Alberta Forest Products Association
Partnerships in Injury Reduction (PIR)
Small Employer Audit Protocol
Company Name:
Auditor Name(s):
Audit Date(s):
Last Audit Score:
Last Audit Date(s):
Element 1: OWNER COMMITMENT AND PROGRAM ADMINISTRATION
QUESTIONS
1.1
D
INSTRUCTIONS
Score
Review the written health and
safety policy.
The policy must state:
Is there a current, written Health and Safety Policy signed and dated by the owner?
Notes:

(0 or 2)



1.2
I
Do employees know what the Workplace Health and Safety Policy states?
Notes:
(0 - 3)
1.3
D
Have specific health and safety responsibilities been written for:
a) Manager(s)?
Notes:
management’s commitment to
health and safety (HS)
overall goals and objectives
general HS responsibilities of
employees & contractors
requirement to comply with
relevant legislation & company
HS standards
Interview employees and
explain how employees are
made aware of the policy.
Score based on percentage of
positive responses from
interviews.
Review the written
responsibilities documents (e.g.
job descriptions, HS manual,
contracts).
(0 or 2)
b) Supervisor(s)?
D
Notes:
(0 or 2)
c) Worker(s)?
D
Depending on the size or
nature of the company, one or
more of these categories may
not be applicable. Indicate with
n/a. Where the company has no
workers, the owner will be
considered the Manager.
Notes:
(0 or 2)
d) Sub-contractor(s) (others)?
D
Notes:
(0 or 2)
Revised 20150110
B-2
External SECOR Health and Safety Audit
Element 1: OWNER COMMITMENT AND PROGRAM ADMINISTRATION
QUESTIONS
1.4
I
Score
Are all of the following knowledgeable about their health and safety responsibilities?
a) Manager(s)?
Notes:
(0 -2)
b) Supervisors?
I
Interview members of each
category and explain how
employees are made aware of
their health and safety
responsibilities. (Score based
on percentage of positive
responses from interviews.)
Notes:
(0 - 2)
c) Workers?
I
INSTRUCTIONS
Notes:
Depending on the size or
nature of the company, one or
more of these categories may
not be applicable. Indicate with
n/a. Where the company has no
workers, the owner will be
considered the Manager.
(0 - 2)
1.5
O
Ensure applicable legislation,
and (current) amendments are
on hand.
Does the company have a current copy of the OH&S Act, Regulation, Code and amendments?
Notes:
(0 or 2)
1.6
I
Do key employees have a working knowledge of OH&S legislation applicable to their work sites?
Notes:
(0 - 3)
Interview to ensure key
company employees have a
working knowledge of the
applicable OH&S legislation.
Score based on percentage of
positive responses from
interviews.
PIR I AUDIT SCORE – Element 1
Audit element score possible
Points scored on this element
Revised 20150110
24
– Points not applicable (N/A)
/ Total points possible
=
B-3
= Total points possible
x 100 =
%
External SECOR Health and Safety Audit
Element 2: Hazard Identification and Assessment
QUESTIONS
2.1
D
Score
INSTRUCTIONS
(0 - 6)
Review documentation. A list
of employee occupations (jobs)
should be in place and the
various tasks within those
occupations (jobs) should be
identified.
Points are awarded based on
the percentage completion of
job and task inventories.
Have formal hazard assessments been conducted to identify both health and safety hazards in the
work place?
a) Has an inventory been taken of jobs and job tasks?
Notes:
b) Are health and safety hazards identified for tasks listed in the inventory?
D
Notes:
(0 – 6)
c) Have the health and safety hazards been evaluated and prioritized according to risk?
D
Notes:
(0 - 6)
2.2
DI
Is a site specific (field level) hazard assessment process in use at unfamiliar or changing work
environments?
Notes:
(0 or 2)
2.3
Review documentation. Points
are awarded based on the
percentage of identified
hazards that have been
evaluated and prioritized. (The
points awarded in this section
must not exceed the points
awarded in 2.1b)
Interview workers and review
documentation. Records of
completed site specific hazard
assessments should be
available to demonstrate
implementation. At least 90% of
those interviewed must be
familiar with the site specific
hazard assessment process to
score.
Review documentation and
interview key employees.
Have the formal hazard assessments been reviewed:
a) when changes to the operation are implemented?
Revised 20150110
Review documentation to
determine if there is a system in
place to identify hazards from
the task inventory. Both health
and safety hazards should be
identified. Points are awarded
based on the percentage of
tasks for which health and
safety hazards have been
identified. (The points awarded
in this section must not exceed
the points awarded in 2.1a)
B-4
External SECOR Health and Safety Audit
Element 2: Hazard Identification and Assessment
QUESTIONS
DI
Score
INSTRUCTIONS
Notes:
(0 or 2)
b) in response to site specific hazard assessment findings, inspection and investigation results?
DI
Notes:
(0 or 2)
2.4
DI
Is there a system in place whereby employees can report unsafe or unhealthy conditions and
practices?
Notes:
(0 or 2)
Review documentation and
interview employees about the
reporting system. Auditor notes
should explain the system
used.
PIR I AUDIT SCORE – Element 2
Audit element score possible
Points scored on this element
Revised 20150110
26
– Points not applicable (N/A)
/ Total points possible
=
= Total points possible
x 100 =
B-5
%
External SECOR Health and Safety Audit
Element 3: Hazard Control
QUESTIONS
3.1
D
Score
Have controls (Engineering, Administrative and Personal Protective Equipment) been identified for
health and safety hazards?
Notes:
(0 or 3)
3.2
O
Are Health and Safety Hazards controlled using the following methods?
a) Engineering
Notes:
(0 - 3)
b) Administration
O
INSTRUCTIONS
Review prioritized hazard
assessment documents (2.1c),
and compare with hazard
controls.
Points are awarded based on
the percentage of hazards for
which controls have been
identified.
Review documentation and
observe the identified controls
methods.
Points are awarded for positive
observations of implemented
controls.
Notes:
(0 - 3)
c) Personal Protective Equipment (PPE)
O
Notes:
(0 - 3)
3.3
O
Are employees using controls developed for identified health and safety hazards?
Notes:
(0 - 3)
3.4
DI
Observe employees using
controls. Verify by interview.
Compare/observe employee
performance against hazard
controls developed in 3.1 and
3.2. Assign points based on the
percentage of controls used by
employees.
Review documentation and
interview workers. 90% positive
response is required in
interviews to award points.
Does the owner ensure health and safety policies and control methods are followed?
Notes:
(0 or 3)
3.5
D
Review documentation.
Is a scheduled Preventative Maintenance program for equipment, machinery and vehicles in place?
Notes:
(0 or 3)
Revised 20150110
B-6
External SECOR Health and Safety Audit
Element 3: Hazard Control
QUESTIONS
3.6
D
INSTRUCTIONS
Score
Review PPE policy and training
records. (Where the company
has no workers, describe how
the owner is trained.)
Where personal protective equipment is required, are workers trained in use, care and maintenance
of the protective equipment?
Notes:
(0 or 3)
3.7
D
Review the written plan.
The plan must address:
a) Has a plan been developed, in consultation with the contracting organization(s), for ensuring
workplace health and safety?

Notes:
(0 - 6)





Identification of site specific
hazards and controls
Ongoing field-level hazard
assessment
Reporting of changes to work
site conditions
Review of emergency
response plans
Process for dealing with
worker non-compliance
On-site supervision of contract
workers
Points awarded based number
of sub-points addressed.
b) Is the plan communicated to all employees?
I
Interview workers. All workers
interviewed must be aware of
the plan to score points.
Notes:
(0 or 2)
PIR I AUDIT SCORE – Element 3
Audit element score possible
Points scored on this element
Revised 20150110
32
– Points not applicable (N/A)
/ Total points possible
=
B-7
= Total points possible
x 100 =
%
External SECOR Health and Safety Audit
Element 4: Training of Workers
QUESTIONS
4.1
D
Score
Are workers provided with a general orientation that covers company policies and procedures,
enforcement policy and worker right to know and refuse unsafe work?
Notes:
(0 - 3)
4.2
D
Are workers given job-specific health and safety orientation that covers job responsibilities, job
hazards and safety precautions?
INSTRUCTIONS
Review orientation checklist(s)
and records.
Points awarded based number
of sub-points addressed during
orientation.
To award points, completed
orientation records must be
dated and signed off.
Notes:
(0 – 3)
4.3
DI
Does the orientation take place within the first week of employment?
Notes:
(0 or 2)
4.4
I
Are critical health and safety issues (e.g. emergency evacuation procedures, alarm systems, hazard /
incident reporting, etc.) addressed on the first day of employment?
Review orientation records and
interview workers. 90% positive
response is required in
interviews to score.
Interview workers. Verify
through review of records. 90%
positive response is required in
interviews.
Notes:
(0 or 3)
4.5
DI
Is job-specific training conducted to help ensure workers perform all tasks competently and with no
adverse affect to their health?
Notes:
(0 - 3)
4.6
D
Is ongoing training provided as required?
Notes:
(0 or 3)
Review training records and
interview workers. Both health
and safety issues must be dealt
with during job-specific training
to obtain full points.
Where the company has no
workers, describe the owner’s
training.
Review training documentation.
Documentation must show
ongoing training, refresher and
recertification in job specific
skills, such as skills upgrading,
WHMIS, first aid, defensive
driving, TDG, etc.
PIR I AUDIT SCORE – Element 4
Audit element score possible
Points scored on this element
Revised 20150110
17
– Points not applicable (N/A)
/ Total points possible
=
= Total points possible
x 100 =
B-8
%
External SECOR Health and Safety Audit
Element 5: Regular Inspection and Monitoring
QUESTIONS
5.1
D
Score
Is there a written inspection policy or procedure that states the frequency of formal inspections of the
company by manager(s), supervisor(s) and worker(s)?
Notes:
(0 or 3)
5.2
D
Is a standard format used for the inspections?
INSTRUCTIONS
Review documentation.
Frequency must be stated for
all applicable levels to award
points.
Review inspection
reports/forms.
Notes:
(0 or 2)
5.3
I
Are formal, written inspections carried out at the worksite (frequency as per process) by:
a) Manager(s)?
Notes:
(0 or 3)
b) Supervisor(s)?
I
Notes:
(0 or 3)
c) Worker(s)?
I
Notes:
Interview manager(s),
supervisor(s) and worker(s).
Verify through review of
inspection records. 90%
positive response is required in
interviews to score.
Depending on the size or nature
of the company, one or more of
these categories may not be
applicable. Indicate with n/a.
Where the company has no
workers, the owner will be
considered the Manager.
(0 or 3)
5.4
DO
Is there a system in place to ensure timely correction of substandard conditions and practices
identified in inspection reports?
Notes:
(0 - 4)
Review documentation and
observe items identified in
inspection reports. Scoring
based on any combination of
documentation and
observation.
PIR I AUDIT SCORE – Element 6
Audit element score possible
Points scored on this element
Revised 20150110
18
– Points not applicable (N/A)
/ Total points possible
=
= Total points possible
x 100 =
B-9
%
External SECOR Health and Safety Audit
Element 6: Emergency Response
QUESTIONS
6.1
D
INSTRUCTIONS
Score
Is there a written emergency response plan at each work site appropriate to the potential
emergencies at the site?
Notes:
(0 -4)
Review written emergency
response plan (ERP).
The plan(s) must be specific to
the worksite(s) and include:




Communication procedures
Emergency phone numbers
List of emergency response
personnel
Evacuation procedures
Working under the ERP of the
contracting organization is
acceptable.
6.2
I
Are all employees at the site knowledgeable about the plan?
Interview employees. All must
be aware.
Notes:
(0 or 2)
6.3
D
Are employees given emergency response training appropriate to their individual responsibilities?
Review emergency response
training records. Verify by
interviewing employees.
Notes:
(0 - 2)
6.4
DI
Are periodic emergency response drills conducted to test the response of all employees?
Notes:
(0 or 2)
6.5
D
a) Are records kept of all emergency responses, including drills?
Notes:
(0 or 2)
b) Are these records reviewed to correct deficiencies?
D
Interview employees and review
records from previous 12
months. 90% positive response
is required in interviews to
score. Participation in drills held
by the contracting organization
may be appropriate to the
needs of the small employer.
Review policy (requiring
emergency response records to
be kept) and records from the
past 12 months.
Review documentation.
Notes:
(0 or 2)
Revised 20150110
B- 10
External SECOR Health and Safety Audit
Element 6: Emergency Response
QUESTIONS
Score
INSTRUCTIONS
PIR I AUDIT SCORE – Element 9
Audit element score possible
Points scored on this element
Revised 20150110
14
– Points not applicable (N/A)
/ Total points possible
=
B- 11
= Total points possible
x 100 =
%
External SECOR Health and Safety Audit
Element 7: Investigation of Incidents and Occupational Diseases
QUESTIONS
7.1
D
Score
Is there a written incident investigation process which requires reporting of all incidents, occupational
health occurrences and incidents involving no losses (near misses)?
Notes:
(0 - 3)
7.2
I
Are employees knowledgeable about the Incident Reporting Process?
INSTRUCTIONS
Review incident investigation
process documents and confirm
legal reporting responsibilities
are included (e.g. WHS, WCB).
Interview employees. Points
awarded based on percentage
of positive response.
Notes:
(0 - 3)
7.3
D
Is there an incident report form which requires management sign-off?
Review incident form.
Notes:
(0 or 2)
7.4
D
Is there a written incident investigation process which requires investigation of all incidents,
occupational health occurrences and incidents involving no losses (near misses)?
Review documentation.
Notes:
(0 - 3)
7.5
D
Do investigations focus on gathering evidence and identifying root causes?
Review completed incident
report forms.
Notes:
(0 - 3)
7.6
DO
Are corrective actions taken to prevent recurrence?
Notes:
(0 or 5)
Review completed incident
report forms and observe the
corrective actions. If no
incidents have occurred in
previous 12 months, score
based on policy stipulation
requiring corrective action.
PIR I AUDIT SCORE – Element 10
Audit element score possible
Points scored on this element
Revised 20150110
19
– Points not applicable (N/A)
/ Total points possible
=
= Total points possible
x 100 =
B- 12
%
External SECOR Health and Safety Audit
Element 8: Process Administration and Review
QUESTIONS
8.1
DI
Is there a system in place to ensure:
a) health and safety issues, including improvements, are communicated to employees?
Review documentation and
interview workers.
Notes:
(0 - 2)
b) feedback on health and safety issues is sought from employees?
DI
INSTRUCTIONS
Score
Use any combination of
documentation and interview to
score the question.
Notes:
(0 - 2)
c) Follow-up of significant items identified during health and safety meetings?
I
Notes:
(0 - 2)
8.2
D
Are safety and loss control statistics maintained and analyzed to identify trends and needs?
Interview workers. Verify
through reviewing minutes of
health and safety meetings.
90% positive response is
required in interviews.
Review records (e.g. first aids,
medical aids, claim rates,
number of inspections /
orientations / safety meetings).
Notes:
(0 - 2)
8.3
D
Have health and safety processes been evaluated through the use of an audit process within the last
12 months?
Review previous annual audit /
assessment.
Notes:
(0 or 1)
8.4
D
Was an action plan developed and have previous action items been implemented, or initiated?
Review previous action plan.
The plan should include:
Notes:

(0 - 3)

Target and actual completion
dates
Person responsible
Points awarded based on the
percentage of action items that
have been implemented or
assessed and action planned.
PIR I AUDIT SCORE – Element 13
Audit element score possible
Points scored on this element
Revised 20150110
12
– Points not applicable (N/A)
/ Total points possible
=
= Total points possible
x 100 =
B- 13
%
External SECOR Health and Safety Audit