   PORTABLE CONTAINERS OF FLAMMABLE SUBSTANCES................................................................................................................................... 10
MOULD MANAGEMENT .............................................................................................................................................................................. 10

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NOISE ................................................................................................................................................................................................................ 10

OFFICE AREAS ............................................................................................................................................................................................... 11
   PHOTOCOPIERS ................................................................................................................................................................................................ 11
   MANUAL MATERIAL HANDLING ...................................................................................................................................................................... 11
POWER SYSTEMS .......................................................................................................................................................................................... 12
   PNEUMATIC POWER SYSTEM, AIR COMPRESSORS, COMPRESSED AIR HOSES AND HOSE ATTACHMENTS........................................................ 12
PERSONAL PROTECTIVE EQUIPMENT (PPE) ....................................................................................................................................... 12

SAFETY NOTICE BOARDS .......................................................................................................................................................................... 12

SPRAY PAINTING OPERATIONS ............................................................................................................................................................... 12

TOOLS ............................................................................................................................................................................................................... 12

TRAINING ........................................................................................................................................................................................................ 12

VEHICLE INSPECTIONS .............................................................................................................................................................................. 13
   TIRE CAGE (AS USED IN SELECTED GARAGES) .................................................................................................................................................. 13
WORK BENCH ................................................................................................................................................................................................ 13
   HOUSEKEEPING................................................................................................................................................................................................ 13
   CONTAINERIZED PRODUCTS ............................................................................................................................................................................ 13
WARNING SYSTEMS, COLOUR CODING ................................................................................................................................................ 13

WELDING ......................................................................................................................................................................................................... 13




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                                     JHSC Workplace Inspection Checklist Template

                                             Categories / Contents                                                   Resources
       Air Sampling System
         Are supply and exhaust vents and ductwork cleaned regularly? Is there a log of cleaning
          activities?                                                                                          Industry IAQ standards:
        Are air filters changed on a routine schedule?                                                        -Health Canada, Ministry
        Are humidifiers, cooling coils and drain pans kept free of stagnant water and inspected for
                                                                                                               of Labour guidelines,
                                                                                                               Canadian Standards
          mould, and other bio-contaminants?                                                                   Association, American
        Is a copy of the ventilation inspection report provided to the JHSC?                                  Society of Heating
        Are mechanical ventilation systems inspected on a regular basis and are there records of              Refrigeration and Air
          inspections and performed maintenance?                                                               Conditioning Engineers
       General Ventilation (i.e. Heating Ventilation Air Conditioning System)                                  (ASHRAE)
        Are the supply vents and exhaust vents clean?
        Is air movement coming from the supply vents and being drawn out through the exhaust vents?
        Are the thermostats working?                                                                          Building Code
        Are thermostats set at appropriate levels? [Summer: 23-26 C (73-79F), Winter: 20-24C (68-75 F)]
        Are odours, dusts or fumes absent at the time of inspection?
       Local Exhaust Ventilation (e.g. fumehoods, paint booths, hoods, dust collection equipment, etc.)        Occupational Health &
        Is the type of local exhaust appropriate for the chemicals or operation that is to be controlled?     Safety Act
        Do exhaust hoods draw contaminants away from a person’s breathing zone?
        Is hood placement close to the contaminant emission source?
                                                                                                               Industrial Reg. 851
        Are odours, dusts or fumes absent at the time of inspection?                                          Health Care Reg. 67/93

       Aisles & Passageways, Access & Egress, Floors & Stairways
       Aisles and Passageways
        Are aisles and passageways clear and unobstructed?                                                    Building Code
        Are aisles and passageways adequately lighted?
        Are aisles and passageways wide enough for intended movement?
                                                                                                               Ontario Fire Code (O.Reg
                                                                                                               388/97)
       Access and Egress
        Are there adequate exits for prompt escape?
        Are the exits un-locked from the inside (opened from inside without the use of keys)?                 Also refer to Emergency
        Are routes and exits clearly marked and unobstructed?                                                 Lighting under
        Do exits open in the direction of travel when exiting building?                                       Emergency Equipment &
        Are doors provided with a self-closing mechanism?                                                     Procedures (this checklist)
        Are exits and exit routes equipped with emergency lighting?
        Is a security system in place where it is considered to be necessary?                                 City of Toronto
        Are appropriate measures in place to control for potential workplace violence?
                                                                                                               Workplace Violence
                                                                                                               Policy and Guidelines
        Are flammables kept away from exit areas?
        Are exit areas cleared of snow and ice/refuse?                                                        City of Toronto Policy for
       Floor and Stairways                                                                                     Working Alone Safely
        Are floor and stairways free from loose material, debris, cords or cables?
        Are floors and stairways free from slip hazards (oily, wet, or badly worn)?
        Are stairway treads in good shape?
        Is railing in stairway mounted and secure?
       Confined Space (as defined by the OHSA and work practice)
          Are workers entering confined space trained on its dangers and proper procedures?                   Occupational Health &
          Is safe egress provided for evacuation from confined spaces?                                        Safety Act
          Are there entry procedures in place and followed?                                                   Industrial Reg. 851
          Is the calibration of gas testing equipment current?
          Is there a permanent record of air test prior to entry?                                             Construction Reg. 213/91
          Is air tested, continuously monitored and regularly recorded while work is in progress?             Health Care Reg. 67/93
          If welding, are low explosive limit (LEL) and oxygen levels checked and monitored?
          Is confined space ventilated where necessary?
          Is fall arrest / retrieval equipment worn as applicable to the job demands?
          Is there a 2nd competent worker stationed immediately outside the confined space?                   City of Toronto policy on
          Is a worker trained in artificial respiration/CPR conveniently available?                           Confined Space Entry
          Is smoking prohibited within the immediate vicinity?                                                (available on the intranet)
          Is mechanical equipment locked & tagged out?
          Is mechanical equipment disconnected from power source?
          Are pipes blanked off (capped)?
       Electrical
          Are electrical cords in good condition?
          Are ground pins in place?                                                                           Canadian Standards
          Are receptacle faceplates in place?                                                                 Association
          Are electrical cords located so that they are not a tripping hazard?
          Is electrical equipment approved (CSA, ESA)?                                                        Electrical Safety
          Is electrical equipment that is being worked on, locked & tagged out?                               Authority
          Are outer casings on tools in good condition (having no cracks, dents or visible damage)?
          Are electrical rooms clearly identified?
          If exposed live electrical parts are present, are warning signs present prohibiting unauthorised    Occupational Health &
           entry?                                                                                              Safety Act
        Are receptacles properly loaded (i.e., not overloaded: number of appliances plugged-in do not
                                                                                                               Industrial Reg. 851
           exceed current rating)?
       Electrical Power Systems                                                                                Construction Reg. 213/91
        Are high voltage control panels identified, closed, and secured?
                                                                                                               Health Care Reg. 67/93
        Is a current electrical system schematic diagram posted in switch gear rooms?
        Are electrical system circuits identified?


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                                             Categories / Contents                                                      Resources
          Are tie-breakers clearly identified?
          Are control panels identified and accessible?
          Are isolation switches and controls identified?
          Are there proper fixtures and power points for the types of hazard in the area?
          Are lock out provisions available and identified?
          Are ground fault circuit interrupters provided?
          Are ground fault circuit interrupters in good working order?
          Are there proper cable connections for portable tools and lighting?
          Are ground fault interrupters used where moisture is a concern?
          Are electrical switches accessible and unobstructed?
          Are electrical switches labelled (i.e., circuit breaker panel, control panel)?
       Elevating Devices (for movement of persons)
          Are elevating devices used only within capacity?                                                      Construction Reg.
          Are capacities posted on equipment?                                                                   213/91Elevating Work
          Is the device regularly, tested, maintained and inspected (inspection up-to-date)?                    Platforms, s 143-149, Fall
          Are controls of the “dead-man type”?                                                                  Protection, s 26,
                                                                                                                 Access/Egress, s 70-72
          Are operators trained and competent?
          Is proper fall protection available?                                                                  Industrial Reg. 851 Fall
          Is fall protection properly used?                                                                     Protection, s 85

                                                                                                                 Canadian Standards Assoc.

                                                                                                                 TSSA Technical Standards
                                                                                                                 and Safety Authority
       Emergency Equipment and Procedures
       First Aid Kits/Stations/Equipment
        Are first aid kits/stations/equipment properly located as prescribed by legislation and any
                                                                                                                  WSIB First Aid
           divisional standards?                                                                                  Requirements (Regulation
        Are first aid kits/stations/equipment readily available and accessible                                   1101)
        Is there a notice board with the following:
                 - the WSIB poster (form 82) “In All Cases of Injury at Work”
                 - valid first aid certificates of qualification of the trained workers on duty
                 - an inspection card with spaces for recording the date of the most recent inspection of
                      the first aid box and the signature of the person making the inspection                     Occupational Health &
        Are first aid kits/stations/equipment inspected at least quarterly and restocked in compliance           Safety Act
           with WSIB regulations (an inspection card should be in the box)?                                       Industrial Reg. 851
        Is the first aid station in the charge of someone who works in the vicinity and who is qualified in
           first aid?
        Are first aid kits/stations/equipment clean?
       Eye Wash/bath & Deluge Showers
          Are stations readily available where required (i.e., where there is potential exposure to hazardous    Ontario Fire Code (O.Reg
           substances)?                                                                                           388/97)
        Are pathways to the eye wash/bath and deluge shower stations clear & unobstructed?
          Are units clean and sanitary?
        Are eye wash station supplies in order (stocked, clean, accessible)?
           Is the eye wash solution up to date?
          Are stations labelled and instructions present?
          Are units in functioning order (operate to verify functionality where feasible)
          Are units flushed frequently to eliminate contaminants?
          If the station is portable, is water regularly changed?
       Fire Prevention and Fire Protection
        Are flammable substances properly stored?
        Are explosion proof and intrinsically safe electrical systems installed in areas where flammable
           substances are stored, dispensed or used?
        Are grounding and bonding cables or devices provided for flammable liquid dispensing?
        Is grounding continuity maintained (grounding cable not cut off, not disconnected)?
        Is proper signage posted where flammable substances are stored, dispensed or used?
        Are proper containers used for transporting flammable substances?
        Are suitable types of fire extinguishers available?
        Is fire-fighting equipment properly mounted, accessible and maintained?
        Are signs showing fire fighting equipment storage locations visible?
        Are fire extinguishers and fire hoses stored in their designated locations?
        Are fire extinguishers properly charged? (check pressure gauge needle in green zone fro “ABC”
           type fire extinguishers)
        Are records of periodic testing and reviews of fire equipment kept on site?
        Are fire extinguisher handles, safety pins, discharge nozzles or horns and inspection tags in
           place?
        Are fire extinguishers checked monthly?
        Are fire hoses inspected and re-hung at least once every year?
        Are emergency exits identified, illuminated and unobstructed?
        Are fire doors, lids and shutters in good repairs and unobstructed?
        Are emergency alarms (e.g. pull stations) available, identified and operational?
        Do sprinkler heads have a minimum of 0.5 metre clearance between its deflector and the top of
           any stack of material below it?
        Are sprinkler master control valves accessible and locked open?
        Are fire/emergency evacuation and escape plans posted?
        Is a written fire plan available and are there regular fire drills?
       Emergency Lighting
        Is emergency lighting provided where required?


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                                             Categories / Contents                                                     Resources
          Do emergency lights come on when the test button is pressed?
          Is the emergency lighting system tested every month?
          Are emergency lighting testing procedures and records maintained?
       Excavation
          Are stakeouts obtained?
          Is adequate shoring in place or progressively installed as depth increases?
          Are utilities protected/supported?                                                                     Occupational Health &
          Are soil & equipment & materials at least 3 feet away from the excavation??                            Safety Act
          Is there adequate fencing or cover if left unattended?                                                 Construction Reg.
          Is the excavation barricaded to prevent unauthorized access?                                           213/91Excavations,
          Is excavation reasonably free of water?                                                                Section 222-242
          Are walls stripped of loose material?
       Fall Protection
          Are floor openings covered or protected with guardrails?
          Are floor edges protected with guardrails?
          Are guardrails between 91 cm and 101 cm?                                                               Occupational Health &
          Do guardrail supports span less than 2.4 metres?                                                       Safety Act
          Are wire rope guardrails properly designed by an engineer and installed following the design?          Industrial Reg. 851
          Are fall arrest, fall restraint or travel restrain systems attached to a proper anchor? (e.g., not a
           guard rail)                                                                                            Construction Reg. 213/91
          Are anchorage points for attachment of fall arrest system installed, identified and used?              Health Care Reg. 67/93
          Are safe work practices in place to ensure that no person rides or is lifted by any part of a crane
           or lifting device.
          Are only devices designed for raising and lowering personnel used for this purpose? (i.e.,
           material handling devices are not used to move personnel)
          Are devices for raising and lowering personnel equipped with adequate guardrails?
          Are loose objects kept away from floor edges and openings, and points of access and egress?
          Where an individual may fall into a liquid, are lifejackets and other applicable equipment
           available?
       Hazardous / Designated Substances
          Are hazardous substances identified for chemical, biological, physical properties?
          Are hazardous substances identified for adverse health effects?                                        Occupational Health &
          Are worker exposure concerns regarding hazardous substances investigated?                              Safety Act
          Is medical testing monitored as prescribed for the specific hazard in concern?                         Industrial Reg. 851
          Are correct handling methods identified?
          Do competent, qualified persons carry out industrial hygiene testing?                                  Health Care Reg. 67/93
          Is the JHSC notified of industrial hygiene testing results?
          Are hazardous substances appropriately and legibly labelled?                                           WHMIS Reg. 860
          Are substitutes for hazardous substances sought/requested (refer to site supervisor)?                  Designated Substances
          Are MSDS available, accessible, and current (within 3 years)?
          Are employees properly trained to handle hazardous substances?
          Are storage, spill and cleanup procedures posted?
          Are adequate spill/leak containment systems in place and readily available?
          Is proper drainage provided?                                                                           City of Toronto policy
          Is container corrosion protection provided and are containers kept away from moisture or matters       on Designated
           that would cause rust corrosion?                                                                       Substances
          Is the storage of hazardous substances climate controlled as required for the specific hazard in
           concern?                                                                                               City of Toronto policy
          Are approved portable safety containers available?                                                     on Hazardous Waste
          Are materials separated to avoid incompatibility reactions?                                            Management
          Are the means of exit/egress as prescribed for the hazardous substance in concern and posted?
          Are containers properly placed, stacked and supported?
          Are hazard warnings, directional and informational signs and tags used where there are                 City of Toronto policy
           immediate dangers, potential hazards, or where there is a need for general instructions?               on WHMIS
          Are signs and tags used consistently throughout the facility?
       Battery Rooms
          Are workers trained in material handling precautions and clean-up procedures?
          Is an absorbent material available to contain a spill (e.g., sand, clay, diatomaceous earth)?
          Is lime or soda ash available for dilution and neutralization of a spill/leak?
          Is a fresh water supply and hose available for spill dilution?
          Is room equipped with floor drains?
          Are ventilation fans running while batteries are being recharged?
       Chemicals/Solvents/Cleaners
          Is proper ventilation used in storage and usage areas?
          Are personal protective equipment requirements posted, provided and used?
       Fuels/Flammables/Combustibles
          Are flammables correctly stored?
          Are bonding/grounding means provided and readily available for dispensation of flammables/
           combustibles?
          Are flammable compressed gasses and liquids stored in areas serviced by non-sparking, non-
           arcing sources, fans, etc.?
          Are there adequate fire resistant and vented flammable storage cabinets?                               Ontario Fire Code
          Is the storage of Class I liquids (flammable liquids with a flash point below 22.8c) limited to 60    (O.Reg 388/97) Part 4
           gals.
           Is the storage of Class II liquids (combustible liquids with a flash point between 37.8c to 60c)
           limited to 60 gals.
          Is the storage of Class IIIA liquids (combustible liquids with a flash point between 60c to
           93.3c) limited to 120 gals.?

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                                             Categories / Contents                                                    Resources
         Are storage areas for flammable/combustible liquids separated from storage areas for
          flammable/combustible-compressed gasses?
         Are flammable and combustible materials stored in buildings approved for their Class or outside
          of buildings?
         Are fire-rated metal containers available for disposal of oily or flammable contaminated
          rags/waste?
       Compressed Gases (consider all pressure cylinders: SCBA, O2, welding, spray cans, etc.)
         Are compressed gases stored in a secured, upright position?
         Are compressed gases segregated by contents and legibly marked as prescribed (WHMIS,
          CPA)?
         Are valve caps secured in place?
         Are gases stored away from ignition, heat/spark sources, stairs, elevators, access/egress routes,
          and vehicular and pedestrian traffic?
         Are empty cylinders segregated from full supplies?
         Are cylinders in use properly connected, i.e. propane or welding operations?
         Are proper cylinder transport carriages and cradles/carts readily available?
         Are cylinders free of dents, corrosion, rust, and are test records readily available or accessible?
         Is adequate ventilation, as prescribed, available in storage areas?
         Are gauges clearly visible and in good condition?
         Are welding hoses neatly coiled and stored off of the floor?
         Is stamped tank date visible and un-expired?
         Are hoses and torch tip in good working condition?
       Tank Storage systems
         Are tanks/drums fabricated of steel or other appropriate material?
         Is tank storage capacity limited to 2500 gals., or prescribed levels, if above ground?
         Is adequate ventilation available and functional?
         Are tanks equipped with pressure release valves?
         Are tanks and drums adequately supported?
         Are grounding and bonding provisions made when dispensing form tank/drum?
         Are gauges clearly visible and in good condition?
         Is the stamped tank date visible and un-expired?
       Designated Substances                                                                                     Occupational Health &
          Is there a written control program for the applicable designated substance(s)?                        Safety Act
       Asbestos                                                                                                  Designated Substances
          Are asbestos containing materials appropriately and legibly identified?                               WHMIS Reg. 860
          Is asbestos inventory current and available?
          Is asbestos in good condition and properly encapsulated (i.e., no water damage, rips, tears, dents,
           cracks or other indications of damage)?                                                               City of Toronto policies:
          Are workers, (including inspectors) free from exposure to asbestos?                                   Designated Substances
       Acrylonitrile, Arsenic, Benzene, Coke Oven Emissions, Isocyanates, Lead, Mercury, Silica, Vinyl           Asbestos Management
       chloride                                                                                                  Policy
          Are applicable substances appropriately labelled?                                                     Hazardous Waste
          Are workers potentially exposed to designated substances trained?                                     Management
          Is medical testing monitored as prescribed for the specific substance of concern?                     WHMIS
       General Housekeeping
         Are facilities generally clean and neat, and in good repair?
         Are refuse containers adequate, suitable and regularly emptied?
         Are objects leaning against walls prevented from unintentional movement that may result in an
          injury?                                                                                                Occupational Health &
                                                                                                                 Safety Act
        Are containers sealed when not in use?
        Are floor surfaces free from slip hazards? If wet or slippery, is warning sign in place?                Industrial Reg. 851
        Are floors absent of cracks and chips?
        Are floor coverings secured in place?
        Are there any musty or mouldy odours or are there any signs of water stains or mould?
       Employee Facilities (Kitchens/Washrooms/Shower/ Change rooms)
        Is drinking water readily available?
        Are facilities clean and sanitary?
        Are facilities in good repair?
        Is hot and cold water available for washing up?
        Do washroom doors, walls, partitions afford reasonable privacy?
        Is ventilation provided?
        Are reasonable person hygiene materials supplied?
        Are there adequate and suitable waste containers?




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                                             Categories / Contents                                                   Resources
       Ladders & Scaffolds
       Ladders
        Are metal ladders not used on electrical work?
        Are there no missing or broken rungs and side rails?                                                  Occupational Health &
        Are non-slip feet used, and in good working condition?
                                                                                                               Safety Act
        Is the ladder set up on firm and even footing?                                                        Industrial Reg. 851
        When ladder is placed in front of a door, is the door blocked open, locked, or guarded?
        Do both side rails rest on firm support?
                                                                                                               Construction Reg.
                                                                                                               213/91Scaffolding and
        Is ladder tied off to prevent all lateral movement?
                                                                                                               Work Platforms, s125-
        Is ladder set up at an appropriate incline where it is not tied-off?                                  142
        Does ladder extend above landing by at least three rungs?
        Are the braces for folding stepladders in good working condition and fully extended when in use?
        Is there clear and unobstructed landing?
        Is there only one person working on a ladder at a time?
        Are wooden ladders unpainted?
        Are rungs free from oil, grease and dirt?
        Are ladders placed on their rails when not in use?
        Are defective ladders tagged out of service?
        Do permanent access ladders greater than 5m have a safety cage?
        Where a worker is performing work while on
       Scaffold & Platforms
        Are scaffolds and platforms constructed with sound frames, boards, and hardware (appropriate
           size planks, overhang, tightly planked, toe boards where necessary, etc.)?                          Electrical & Utility Safety
        Are scaffolds and platforms erected on firm and even footing?                                         Association (EUSA) rule
        Do scaffolds and platforms appear plumb/vertical?                                                     book
        Are scaffolds and platforms adequately braced and secured to the frame with safety catches?
        Are scaffolds and platforms tied off against lateral movements or proper and adequate outriggers
           or guy wires are used?
        Are brakes on castors in good working order?
        Are brakes on all castors on rolling scaffolds fully applied?
        Are no scaffolds supported on inflatable tires?
        Did a Professional Engineer design drawings and are certificates for scaffold over 10m available
           on site?
        Is a record of pre-use inspection for scaffold over 10 M available on site?
        Are guard rails installed (height between 900 mm to 1100 mm)?
        Is safe and secure access to the platform provided and maintained?
        Does platform provide adequate clearance from overhead electrical wiring?
        Are loose objects, parts, tools and equipment on platforms kept in secured containers or removed?
        Are fall arrest systems properly used when erecting, dismantling or moving scaffolds?
       Lighting
       General Lighting
        Are walking and working areas adequately illuminated during periods of occupancy?
        Are bright light sources positioned or shielded to avoid glare?
        Are light fixtures/reflectors clean?
       Office Lighting
        Are illumination levels adequate to support paper-based tasks?
        Is direct or indirect glare prevented from being within the worker’s viewing area (direct from
           source or reflected)?
       Lockout/Barricades
          Are lockout bars, tags, chains, cables and locks provided?
          Are lockout bars and tags made of non-conductive materials?
          Are positive lockouts provided for all power systems and individual power equipment?
          Are tags used to inform others the equipment is being serviced, by whom, and time it is
                                                                                                               Occupational Health &
           available?                                                                                          Safety Act
          Are equipment locked out and tagged as prescribed?
          Is lockout log kept current?                                                                        Industrial Reg. 851
          Are measures in place to ensure that residual energy stored in a system has been eliminated
           before work is started?
          Is work area isolated with barricade tapes or other effective means for restricting unauthorised
           entry?
       Machinery and Machine Guarding
          Are dangerous parts guarded?
          Are guards properly adjusted and secured?
          Are shields for deflecting flying particles in proper position and adjustment?
          Are fixed guards secured in position?
          Are interlocking guards operative?                                                                  Occupational Health &
          Are trip-guards properly set and adjusted?                                                          Safety Act
          Is adequate local lighting provided for the task?
                                                                                                               Industrial Reg. 851
          Is work area kept tidy and free of small objects?                                                   Machine Guarding s24-44
          Is emergency “STOP” clearly identified and accessible to the operator?
          Is emergency “STOP” operational?
          Are machinery and guards in good repair? (i.e., no visible signs of damage)
          Are machinery and guards maintained, cleaned and lubricated?
          Are defective machine, tools and guards tagged and put out of service?
          Are valves and mechanical controls properly identified?
          Are valves and controls operational (request demonstration from a knowledgeable operator – do not
           operate it yourself)?
          Are valves and controls accessible to machine operator?

…/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                                                                                    Page 8 of 17
                                             Categories / Contents                                           Resources
          Are valves and controls protected from inadvertent actuation?
          Are isolation and lock out points provided and identified?
          Are push stick, push blocks provided and used as needed?
          Are loose clothing and objects that may get entangled with machine tucked-in or removed when
           operating machine?
        Where required, is machine in operation under the full attention of the operator?
        Are trainee-operators under the constant supervision of a skilled operator when learning to
           operate the machine?
       Conveyors
        Are gears, shafts, pulleys and nip points guarded?
        Are drop guards installed to catch falling materials?
        Are emergency stop controls installed and identified clearly?
        Are emergency stop controls in good working order (testing should be conducted in consultation
           with the operation supervisor)?
        Is adequate access provided for maintenance and repair?
        Are adequate crossover facilities available?
        Is an automatic start up alarm available and set properly?
        Are emergency shut off procedures posted?
        Are emergency shut off devices clearly identified and easily accessible?
        Is there a remote shut off to pump?
        Are hose connections secured with restraining clips?
       Hydraulic Systems
        Are meters and control switches located on the operating floors?
        Are overpressure-warning systems available?
        Are pipes, fittings, connections and vessels free of dents, notches and major scratches?
        Are control switches marked and easily accessible?
        Is the master control switch marked?
        Can control switches be locked out?
        Are dangerous parts (pulleys, belts, shafts, etc.) guarded?
        Are operation instructions posted?
        Are valves marked and in proper working order?
        Are oil filters changed as required?
        Is water drained from the compressor tank?
        Is inspection record kept up-to-date?
       Grinding Wheels
        Is machinery securely mounted in accordance with manufacturer’s specifications (no vibration
           when in operation)?
        Is the maximum speed clearly marked on the wheel, spindle and motor?
        Is the condition of the grinding stone checked regularly?
        Are protective hoods/shields in place and properly maintained to allow the operator to see
           through it?
        Are guards kept in their proper position?
        Is work rest in a position at the centre line of the grinding wheel (not more than 3mm from the
           wheel)?
        Are control switches easily accessible by the operator?
        Is eye protection readily available and eye shields in place?
        Is a sign posted indicating eye protection is mandatory?
        Is the grinding wheel the proper size as per manufacturer’s specifications?
        Are flanges the proper type?
        Flanges are of equal diameter and are not less than one-third the original diameter of the wheels
           and their surfaces are free from burs?
        Is grindstone properly dressed?
        Is ventilation (where required) connected to the grinding wheel switch?
        Are grinding wheel procedures posted?
        Are grinding wheels stored in a cool dry place, separate from other objects and secured against
           falling?
        Are measures in place to prevent spillage of any chemical onto the grinding wheels when in
           storage?
        Are grinding wheels kept in an upright position to avoid stacking (with the exception of cup,
           dish and cutting off wheels?)
        Are individuals using, replacing or maintaining the grinding wheel properly trained?




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                                  Categories / Contents                                                                 Resources
       Material Handling & Storage
       Material Handling (Mechanical)
        Is a serviceable fire extinguisher is easily accessible in the area of material handling equipment?
        Are only trained/licensed operators allowed to operate lifting devices and forklift trucks?
        Are forklift and pallet trucks parked in their designated storage areas?
                                                                                                                   Occupational Health &
                                                                                                                   Safety Act
        Are electric forklift and pallet trucks parked and recharged in designated areas?
        Are there adequate devices to ensure safe lifting and storage of materials?                               Industrial Reg. 851
        Are lifting device load capabilities thoroughly examined at least yearly & a permanent record kept?       Material Handling s51 (1)
        Are lifting appliance and lifting gear load capacities clearly labelled?
        Are chain hoists, ropes and slings operated only within their load limit?
        Is a proper sling angle maintained (no more than 90 at the attachment to the hook)?
        Are chain hoists, ropes and slings in good repair and inspected by a competent worker at least
       weekly?
        Are dock boards (bridge plates) available and used when loading or unloading from dock to truck?
        Are vehicle wheels chocked to prevent the vehicle from rolling forward?
        Are shelving, rack, floor and platform load limits posted and observed?
        Is the safety catch on hooks in place and used on all lifting appliances (cranes, hoists, etc.)?
        Are pallets the correct type and inspected before use?
        Are elevators, hoists, conveyors, balers, etc. operated safely and used with appropriate signals
       and directional warning signs?
        Are dock platforms, bumpers, stairs and steps in good condition?
        Are light fixtures in good condition and adequate for the purpose?
        Are there metal containers for oily rags?
        Are floors free of oil spillage or leakage?
        Is absorbent material available for immediate clean up of spills and leaks?
        Are all flammable products stored in approved buildings or locations?
       Manual Material Handling (refer to resources for thorough checklist on manual material
       handling)
        Are personnel trained in proper manual material handling techniques?
        Are loads minimized when possible?
        Is assistance available for loads that are considered heavy?
        Can loads be held close to the body?                                                                      Material Handling
        Are frequently handled loads stored between waist and chest level?                                        guidelines to Avoid Injury
        Are bending and reaching minimized during the load-handling task?                                         (Ergonomics Unit – City
        Are load-handling tasks free of twisting?                                                                 of Toronto 2-5049)
        Are measures implemented to reduce potential injuries associated with manual material
       handling?
       Stacking and Storage
        Are aisle and access paths clear and unobstructed?
        Is there safe clearance for all equipment through aisles and doors?
        Are all stacks stable and secure to prevent sliding and collapsing?
        Are small or irregular-shaped items properly blocked?
        Are heavy objects stacked close to floor level?
        Is the storage area clean and cleared of foreign objects/materials?
        Is there proper drainage in storage area?                                                                 Dangerous Goods
        Are shelving, rack, floor and platform load limits posted and observed?                                   Transportation Act
        Are containers stored with lids securely closed?
        Are incompatible materials stored separately?
        Do sprinkler heads have a minimum of 0.5 metre clearance between its deflector and the top of
       any stack of material below it?
       Labelling
        Are containers clearly marked as to contents?
        Are WHMIS controlled products properly labelled?
        Are labels visible and legible?
        Are there up-to-date MSDS for WHMIS controlled products?
        Are vehicles transporting hazardous materials affixed with proper signage that meets legislated
       requirements?
       Portable Containers of Flammable Substances
        Are containers stored in metal ventilated and grounded lockers?
        Are containers clearly marked as to contents?
        Is the container generally in good condition?
        Are portable containers approved for the Class of goods it contains?
        Is the spring-loaded cap in good working condition?
       Mould Management
          Is the area free from musty odours?
          Are all surfaces clean and dry with no evidence of mould, mildew or staining? (look at ceiling
           tiles, carpets, paper and cardboard supplies, drapes, indoor plant soils, furniture, etc)
        Are wallpaper and painted surfaces in good condition (not wrinkled, peeling, blistering or
           damaged)?
        Is the soil of indoor plants in good condition (no signs of mould)?
        Are basements and sub-grades dry and finished with no areas of exposed soil?
        Is the air comfortably dry (no areas of high humidity or signs of condensation)?
        Where portable humidifiers are used, are they maintained?
        Are walls, windows and/or doorframes in good condition, not deteriorated, cracked or soft?
       (Note: Drying needs to be initiated within 24-48 hours of materials becoming wet to prevent mould growth)

       Noise
          Are excessive noise areas identified and posted?

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                                             Categories / Contents                                                  Resources
          Are engineering controls implemented to reduce noise where feasible?
          Is hearing protection provided and used in areas where required?
          Is medical testing/monitoring carried out as prescribed?
       Office Areas
          Are carpets, floors and gratings in good repair?
          Are plugs and cords in good working order and used properly?
          Are extension cords used only as a temporary measure?                                              Occupational Health &
          Are aisles and passageways clear and unobstructed ? (i.e., is cable management employed)           Safety Act
          Are receptacles covered with faceplates that are not cracked or burnt?
          Where an office appliance has a three-prong plug is the ground pin used?                           Industrial Reg. 851
          Is equipment and furniture smooth with no sharp edges, protrusions or catch areas that may
           result in injury?
          Are wall and ceiling fixtures securely fastened?
          Are papers and waste properly disposed of?
          Are desk and file drawers closed when not in use?
          Are file units secured and prevented from falling?
          Is furniture in good repair?
          Are task chairs in usable or repairable condition? Consider condition of upholstery, cushion,
           height mechanism, rolling ability of casters (where repair is required, place entry on workplace
           inspection form).
         Do task chairs have 5 casters and visible lumbar support?
         Are computer monitors positioned directly in front of the keyboard?
         Are both the monitor and keyboard located directly in front of the worker when computer
          activities are performed?
        During computer activity, are frequently viewed documents supported on a raised vertical angle?
        Are documents that are handled frequently positioned within easy reach?                              Office Ergonomics
        Are keyboards positioned at the proper typing height for the individual worker using it? (refer to   (Ergonomics Team – City of
                                                                                                              Toronto 2-5049)
          Office Ergonomics keyboarding guidelines)
        Where used by several workers, are keyboard platforms height adjustable?
        Are mouse input devices positioned directly adjacent to the keyboard?
        Are mouse pad areas flat and free from any wrist rest or other obstructions?
        Are mouse input devices approximately level with or slightly above the keyboard platform? (not
          significantly lower such that it results in a bent wrist)
        At seated desk stations, is the knee-well space a minimum of 24” wide and is there comfortable
          forward legroom?
        Where modular systems furniture exists in an “L” configuration, are keyboard platforms
          positioned on one of the flat edges and NOT in corner of the workstation?
        In an “L” configured modular system workstation, are keyboard platforms positioned close to the
          adjacent work surfaces to minimize reaching?
             - for surfaces to the right of the keyboard, with a left handed mouse user - 1”
             - for surfaces to the right of the keyboard, with a right handed mouse user - 1”
             - for surfaces to the left of the keyboard, with a left handed mouse user - 1”
             - for surfaces to the left of the keyboard, with a right handed mouse user - 7.5”
        Does workstation design allow for neutral body postures when seated or standing (i.e., minimal
          twisting, bending, reaching or any other awkward posture)?
       Photocopiers
        Are copiers adequately maintained?
        Are copiers located in a well-ventilated area?
       Manual Material Handling
        Are frequently handled loads stored between waist and chest level?
        Are loads held close to the body?
        Is assistance available for loads that are considered heavy?
        Is twisting and bending avoided during load handling tasks?
        Is a cart/trolley or other device available to assist with the movement of loads?
        Is a stable stool or platform available for safe access to high shelves?




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                                             Categories / Contents                                                      Resources
       Power Systems
       Pneumatic Power System, Air Compressors, Compressed Air Hoses and Hose Attachments
        Are meters and control switches located on the operating floors?
        Is an overpressure warning system available?
        Are pipes, connections and vessels free of dents, notches and major scratches?
        Are control switches marked and easily accessible?
        Is master control switch marked?
        Can control switches be locked out?
        Are dangerous parts (pulleys, belts, shafts, etc.) guarded?
        Are operation instructions posted?
        Are valves marked and in proper order?
        Are air filters changed or cleaned?
        Are pressure gauges visible and in good working order?
        Is pressure regulated within the manufacturer’s specified limit as indicated on the pressure
          gauge?
        Is water drained from the compressor tank?
        Is the inspection record kept up-to-date?
        Are air hoses and tools in good working condition?
        Are air hoses and tools rated for pressure?
        Are air hoses and tools properly and securely connected?
        Are emergency shut off procedures posted?
        Are emergency shut off devices clearly identified and easily accessible?
        Is there a remote shut off to the pump?
        Are hose connections secured with restraining clips?
       Personal Protective Equipment (PPE)
          Is required PPE available, maintained, and used? (i.e., head protection, hearing protection, eye
           protection, respiratory protection, safety belts/harness, hand/foot protection, body protection, ear   Occupational Health &
           protection, fall protection, and other workplace specific PPE as applicable)                           Safety Act
          Are appropriate storage and cleaning facilities provided for PPE?                                      Industrial Reg. 851
          Are personnel properly trained in the use and care of PPE they use?
                                                                                                                  Construction Reg. 213/91
          Does the PPE meet the requirements for the type of work performed?
          Does the PPE fit properly?
          Is the PPE utilised only when it is not reasonable or practicable to eliminate or control the          Departmental Policies as
                                                                                                                  applicable
           hazardous substance at the source?
          Are warning signs prominently displayed, warning of all hazards and stating protection required
       Safety Notice Boards
          Are emergency / evacuation procedures posted?
          Are posted articles clean and legible?
          Is a copy of the Occupational Health and Safety Act posted?
          Are the names of the JHSC members posted?
          Is a copy of the City Health and Safety Policy posted?
          Is the WSIB poster “In all cases of injury at work” posted?
          Are the minutes of the JHSC posted?
          Is the Occupational Health and Safety Notice Board labelled?
          Where one exists, is the divisional safety manual readily available to committee members?
          Are emergency telephone numbers posted (i.e., 911, MOL, MOE, etc) ?
       Spray Painting Operations
          Are booths/rooms clean and in good condition?
          Are records available that indicate booth filters are operational and regularly maintained?
          Are operator instructions posted?
          Are PPE requirements posted and easily available?
          Where spray painting is not carried out in booths or rooms, is ventilation adequate (determined
           by no lingering odours/particulates)
          Are fire extinguishers immediately available?
       Tools
          Are personnel trained in proper use of hand tools?
          Are manufacturer’s safety /operator’s procedures available?
          Are safe use procedure’s posted?
          Are there written procedures for replacement of defective tools?
          Do tools conform to CSA standards?
          Does the tool conform to manufacturer’s standards?
          Are electrical cords and three prong plugs in good condition?
          Are electrical tools grounded or double insulated?
          Are GFCI used when outdoors or indoors in wet conditions?
          Are tools appropriately used to avoid electrical hazards?
          Are guards and safety devices in good repairand being used?
          Do all air lines and hose connections fit securely in air powered tools?
          Are retainers installed on air-powered tools?
          Are tools and machinery properly stored?
          Are defective tools tagged and removed from service as part of a regular maintenance program?
       Training
          Is appropriate training provided for employees newly assigned to a job?
          Is training provided on the use of personal protective equipment?
          Are employees properly trained in equipment use, including emergency equipment as applicable
           to potential job hazards?




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                                             Categories / Contents                                                     Resources
       Vehicle Inspections
          Does the vehicle appear to be in good condition ( consider the following: unusual tire size, worn
           treads, uneven wear, fluid leakage, condition of windows, external lights, mirrors, seat belts, any   Highway Traffic Act
           other visible signs of damage)?
        Where applicable, are fire extinguishers available, easily accessible and regularly inspected?
                                                                                                                 City of Toronto FLEET
        Where loads are transported are securing devices available and in good condition?
                                                                                                                 Services Website:
        Is there ease of access/egress to/from the vehicle (i.e., step heights, hand holds, etc.)               Homepage
        Where required, does the vehicle have a functioning reverse notification alarm?
       Tire Cage (as used in selected garages)                                                                   Daily pre-trip inspection
        Are personnel properly trained in use of the tire cage?                                                 Safety Bulletins
        Are all required safety chains in good condition?
        Is the cage in good condition?
       Work Bench
       Housekeeping
        Is work surface and area clean and free of clutter?
        Is workbench stable and in good condition?
        If workbench is metal, is it properly grounded?
       Containerized Products
        Are containers clearly identified and properly labelled (e.g., WHMIS, TDG, etc.)?
        Are containers sealed when not in use?
        Are containers not used as a work platform?
       Warning Systems, Colour Coding
          Is a consistent colour coding system used for warning systems in the workplace?                       Occupational Health &
          Are pipes properly labelled ?                                                                         Safety Act
                                                                                                                 Industrial Reg. 851
                                                                                                                 WHMIS Reg. 860
       Welding
          Is hot work permit used as required?
          Are welding tanks properly secured from tipping?
          Are gauges and tanks visibly in good condition?                                                       Occupational Health &
                                                                                                                 Safety Act
          Are hoses and cables neatly coiled and protected?
          Are hoses, torch tip, and cables in good condition?                                                   Construction Reg. 213/91
          Are welding tanks stored in an upright position?                                                      Welding and Cutting,
          Is valve protection cap in good condition?                                                            Section 122-124
          Is flashback prevention check-valve in use?
          Is welding curtain or screen set up?
          Are fire prevention measures in place (i.e., fire extinguisher immediately available
          Are flashback arresters used?
          Are combustibles removed or covered?
          Are smoke and fume extractors effective?
          Is a spark lighter used?




…/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                                                                                     Page 13 of 17
                                                                                                                                                                                                                                               Page      of
                               Workplace Inspection Report                                                                                                               To (name/title):

Inspection Site (Name, Address):                                                                                                            Inspection Date:                                                Time:

Inspection Team (all participants):

         Inspection Team Report                     (Inspection Team use ONLY)                                                                        Management Response               (For Management Response ONLY)
                                                                                                                                                                                                                                                          Date
Item                                                   Hazard Concern                                                                       Item                                                                                               Action
#                     (Include specific location, interim actions taken if any, suggestions, comments etc.)
                                                                                                                             Priority
                                                                                                                                            #
                                                                                                                                                      Corrective Action Taken                                                                    By
                                                                                                                                                                                                                                                           of
                                                                                                                                                                                                                                                         Action




         Signature ________________________________________ Phone # ____________                                                                      Signature ______________________________ Phone # ____________
                        Inspection Team Representative                                                                                                               Management responsible for corrective action
                       Priority Rating                                                                                                                                                         Distribution of Report:
            1 > Hazard is likely to cause permanent disability, loss of body parts, loss of life and/or extensive loss of or damage to property. When encountered the inspection team          Worksite Safety Notice Board
                shall immediately advise the workers and report findings to the workplace supervisor on duty.                                                                                  Management responsible for corrective actions
            2 > Hazard is likely to cause serious injury or illness resulting in temporary disability, and/or property damage that are disruptive to the work.                                 Workplace Joint Health & Safety Committee
            3 > Hazard is likely to cause a non-disabling/no loss time injury, or non-disruptive property damage.                                                                              Human Resources Occupational Health & Safety Consultant




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                                       Joint Health & Safety Committee Recommendation Form
         Date Submitted: __________ Submitted to: ______________________ Tel. #                  Recommendation
         ______                                                                                  # _________
         Health and Safety Concern/Hazard
         (Clearly identify the concern/hazard and provide an item number or other identifier from JHSC minutes where
         applicable)




         Supporting Background Information
         (Include injury reports, work refusals, MoL intervention, related legislation, City policy, industry best practices, etc)




         Recommended Solutions (Clearly outline the proposed solution and indicate the urgency)




         This recommendation by the ______________________________ Joint Health & Safety Committee has been reached
         through consensus of all committee members. Signed on behalf of the committee

         _________________________________                                         _________________________________
                   Co-Chair, Labour                                                       Co-Chair, Management

                                      Recommendation Resolution (Management)

         Action Taken




         Date Resolved:____________________                        Verified as resolved on behalf of the Committee

         ____________________________________                      ___________________________________________
         Co-chair, Management                                      Co-chair, Labour

Mar-08
                 (Refer to the Guidelines on JHSC Recommendation Form Completion for assistance) Page 1 of ____

          …/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                                                                         Page 15 of 17
                            Guidelines on Safety Recommendation Form Completion
Date of Recommendation:

Reference Number:
       If applicable provide a reference number from the committee minutes

Health & Safety Concern/Hazard
         Clearly identify what the concern or hazard is
         Be clear to address the “root cause” and not just the “immediate cause”

Supporting Background Information
         Previous injuries or illnesses including their severity and/or associated costs
         Number of employees potentially at risk
         Previous work refusals, work stoppages or grievances
         Ministry of Labour orders
         Related legislation including:
                   Statutes
                   Regulations
                   Standards
                   Codes
                   Guidelines
                   City policies or procedures
                   Collective agreement provisions
                   Accepted industry standards

         Was the recommendation initiated by or endorsed by City staff including:
                  Safety Consultants
                  Ergonomists
                  Hygienists
                  WSIB Consultants
                  Employee Health and Rehabilitation
                  Public Health
                  Emergency Services (EMS/Fire)
                  Life Safety
                  Security
                  Legal

        Copies of documents that provide technical data such as:
   Technical manuals
   Maintenance schedules/logs
   Manufacturers’ specifications
   Material Safety Data Sheets

         Comments or recommendations of workers or supervisors in the affected area which provide testimonial data.



Recommended Solutions
         How urgent is it that the problem be addressed?
         The potential seriousness of any injury/illness that could result if the problem is left unattended
         How practical the solution is that is being recommended

         Resources
         Provide resources that may be able to assist in implementing the solution (If the recommendation is to provide training, who can
         provide the training, when are the dates of upcoming courses, how long is the course, where is it, how much is it. If the
         recommendation is to purchase something, provide the name of prospective suppliers including product specifications and costs)

…/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                                                                                 Page 16 of 17
         Target Dates
         For each specific solution or action, set a proposed target date for completion


Consensus
         Indicate that the recommendation was reached through consensus of all committee members including union and management.
         Provide names of the committee members including their positions.




…/28b2921f-a953-4eb2-af23-3501b7b511f1.doc                                                                          Page 17 of 17

				
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