Safety Management System. Compliance Checklist/Statement



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Safety Management System Compliance Checklist/Statement. Version 1 Page 1 of 22

Organisation: Approval Signature: Position: Print Name: Date of signing: SMS Manual Revision: To be completed and signed for by the Safety Manager and the Accountable Manager. For the Danish Transport Authority use only: spector: Name: Signature Date of assessment: Version 1 Page 2 of 22

CONTENT Page 0. General Issues and SMS Implementation. 4. 1. Safety Policy and Objectives. 6. 1.1 Management Commitment and Responsibility 6. 1.2 Safety Accountabilities 8. 1.3 Appointment of key safety personnel 10. 1.4 Coordination of Emergency Response Planning 12. 1.5 SMS Documentation 13. 2. Safety Risk Management - 14. 2.1 Hazard Identification 14. 2.2 Safety Risk assessment and mitigation process 16. 3. Safety Assurance 17. 3.1 Safety performance monitoring and measurement 17. 3.2 The Management of Change 18. 3.3 Continuous improvement of the SMS 19. 4. Safety Promotion 20. 4.1 Training and Education 20. 4.2 Safety communication 21. 5. Flight Data Monitoring (FDM) aeroplanes. To be amended. 6. Compliance Monitoring General. To be amended. 7. Contracted Activities General. To be amended. Version 1 Page 3 of 22

0. General Issues and SMS Implementation SMS Scope and Implementation The Organisation should define the scope of the organisation and its activities and this should include how it addresses safety provisions in its contractors that provide safety services to the organisation. establishing an SMS a GAP analysis should be carried out and an implementation plan that will address how the organisation will transition to a fully functioning and effective SMS AMC1 ORO.GEN.200(a)(1) 0.1 respect of the management system has the structure, activities and the scope of the organisation been defined? AMC1 ORO.GEN.200(b) 0.2 Does the SMS correspond to the size, nature and complexity of the organisation and the hazards and associated risks inherent with its activities? 1 Yes (Y), No (N) or Partial (P) 2 Where is it documented in your documentation? 3 Provide details that describe or demonstrate your response to the question. 4 This will be completed by the Danish Transport Authority during the assessment process Version 1 Page 4 of 22

ICAO Doc 9859, Third Edition, 5.4.3 0.3 Has a gap analysis been carried out? ICAO Doc 9859, Third Edition, 5.4.4 0.4 Is there an SMS implementation plan that reflects the gap analysis? AMC1 ORO.GEN.205 GM1 ORO.GEN.205 - GM2 ORO.GEN.205-0.5 Are safety management provisions required for all new safety related contracted service providers? Version 1 Page 5 of 22

1. Safety Policy and Objectives - AMC1 ORO.GEN.200(a)(b) (c) - Management System 1.1 Management Commitment and Responsibility ORO.GEN.200 Management System ORO.GEN.210 Personnel requirements ORO.GEN.220 Record keeping ORO.AOC.130 Flight Data Monitoring (FDM) The organisation should define its safety policy which should be in accordance with international and national requirements, and which shall be signed by the Accountable Manager of the organisation. The safety policy should reflect organisational commitments regarding safety, including a clear statement about the provision of the necessary human and financial resources for its implementation and be communicated, with visible endorsement, throughout the organisation. The safety policy should include the safety reporting procedures and clearly indicate which types of behaviours are unacceptable and shall include the conditions under which disciplinary action would not apply. The safety policy should be periodically reviewed to ensure it remains relevant and appropriate to the organisation. AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.1 Is there a written safety policy endorsed by the Accountable Manager? AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.2 Were key staff consulted in the development of the safety policy? Version 1 Page 6 of 22

AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.3 Has the safety policy been communicated effectively throughout the organisation? AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.4 Does Senior Management continuously promote and demonstrate its commitment to the safety policy? AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.5 Does the safety Policy include a commitment to; strive to achieve the highest safety standards, observe all applicable legal requirements, standards and best practice, providing appropriate resources and safety as a primary responsibility of all Managers? AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.6 Does the Safety policy actively encourage safety reporting Version 1 Page 7 of 22

AMC1 ORO.GEN.200(a)(2) GM1 ORO.GEN.200(a)(2) 1.1.7 Is the safety management system based on the safety policy 1.2 Safety Accountabilities - AMC1 ORO.GEN.200(a)(1) The organisation shall identify the accountable executive who, irrespective of other functions, shall have ultimate responsibility and accountability, on behalf of the organisation, for the implementation and maintenance of the SMS. The organisation shall also identify the safety accountabilities of all members of senior management, irrespective of other functions, as well as of employees, with respect to the safety performance of the SMS. Safety responsibilities, accountabilities and authorities shall be documented and communicated throughout the organisation, and shall include a definition of the levels of management with authority to make decisions regarding safety risk tolerability. AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) GM2 ORO.GEN.200(a)(1) 1.2.1 Does the Accountable Manager have full responsibility and accountability for the SMS and corporate authority for the organisation? AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) GM2 ORO.GEN.200(a)(1) 1.2.2 Does the Accountable Manager have an awareness of their SMS roles and responsibilities in respect of the safety policy, Version 1 Page 8 of 22

safety standards and safety culture of the organisation? AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) GM2 ORO.GEN.200(a)(1) 1.2.3 Are safety accountabilities, authorities and responsibilities defined throughout the organisation? AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) GM2 ORO.GEN.200(a)(1) 1.2.4 Are there clearly defined lines of safety accountabilities throughout the organisation AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) GM2 ORO.GEN.200(a)(1) 1.2.5 Are all staff aware of and understand their safety accountabilities, authorities and responsibilities? Version 1 Page 9 of 22

1.3 Appointment of key safety personnel The organisation shall identify a safety manager to be the responsible individual and focal point for the implementation and maintenance of an effective SMS. addition the safety committees that support the Accountable manager and the Safety manager in delivering an effective SMS should be defined and documented. AMC1 ORO.GEN.200(a)(1) GM1 ORO.GEN.200(a)(1) 1.3.1 Has a Safety Manager (or equivalent) been appointed with the appropriate knowledge, skills and experience as defined in the guidance material? ORO.GEN.210(a)(b) ORO.GEN.215 1.3.2 Is there a direct reporting line between the Safety Manager and the Accountable Manager? AMC1 ORO.GEN.200(a)(2) 1.3.3 Does the safety Manager carry out the functions as detailed in the AMC guidance material? AMC1 ORO.GEN.200(b(1)(2)(3) 1.3.4 Has a Safety Review Board or equivalent been established? Version 1 Page 10 of 22

AMC1 ORO.GEN.200(b)(1)(2)(3) 1.3.5 Does the Accountable Manager chair the Safety Review Board? AMC1 ORO.GEN.200(b)(1)(2)(3) (c)(d) 1.3.6 Does the Board monitor the safety performance and effectiveness of the SMS as detailed in the guidance material? AMC1 ORO.GEN.200(a)(1) (b) - 1.3.7 Is the Board membership and frequency of meetings defined and minuted? GM2 ORO.GEN.200(a)(b)(c)(d) (e) 1.3.8 Has a Safety Action Group or equivalent been established that fulfils the functions defined in the guidance material? Version 1 Page 11 of 22

1.4 Coordination of Emergency Response Planning AMC1 ORO.GEN.200 (a)(3) (g (1)(2)) The organisation shall ensure that an emergency response plan that provides for the orderly and efficient transition from normal to emergency operations and the return to normal operations, is properly coordinated with the emergency response plans of those organisations it must interface with during the provision of its services. AMC1 ORO.GEN.200 (a)(3) (g) - 1.4.1 Has an emergency response plan been developed that include all the considerations in the guidance material as appropriate? ICAO Doc 9859, Third Edition, Appendix 3, 4. b) and 6. b) 2) 1.4.2 Are the roles, responsibilities and actions of the various agencies and key personnel defined? ICAO Doc 9859, Third Edition, Appendix 3, 5. b) 1.4.3 Do the key personnel in an emergency have easy access to the ERP at all times? ICAO Doc 9859, Third Edition, Appendix 3, 5. e) and f). 1.4.4 Is the ERP regularly reviewed and tested? Version 1 Page 12 of 22

1.5 SMS Documentation AMC1 ORO.GEN.200 (a)(5) Management System Documentation general - AMC3 ORO.MLR.100 The organisation shall develop and maintain SMS documentation describing the safety policy and objectives, the SMS requirements, the SMS processes and procedures, the accountabilities, responsibilities and authorities for processes and procedures, and the SMS outputs. The organisation shall incorporate the SMS documentation into its existing organisation documentation, or shall develop and maintain a safety management systems manual (SMSM), to communicate its approach to the management of safety throughout the organisation. AMC1 ORO.GEN.200(a)(5) Management System Documentation general - AMC2 ORO.GEN.200(a)(5) Management System Documentation general - GM1 ORO.GEN.200(a)(5) 1.5.1. Does the Safety management manual contain all the elements as detailed in the guidance material. AMC1 ORO.GEN.200(a)(3) (f) (1) - 1.5.2 Is it regularly reviewed? AMC1 ORO.GEN.220(b) GM1 ORO.GEN.220(b) 1.5.3 Is there a system for the recording and storage of SMS documentation and records i.e. hazard logs, risk assessments and safety cases? Note: all records should be kept for a minimum period of 5 years. Version 1 Page 13 of 22

2 Safety Risk Management - AMC2 ARO.GEN.300 (a); (b): (c) ORO.GEN.200(a)(3) AMC1 ORO.GEN.200(a)(3) GM1 ORO.GEN.200(a)(3) 2.1 Hazard Identification AMC1 ORO.GEN.200(a)(1) (2) The organisation shall develop and maintain a formal process that ensures that aviation hazards are identified. This should include the investigation of incidents and accidents to identify potential hazards. Hazard identification shall be based on a combination of reactive, proactive and predictive methods of safety data collection. AMC1 ORO.GEN.200(a)(1) (2) 2.1.2 Is there a process for establishing how hazards are identified and from what sources? AMC1 ORO.GEN.200(a)(3) (a)(2) 2.1.3 Is there a confidential safety reporting scheme that encourages errors, hazards and near misses to be reported by staff? AMC1 ORO.GEN.200(a)(2) 2.1.4 Is there feedback to the reporter and the rest of the organisation? Version 1 Page 14 of 22

AMC1 ORO.GEN.200(a)(1) 2.1.5 Does Hazard identification include reactive, proactive and predictive schemes? AMC1 ORO.GEN.200(b)(1) (2) 2.1.6 Have the major hazards and risks been identified and assessed for the organisation and its current activities? AMC1 ORO.GEN.200(c)(1) 2.1.7 Are safety investigations being carried out to identify underlying causes and potential hazards? AMC1 ORO.GEN.200(d)(1) (2) 2.1.8 Are the hazards identified from safety investigations addressed and communicated to the rest of the organisation? AMC1 ORO.GEN.200(a)(1) 2.1.9 Are errors, hazards and near misses being reported by staff? Version 1 Page 15 of 22

2.2 Safety Risk assessment and mitigation process ORO.GEN.200 (a) (3), AMC1 ORO.GEN.200(a)(3) (b) The organisation shall develop and maintain a formal process that ensures analysis, assessment and control of the safety risks in operations to as low as reasonable practical. AMC1 ORO.GEN.200 (a)(3) (b) 2.2.1 Is there a process to assess the risks associated with identified hazards? AMC1 ORO.GEN.200 (a)(3) (b) ICAO Doc 9859, Third Edition, 2.14.9 2.2.2 Is there criteria (eg risk tolerability matrix) that evaluates risk and the tolerable levels of risk an organisation is willing to accept? AMC2 ARO.GEN.300 (a); (b); (c) (a) 2.2.2 Are corrective / preventative actions, including timelines and responsibilities documented? Version 1 Page 16 of 22

3. Safety Assurance AMC1 ORO.GEN.200(a)(3) (d) 3.1 Safety performance monitoring and measurement The organisation shall develop and maintain the means to verify the safety performance of the organisation, and to validate the effectiveness of safety risks controls. The safety performance of the organisation shall be verified in reference to the safety performance indicators and safety performance targets of the SMS. AMC1 ORO.GEN.200(a)(3) (f) 3.1.1 Are risk mitigations and controls being verified / audited to confirm the effectiveness? AMC1 ORO.GEN.200(a)(3) (d) 3.1.2 Are lessons learnt incorporated into your policy and procedures? AMC1 ORO.GEN.200(a)(3) (d) 3.1.3 Have safety performance indicators been defined, promulgated and being monitored and analysed for trends? AMC1 ORO.GEN.200(a)(3) (f) 3.1.4 Are safety audits carried out that focus on the performance of the organisation and its services and assess normal operations? Version 1 Page 17 of 22

AMC1 ORO.GEN.200(a)(3) (d) 3.1.5 Is the SMS audited to assess its effectiveness and that the regulations and standards are being followed? AMC1 ORO.GEN.200(a)(3) (d) 3.1.6 Are safety / cultural surveys carried out? 3.2 The Management of Change ORO.GEN.130 AMC1 ORO.GEN.130 - Changes GM1 ORO.GEN.130(a) Changes GM1 ORO.GEN.130(b) Changes AMC1 ORO.GEN.200(a)(3) (e) The organisation shall develop and maintain a formal process to identify changes within the organization which may affect established processes and services; to describe the arrangements to ensure safety performance before implementing changes; and to eliminate or modify safety risk controls that are no longer needed or effective due to changes in the operational environment. AMC2 ORO.GEN.200(a)(3 (d) (2) (iii)) AMC2 ORO.GEN.200(a)(5) (b) (11) 3.2.1 Is there a documented change management process to proactively identify hazards and to mitigate risks during organisational changes? Version 1 Page 18 of 22

AMC2 ORO.GEN.200(a)(3 (d) (2) (iii)) 3.2.3 Are there periodical reviews of the safety performance after organisational changes to assure assumptions remain valid and the change was effective? 3.3 Continuous improvement of the SMS AMC1 ORO.GEN.200(a)(3) (f) The organisation shall develop and maintain a formal process to identify the causes of substandard performance of the SMS, determine the implications of substandard performance of the SMS, determine sub-standard performance in operations, and eliminate or mitigate such causes. AMC1 ORO.GEN.200(a)(3) (f) 3.3.1 Is there a means to monitor the overall performance of the SMS to allow for continuous improvement to be achieved? AMC1 ORO.GEN.200(a)(3) (f) 3.3.2 Is there evidence of continuous improvement being achieved? Version 1 Page 19 of 22

4 Safety Promotion 4.1 Training and Education AMC1 ORO.GEN.200(a)(4) (a) (b), GM1 ORO.GEN.200(a)(4) The organisation shall develop and maintain a safety training programme that ensures that personnel are trained and competent to perform the SMS duties. The scope of the safety training shall be appropriate to each individual s involvement in the SMS. AMC1 ORO.GEN.200(a)(4) (a) 4.1.1 Have all staff received training on the organisation s SMS and their roles and responsibilities in respect of the SMS including the Accountable Manager, Senior Management, Managers, supervisors and operational staff? ICAO Doc 9859, Third Edition, 2.15.6 4.1.5 Does the organisation provide training on human and organisational factors? ICAO Doc 9859, Third Edition, 5.3.86 g) 4.1.6 Is the effectiveness of the training measured? Version 1 Page 20 of 22

4.2 Safety communication ICAO Doc 9859, Third Edition, 5.3.92 The organisation shall develop and maintain formal means for safety communication that ensures that all personnel are fully aware of the SMS, conveys safety critical information, and explains why particular safety actions are taken and why safety procedures are introduced or changed. AMC1 ORO.GEN.200(a)(2) (c) (1) 4.2.1 Does safety communication reach all levels of staff in the organisation? 4.2.2 Does the safety communication compliment and enhance the organisation s safety culture? GM1 ORO.AOC.130 (c) (2) (v) ICAO Doc 9859, Third Edition, 5.3.93 4.2.3 Is the safety information disseminated in a suitable medium and monitored for its effectiveness? GM1 ORO.AOC.130 (d) (3) (vii) 4.2.4 Does relevant safety information reach external users / customers etc? Version 1 Page 21 of 22

5. Flight Data Monitoring (FDM) aeroplanes AMC1 ORO.AOC.130 GM1 ORO.AOC.130 Appendix 1 to AMC1 ORO.AOC.130 GM2 ORO-AOC.130 CAA UK CAP 739 6. Compliance Monitoring - GENERAL AMC1 ORO.GEN.200(a)(6) - GM1 ORO.GEN.200(a)(6) - GM2 ORO.GEN.200(a)(6) - 7. Contracted Activities GENERAL AMC1 ORO.GEN.205 - GM1 ORO.GEN.205 - GM2 ORO.GEN.205 - Version 1 Page 22 of 22