Safety Mosaic Magazine

Spring 2008

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Report Card Survey

Use the following Survey to assess your organization's Health & Safety program. This assessment will generate a report on a following webpage that will identify your organization's strengths and areas for improvement along with recommendations to help build health and safety into the workplace.

Click to start

Question: 01	Yes	No	Not Sure
Are your employees exposed to any of the following designated substances (Acrylonitrile, Arsenic, Asbestos, Asbestos on Construction Projects, Benzene, Coke Oven Emissions, Ethylene Oxide, Isocyanates, Lead, Mercury, Silica, Vinyl Chloride) in the workplace?

Question: 02	Yes	No	Not Sure
Does your organization have five employees or less?

Question: 03	Yes	No	Not Sure
Does your organization have between six and nineteen employees?

Question: 04	Yes	No	Not Sure
Does your organization have twenty or more employees?

Question: 05	Yes	No	Not Sure
Does your organization have a Health and Safety representative?

Question: 06	Yes	No	Not Sure
Is your current Health & Safety representative trained?

Question: 07	Yes	No	Not Sure
Does your organization have a Joint Health and Safety Committee?

Question: 08	Yes	No	Not Sure
Have at least two current members of your Joint Health and Safety Committee attended Certification Part I & II training and been certified?

Question: 09	Yes	No	Not Sure
Does the Joint Health & Safety Committee or the Health & Safety Representative conduct monthly workplace inspections?

Question: 10	Yes	No	Not Sure
Has your organization identified all Health & Safety risks and hazards as required by the Occupational Health & Safety Act?

Question: 11	Yes	No	Not Sure
Has your organization provided training and supervision to effectively manage all the risks and hazards in your workplace?

Question: 12	Yes	No	Not Sure
Does your organization have written, up-to-date, Health & Safety policies and procedures?

Question: 13	Yes	No	Not Sure
Does your organization have a Workplace Hazardous Materials Information System (WHMIS) program?

Question: 14	Yes	No	Not Sure
Does your organization train all its employees, annually, in WHMIS?

Question: 15	Yes	No	Not Sure
Are Material Safety Data Sheets (MSDS) current and readily available for all hazardous materials?

Question: 16	Yes	No	Not Sure
Do all the employees know both their own and their employer's legal obligations and rights under the Occupational Health & Safety Act?

Question: 17	Yes	No	Not Sure
Does your organization have an Emergency Response Plan to deal with fire, chemical spills and any other emergency?

Question: 18	Yes	No	Not Sure
Are all employees provided with appropriate Personal Protective Equipment (PPE)?

Question: 19	Yes	No	Not Sure
Are all employees trained to use their Personal Protective Equipment (PPE) correctly?

Question: 20	Yes	No	Not Sure
Are all workers provided with adequate training to raise their awareness of identified workplace hazards and controls?

Question: 21	Yes	No	Not Sure
Is all PPE maintained to ensure effectiveness?

Question: 22	Yes	No	Not Sure
Is your organization in the process of responding to orders from the Ministry of Labour?

Question: 23	Yes	No	Not Sure
Is your organization preparing for, or responding to, a Workwell Audit letter from the WSIB?

Question: 24	Yes	No	Not Sure
Have all managers, front-line supervisors and workers been trained to recognize and report problems that could lead to an injury?

Question: 25	Yes	No	Not Sure
Are reports of potential hazards investigated promptly?

Question: 26	Yes	No	Not Sure
Are injury or first aid statistics reviewed by either the JHSC or your H&S rep each month for trends that need to be investigated to prevent incidents in the workplace?

Question: 27	Yes	No	Not Sure
Are all front-line supervisors actively looking out for conditions or work practices that could lead to injury?

Question: 28	Yes	No	Not Sure
Does your organization celebrate its safety achievements at least annually?

Question: 29	Yes	No	Not Sure
Is your organization looking to achieve Health and Safety Accreditation?

Question: 30	Yes	No	Not Sure
Is management and supervisory compensation or awards based-at least partially-on health and safety goals/achievements?

Question: 31	Yes	No	Not Sure
Are hazards always considered when your organization plans a new process, changes an old process, or purchases new equipment?

Question: 32	Yes	No	Not Sure
Are workers provided with all required equipment that can help reduce the risk of injury?

Question: 33	Yes	No	Not Sure
Are workers always provided with training on how to use equipment that can help reduce the risk of injury?

Question: 34	Yes	No	Not Sure
Are your workplace health and safety activities evaluated/reviewed yearly for improvement opportunities?

Question: 35	Yes	No	Not Sure
Does the employer or, as appropriate, JHSC or H&S representative know how to conduct an accident investigation?

Congratulations! You've now finished the Survey.
Click the button below to view a Report of recommended actions