| | The following group rating program survey has been developed to review how each group member company is doing in meeting the new safety guidelines. The survey will only take 15-20 minutes of your time. If you have not completed all the items yet, still fill out the survey and advise of actions that you are taking. The survey will not be used against any group company and will not be given to the B.W.C. Please return the survey to RiskControl360. |
| Yes | No | |
| _____ | _____ | Do you have a written Safety and Health Policy in place, which was signed by the President or appropriate senior management representative? |
| _____ | _____ | Has a copy been posted in the work area so all employees can review and read? |
| _____ | _____ | Is it reviewed with all new employees at the time of hire? |
| _____ | _____ | Does senior management take an active role in supporting the safety efforts of the company? |
| _____ | _____ | Have clear safety responsibilities been developed for management/supervisor employees? |
| _____ | _____ | Are management/supervisors held accountable for their safety performance? |
| _____ | _____ | Is there an active effort to get employees involved in the Safety Program? |
| _____ | _____ | Is there a Safety Committee in place? |
| _____ | _____ | Is there a Suggestion Program in place that will allow employees to make recommendations to improve the safety program? |
| _____ | _____ | Are all accidents and/or misses reviewed with all employees? |
| _____ | _____ | Have all pertinent management employees received training in their safety responsibilities and duties? |
| _____ | _____ | Is there a New Employee Safety Orientation Training Program in place covering the company's safety program, specific job safety procedures and required OSHA mandated training? |
| _____ | _____ | Has any management employee been trained in how to conduct employee safety training? |
| _____ | _____ | Is there a written Safety Policy Manual in place? |
| _____ | _____ | Have job specific guidelines been written up for the specific jobs? |
| _____ | _____ | Has an appropriate level management individual been designated as the company Safety Coordinator? |
| _____ | _____ | Has this individual received training in these responsibilities and duties? |
| _____ | _____ | Does this employee have the authority necessary to ensure company safety policies are implemented and enforced? |
| _____ | _____ | Is there a Transitional Duty Program in place? |
| _____ | _____ | Is there a Safety/Housekeeping Inspection Program in place? |
| _____ | _____ | Are items noted on the inspection corrected as soon as possible? |
| _____ | _____ | Is there a Injury Report generated, reviewed for repeat injury types and individuals and communicated to all management and hourly employees? |
| _____ | _____ | Are all accidents investigated properly and a detailed Accident Report completed? |
| _____ | _____ | Are employees with safety related problems counseled on their behavior? |
| _____ | _____ | Are all belts, gears, flywheels and pulleys guarded adequately? |
| _____ | _____ | Are points of operation guarded adequately? |
| _____ | _____ | Are operating controls and stop buttons clearly marked and operating properly? |
| _____ | _____ | Are grinders supplied with tongue guards adjusted to within 1/4î of the wheel and work rests adjusted to within 1/8î of the wheel? |
| _____ | _____ | Comments: |
| _____ | _____ | Have employees been trained in proper lifting procedures? |
| | Please explain any actions you are presently taking or plan to take on items that need to be implemented: |
| | Please return a copy of this completed survey to: |
| | RiskControl360 |
| | 5500 Glendon Court, Suite 360 |
| | Dublin, OH 43016
|
| | If you have any questions or need any assistance, please call RiskControl360 at 877.360.3608. |
