11 Emergency Preparedness 27 14 12 Statistics and Records 18 9 13 Legislation 12 6 Total 302 Minimum standard = 80% overall score and 50% minimum in SCSA Supplemental Section each of sections 1 through 13. Possible Actual Standard Section # Section Name Points Points Achieved % Actual Points X 100 = Yes No Possible Points SS1 Physical Conditions 18 No Standard Achieved Yes SS2 Harassment Policy 8 SS3 Committees / Representative 12 Auditor Signature: Auditor Comments Senior Company Officer Name: SS1 SS2 Senior Company Officer Signature SS3 Each supplemental section must attain a minimum of 50% to meet the % Goal for Next Audit SCSA certification standards. Mandatory Information General Guidelines A description of the audit tool - "SCSA National Standard Safety Program Evaluation Tool using the three-step process of observation, Thank the auditee for the opportunity to conduct the audit. documentation and interview". The location of all worksites included in the Remain positive throughout. The total number of interviews conducted; how many were managers; how many were workers. How many of the total interviews are workers Reinforce the importance of support. management from sub-contractors. Do not reference the Certificate of Recognition in the audit summary. The The date or dates of the audit. audit is only one step in several required for COR.
11 Emergency Preparedness 27 14 12 Statistics and Records 18 9 13 Legislation 12 6 Total 302 Minimum standard = 80% overall score and 50% minimum in each of sections 1 through 13. SCSA Supplemental Section Actual Points X 100 = Possible Points Standard Achieved % Yes No Section # Section Name Possible Points Actual Points Standard Achieved SS1 Physical Conditions 18 Yes No SS2 Harassment Policy 8 Auditor Signature: SS3 Committees / Representative 12 Auditor Comments Senior Company Officer Name: SS1 Senior Company Officer Signature SS2 SS3 Goal for Next Audit % Each supplemental section must attain a minimum of 50% to meet the SCSA certification standards. Mandatory Information General Guidelines A description of the audit tool - "SCSA National Standard Safety Program Evaluation Tool using the three-step process of observation, documentation and interview". Thank the auditee for the opportunity to conduct the audit. The location of all worksites included in the Remain positive throughout. The total number of interviews conducted; how many were managers; how many were workers. How many of the total interviews are workers from sub-contractors. Reinforce the importance of management support. The date or dates of the audit. Do not reference the Certificate of Recognition in the audit summary. The audit is only one step in several required for COR.
Self_Audit_Form(31-Mar-2016).docx