Joint Operations (JO) CHESM Q u a lifica tion Qu e s tion n a ire Core Questions

Transcription

1 Joint Operations (JO) CHESM Q u a lifica tion Qu e s tion n a ire Core Questions 1. General Contractor Company Name Service Provided JO Department Sponsor JO Contract Owner Number of Employees Supporting JO Operations Company Director/Manager: Phone: Fax: Contractor Representatives Site Supervisor: Phone: Fax: HES Representative: Phone: Fax: Contractor Management Representative: Phone: Fax: Date of last inspection/audit by a JO representative? Contract Company was founded (Date)? Click here to enter a date. Click here to enter a date. Version 3.1. Revised 20 Feb

2 1. General Years worked in JO Completed By (JO Assessor) Name: Position: Phone: Fax: Date Submitted: Click here to enter a date. te: Please provide resume or work experience (curriculum vitae) for key leadership positions to include site supervisor, project manager, HES representative, and contactor management representative. Version 3.1. Revised 20 Feb

3 2. Health, Environmental and Safety Performance Are key element records listed in available for the last three years? Comments: Provide companywide information (previous three years of data) Total number of employee hours worked. Specify the basis for exposure or employee hours: 8 Hr. Shifts 12 Hr. Shifts Other Total Kilometer driven Use 200,000 man-hour & 1,000,000 Km driven based to calculate rates 2.2 Number of Work-related fatalities 2.3 Number of injuries resulting in days away from work (DAFW) 2.4 Number of recordable injuries (TRI) 2.5 Number of Motor Vehicle Crash (MVC) Version 3.1. Revised 20 Feb

4 2. Health, Environmental and Safety Performance Provide information for work performed within JO facilities or JO geographical region (previous three years of data) Total number of employee hours worked within JO facilities or JO geographical region Total Kilometer driven within JO facilities 2.7 Work-related fatalities within JO facilities or JO geographical region Rate of injuries resulting in days away from work within JO facilities or JO geographical region Rate of recordable injuries within JO facilities or JO geographical region Rate of motor vehicle accidents within JO facilities or JO geographical region Have you received any regulatory citations or been involved in any court litigation related to HES incidents or noncompliance in the last three years? Never: White colour flag Once: Blue colour flag Twice: Yellow colour flag More than twice: Red colour flag Version 3.1. Revised 20 Feb

5 3. Health, Environmental and Safety Management 3.1 HES Organization: Does your organization have the following: a) A director or senior manager responsible for HES? b) Does your organization have a part/full-time position assigned HES responsibilities? (Please describe.) 3.2 HES Benefits: Do you have or provide for your employees: a) Medical insurance? b) HES training? 3.3 HES Targets: What are your company s annual HES targets in: a) Safety: Determined or t Determined b) Health: Determined or t Determined c) Environmental: Determined or t Determined Version 3.1. Revised 20 Feb

6 3.4 HES Written Plan: Does your written HES Plan include: a) HES policy and management commitment and expectations? b) Clearly defined HES responsibilities and accountabilities for managers, supervisors, and employees? c) Resources for meeting HES requirements? d) Periodic management system review of key processes, procedures, and standards to ensure compliance and performance improvement? e) Document control and record retention process? f) Written safe work procedures specific for your work? g) Documented employee fitness for duty (skills, knowledge and physical/medical suitability for job) process? N/A h) Inspection/Audit program? i) Hazard identification and risk control? Version 3.1. Revised 20 Feb

7 3.5 Employee Engagement: a) Periodic HES performance appraisals for all employees? b) Do your employees participate in team activities to improve HES performance? c) Do your employees have the authority to stop work for safety reasons? d) Are HES issues, inspection results, investigation results and learnings communicated to employees? 3.6 HES Meetings: Do you hold periodic HES Meetings that include: Field Supervisors? Employees? Sub-contractors? a) Do you hold daily toolbox safety meetings? b) Are the HES meetings documented with minutes and attendees list? c) Do Managers participate in safety meetings? (Job titles?) Version 3.1. Revised 20 Feb

8 3.7 Sub-Contractors: a) Does your company use sub-contractors? If, provide current list of sub-contractor companies. If, select N/A for remaining questions of this section. b) Is there a written contractor safety management process? (1. Pre qualification and/or selection; 2. Pre job activities and work in progress; 3. Final evaluation.) c) Is there a written contractor safety management process? d) Do you evaluate the ability of sub-contractors to comply with applicable HES requirements as part of your selection process? Provide example or criteria. (1. Expertise HES dedicated personnel) only; 2. Materials/equipments; 3. Other HES programs like training N/A N/A N/A 3.8 Inspections and Audits: a) Do you have a written inspection/audit procedure? b) Do you conduct self-inspections and audits and document them? c) Do you track/measure corrective actions to verify completion within assigned time? Describe verification process. Version 3.1. Revised 20 Feb

9 3.9 Hazard Identification and Control: a) Do you have a documented process to identify work-related hazards including task, work location, natural conditions, and materials? For 3.9.a. (1. Procedure/written process in place, 2. Include title of task and work location, 3. Include also natural conditions and materials) b) Are practices and procedures developed based on the hazards identified to mitigate the risk to employees? 3.10 Incident Reporting, Investigation and Statistical Data: a) Do you have a written process to report, investigate, and record incidents? For 3.10.a. (1. Procedure/written process in place, 2. Inconsistent implementation, 3. Consistent implementation) b) Does your process provide a technique for root cause analysis? c) Do you have a process in place to track recommendations and corrective actions to completion within the assigned time? For 3.10.c. (1. Procedure/process in place, 2. Inconsistent implementation, 3. Consistent implementation) Version 3.1. Revised 20 Feb

10 d) Does your company have a process to share lessons learned on incidents and near misses? For 3.10.d. (1. HES Meeting, 2. Bulletin Board, 3. Town hall Meeting after accident or other communication media) 3.11 Behavior-Based Safety: a) Do you have a behavior-based safety (BBS) process in place? 3.12 Personal Protective Equipment (PPE): a) Do you have a written PPE program that includes? b) Is the program communicated to all employees? c) Do you provide the required PPE for the jobs that you perform? 3.13 Regulatory Compliance: a) Do you know the HES-related government and local regulations pertaining to your work? If you do, please list titles of the regulations Pollution Prevention: a) Does your company have waste management plans? N/A b) Have all your waste streams been identified? N/A Version 3.1. Revised 20 Feb

11 c) Do you have a site-specific spill prevention program? N/A 3.15 Emergency Preparedness and Response: a) Do you have written site-specific emergency response plans? te: Small companies may not have their own plan but still need to have site-specific emergency response plans. b) Do you document emergency response training and drills? te: Small companies still need to document participation in site emergency drill at owner s facility. 4. Fitness For Duty: Skills, Knowledge, and Training 4.1 Short-Service Employee (SSE): employees new to your company or new in their work assignment a) Do you have a documented SSE program? 4.2 Craft Training: a) Have employees been trained in appropriate job skills? Version 3.1. Revised 20 Feb

12 4. Fitness For Duty: Skills, Knowledge, and Training b) Are employees job skills certified where required by regulatory or industry standards? 4.3 Health, Environmental and Safety Orientation: a) Do you have a HES orientation program for newly hired employees? b) Does your orientation program include the requirements as agreed in the contract HES exhibit? 4.4 Health, Environmental and Safety Training Content: a) Do you know the local regulatory and JO HES training requirements for your employees? b) Have your employees received the required HES training and retraining? c) Do you provide specific supervisory HES training for new supervisors and refresher training for existing supervisors? d) Does the training program include work practices and procedures such as: General safe work practices? Equipment lock-out and tag-out (LOTO)? N/A Version 3.1. Revised 20 Feb

13 4. Fitness For Duty: Skills, Knowledge, and Training Permit-to-work procedures? N/A Fall protection? N/A Personal protective equipment? Vehicle/Driving safety? N/A Electrical equipment grounding? N/A Incident reporting and investigation? Emergency preparedness and response? Environmental protection? N/A Hazard identification and control? 4.5 Training Records: a) Do you have HES and crafts training records for each individual employee that include employee identification, date of training, and name of trainer? Version 3.1. Revised 20 Feb

14 5. Fitness For Duty: Medical Suitability and Industrial Monitoring 5.1 Medical Services: a) Do you have a process to provide medical treatment for your employees? 5.2 Medical Examination: a) Do you conduct medical exams for employees for pre-placement job capability? (1. General checkup, 2. Work specific checkup): 0 for ; 0.5 for conducting 1 for field work; 1.0 for office work and conducting 1 and 2 for field work. N/A 5.3 Substance Abuse: a) Do you have a substance abuse monitoring program? N/A 5.4 Industrial Hygiene (IH): a) Do you perform IH monitoring on your employees? If you do, please indicate for what substances (e.g., asbestos, benzene, lead, radiation, total hydrocarbons and welding fumes). b) Do you have a hearing conservation program with annual testing? N/A N/A Version 3.1. Revised 20 Feb

15 6. Equipment and Materials 6.1 General: a) Do you maintain updated and accessible MSDS for paints and chemical? N/A b) Does your company have a motor vehicle safety policy and process? 6.2 Equipment: a) Do you conduct, document and follow up inspections on operating equipment (e.g., cranes, forklifts)? b) Do you maintain operating equipment in compliance with regulatory requirements including certification, calibration, maintenance system, etc.? N/A N/A Version 3.1. Revised 20 Feb