Evaluation of Contractor Safety & Health Performance & Compliance with OSHA PSM Standard

Transcription

1 Evaluation of Contractor Safety & Health Performance & Compliance with OSHA PSM Standard This evaluation is a cooperative effort of the participating companies to minimize redundancy, and ensure that accurate safety and training data is gathered. Federal regulations and individual company policies mandate that employers verify that contractors meet certain minimum standards. GENERAL INFORMATION Company Name: Physical Address: City/State/Zip: Mailing Address: City/State/Zip: Submitted By: Telephone: Type of Work: Telephone: Fax: Title: Date: SIC: STATISTICS (last 3 years) for Local/Regional Workforce Average Number of Employees Employee Exposure Hours Number of Fatalities Number of Lost Workday Cases OSHA Incidence Rate Insurance Experience Modifier (EMR) Loss Ratio If Self Insured Rating Scale Definitions, no audit or review Name of Auditor: Initials: Date: Rev 8/08 1

2 I. MANAGEMENT COMMITMENT N/A No Yes Does your organization have a written Safety & Health Policy 2. Does your organization have a Safety & Health Program 3. Does your organization set annual safety & health goals 4. Are management and supervisors actively involved in your Safety and Health program A. Does the organization conduct workforce safety meetings? At what frequency B. Does management and/or supervision periodically participate in safety meetings with employees C. Does supervision conduct unscheduled/informal safety meetings for field workers? 5. Do you make use of safety committees/teams 6. Does your management hold periodic meetings with the owner s management, specifically to discuss safety, health and job performance 7. Does your organization have a program in place for recognition of excellent safety performance by individuals 8. Does your organization have a program in place for progressive discipline for unacceptable safety performance 9. Does your organization have company-specific safety rules 10. Does your safety representative have sufficient authority to correct hazards 11. Do you use sub-contractors A. Is there a program in place for evaluating the safety performance of sub-contractors prior to hire B. Are pre-job safety conferences conducted with your subcontractors Average Score - Management Commitment Rev 8/08 2

3 II. SAFETY RESPONSIBILITY N/A No Yes Do job descriptions for your supervisors and management personnel include Safety & Health responsibilities 2. Are individuals with Safety and Health responsibilities clearly identified within your organization 3. Does it include individuals dedicated full time to safety? If so, are they professionally certified (CSP, etc.) 4. Does it include individuals dedicated full time to health? If so, are they professionally certified (CIH, etc.) Average Score - Safety Responsibility Rev 8/08 3

4 III. SAFETY PROGRAMS & WORK PRACTICES N/A No Yes Does the organization have a written program for: a. Hazardous Communication (HAZCOM) b. Lockout/Tagout c. Emergency Action Plan d. Personal Protective Equipment (e.g. hard hats, safety glasses, respirators, etc.) e. Fall Protection including Scaffolding f. Confined Space Entry g. Lead Abatement h. Hearing Conservation i. Electrical Safety j. Respiratory Protection k. Asbestos/Man Made Mineral Fibers l. Abrasive Blasting/Hydroblasting m. Excavation/Shoring n. Lifting/Mobile Equipment 2. Does the contractor conduct audits to verify that all work permit systems are followed and its disciplinary action implemented in the event of noncompliance? 3. Do you supply owners a listing chemicals covered by the Hazard Communication Standard (29 CFR 1910:1200) onto the owner s work site? Average Score Safe Work Practices Rev 8/08 4

5 IV. HEALTH & SAFETY TRAINING N/A No Yes Do your employees attend the General Safety and Health Orientation at the Contractors Safety Council, or one with which a reciprocal agreement exist? Have they completed the annual refresher? 2. Do you have indoctrination for new employees? 3. Is there a process in place for monitoring newly assigned workers, for example, a buddy system? 4. Has each employee involved in repairing owners equipment identified as covered or listed (on the owner work site) been trained in the process overview and the hazards of the process 5. Is each contractor employee instructed in the known potential fire explosion or toxic release hazards related to his/her job and the processes and applicable provision of the emergency action plan? 6. Do you have additional Safety & Health training for foreman, supervision and managers? 7. On which of the following subjects do you provide training and ensure verification of understanding as required by their job task or by the applicable government regulation: a. Use and Care of Respirators b. Use and Care of Hearing Protection b. Confined Space Entry c. Fall Protection including Scaffolding Competent Person and Users, ladders & stairways, walking & working surfaces, and aerial lifts. d. Industrial Trucks (Fork lifts, aerial lifts, etc.) e. Heavy equipment operators, riggers and signal persons (Crane, excavators, etc.) f. Material safety data sheets and hazard communication program g. Fire watch h. Electrical safe work practices (Qualified & Unqualified persons) Rev 8/08 5

6 IV. HEALTH & SAFETY TRAINING (continued) N/A No Yes i. Abrasive blasting and Hydro-blasting j. Use of Fire Extinguisher k. HAZWOPER l. Lockout/Tagout m. Transportation of Hazardous Materials n. Line/Equipment Opening o. Use and Care of Personal Protective Equipment (Personal owned and employer provided) r. Excavating shoring & trenches (competent person training) s. Emergency Response Plan t. Other training: i.) Average Score Health & Safety Training Rev 8/08 6

7 V. JOB TRAINING & QUALIFICATION N/A No Yes Are all the contractors employees trained in the appropriate job skills and work practices necessary to perform their job safely? 2. Is there documentation in place that each employee has received and understands the required training? 3. Do you have a process to assess the skills of your workers to assure they are qualified? If so, what assessment process are you using: National Skills (NCCER) Own Other 4. Are employees enrolled in skill upgrade training based on results of craft skill assessment? 5. Are employees job skills certified where required by regulatory or industry consensus standards? a. Welding and Cutting b. Persons performing Non-Destructive Testing 6. Is there a program in place for certifying or qualifying crane operators and riggers? 7. Is training for personnel involved in operating a process equivalent to that provided to owner direct hire employees? a. Is documentation available to verify understanding? b. Is refresher training provided at least every 3 years? c. Is the facility owner expected to assist with training? Average Score Job Training & Qualification Rev 8/08 7

8 VI. INCIDENT REPORTING & INVESTIGATION N/A No Yes Does your organization have a process in place for immediate reporting and investigation of accidents and near misses? 2. Does the process include immediate notification of the owner of all incidents including first aid cases? 3. Does the process include root cause analysis? 4. Do supervisors or managers ensure that, as a result of the investigation, corrective action is taken, tracked, and completed? 5. Communication process to all employees on results of investigation and corrective action taken? Average Score - Incident Reporting & Investigation Rev 8/08 8

9 VII. INSPECTIONS & HAZARD IDENTIFICATION N/A No Yes Are pre-task safety assessments conducted (JSA s etc.) by the crew performing the task? 2. Do supervisors and managers periodically perform Safety and Health inspections of the work-site? At what frequency? 3. Do inspections include at least the following topics? a. Housekeeping b. Proper Use of Personal Protective Equipment c. Compliance with company and client & procedures and government regulations d. Condition of and correct use of tools and equipment 4. Have you had an OSHA inspection in the last three years? 5. Have you had any final findings of violations from OSHA within the last three years? If yes, attach details. 6. Are safety inspections records kept on file and are they available for review by the owner? 7. Do you have any employee safety suggestion program? Are employee suggestions encourages and acted upon? 8. Do you have a program in place for employee recognition and reporting of work place hazards that encourages employee to intervene when unsafe conditions or actions are observed? 9. Have the Safety & Health hazards associated with the type of work and services you provide been identified? a. Has a risk assessment been performed on these hazards? b. Has the facility owner been informed of these hazards? 10. Does the program include a follow-up system to ensure that all reported incidents and conditions are corrected in a timely manner? Average Score - Inspections & Hazard Identification Rev 8/08 9

10 VIII. MEDICAL/MONITORING PRACTICES N/A No Yes Do you have a process in place to provide emergency medical/first aid? 2. Is first aid provided on site? 3. Are First Aid providers trained in CPR and Bloodborne Pathogens? 4. Are adequate first aid supplies available on site? 5. Is there an ongoing medical surveillance program? Which of the following are included? a. Hearing Conservation (CFR & ) b. Respiratory Program (CFR & ) c. Asbestos (CFR & ) d. Benzene (CFR & ) e. Lead (CFR & ) f. Other (specify) i.) ii.) 6. Do you perform exposure monitoring? Which of the following elements are included: a. Noise b. Asbestos c. Benzene d. Lead e. Other (specify) i.) Average Score Medical Monitoring Practices Rev 8/08 10

11 IX. SUBSTANCE ABUSE PROGRAM N/A No Yes Do you have a substance abuse program? Does it include: a. Management Policy Statements b. Description of how policy will be enforced and how violation will be treated c. Employer notification procedure d. Pre-Employment Screening? What percent is tested? 100%? e. Department of Transportation (DOT) f. Does DOT 49CFR Parts 199 and 40 Pipeline Industry requirements apply? g. For Cause Testing h. Post Accident/Near Miss Testing i. Random Screening? What percent? Average Score - Substance Abuse Program Rev 8/08 11

12 X. COMMENTS Rev 8/08 12

13 SCORE SHEET Score I. Management Commitment II. Safety Responsibility III. Safety Programs & Work Practices IV. Health & Safety Training V. Job Training & Qualification VI. Incident Reporting & Investigation VII. Inspection & Hazard Identification VIII. Medical Monitoring Practices IX. Substance Abuse Program TOTAL SCORE AVERAGE SCORE Acceptable for Approved Contractor List NO Score less than 2.0 CONDITIONAL Score YES Score Greater than 2.5 Rev 8/08 13