Specialized PPE: Personal protective equipment that is more specific to Current Number of Workers: The maximum number of workers the particular hazards on a work site. Includes items such as hearing auditee has or is expected to have at the time of the audit, including protection, fall protection, respirators, monitors, etc. sub-contractors. A special training session used to orient new or Orientation: Key Contact: Senior Management or designate responsible for the transferred workers to an organization and /or to a particular work facilities under audit. site. A short routine meeting designed to address safety An auditor's most recent SCSA Auditor Tool Box Meeting: Certification Number: issues and training; also called Tail Gate Meeting. certification number. Policy: Written detailed company protocol. Hazard controls / Recommendations / Follow up / Remedial Action: Policy Statement: A brief description or reference to company Various terms used to refer to the action that has or will be taken to protocol endorsed (signed and dated) by senior company control hazards identified and assessed during hazard assessments, management. meetings, inspections, investigations, job hazard analysis and other Reciprocity: Reference to an agreement between certain Construction processes defined in safety policy. Safety Associations within Canada that promotes interprovincial while maintaining a defined minimum safety standard. 1 List all dates included in the audit. 2 List all locations and worksites included in the audit. Check all boxes that apply for "Type of Audit" and "Type of Auditor". 3 List the name(s) of the most current trained individual(s) representing the Certificate of Recognition complete with the most recent 4 training date. List only one name for each category. Individuals listed must be in full time service to the employer. Enter company information and include the e-mail address for the key contact. The key contact is the person primarily concerned with 5 the detailed administration of the safety program and may not necessarily be a senior company officer. List the number of workers at the time of the Include workers associated with employers under contract to the auditee. This 6 number will be used to determine the interview sample size. 7 auditor information only for the certified auditor. If information does not apply for certain fields enter "n/a". If a student is conducting this audit under supervision list their name above the certified auditor's name with the word student (in 8 brackets) beside the student's name. Do not enter any other information regarding the student. All fields on this form must be completed. 9
Specialized PPE: Personal protective equipment that is more specific to particular hazards on a work site. Includes items such as hearing protection, fall protection, respirators, monitors, etc. Current Number of Workers: The maximum number of workers the auditee has or is expected to have at the time of the audit, including sub-contractors. Orientation: A special training session used to orient new or transferred workers to an organization and /or to a particular work site. Key Contact: Senior Management or designate responsible for the facilities under audit. Tool Box Meeting: A short routine meeting designed to address safety issues and training; also called Tail Gate Meeting. Certification Number: An auditor's most recent SCSA Auditor certification number. Hazard controls / Recommendations / Follow up / Remedial Action: Various terms used to refer to the action that has or will be taken to control hazards identified and assessed during hazard assessments, meetings, inspections, investigations, job hazard analysis and other processes defined in safety policy. Policy: Written detailed company protocol. Policy Statement: A brief description or reference to company protocol endorsed (signed and dated) by senior company management. Reciprocity: Reference to an agreement between certain Construction Safety Associations within Canada that promotes interprovincial while maintaining a defined minimum safety standard. 1 List all dates included in the audit. 2 List all locations and worksites included in the audit. 3 Check all boxes that apply for "Type of Audit" and "Type of Auditor". 4 List the name(s) of the most current trained individual(s) representing the Certificate of Recognition complete with the most recent training date. List only one name for each category. Individuals listed must be in full time service to the employer. 5 Enter company information and include the e-mail address for the key contact. The key contact is the person primarily concerned with the detailed administration of the safety program and may not necessarily be a senior company officer. 6 List the number of workers at the time of the Include workers associated with employers under contract to the auditee. This number will be used to determine the interview sample size. 7 auditor information only for the certified auditor. If information does not apply for certain fields enter "n/a". 8 If a student is conducting this audit under supervision list their name above the certified auditor's name with the word student (in brackets) beside the student's name. Do not enter any other information regarding the student. 9 All fields on this form must be completed.
SELF_AUDIT_FORM_22newest.docx