CHAPTER 3 SAFETY AND HEALTH PROGRAM EVALUATION
I. Purpose.
The objective of the Safety and Health Metrics/Tracking section is to provide a mechanism to measure and track the safety and health performance of all offices in the Region.
II. Scope.
This section applies to all offices (Regional, Area, and District).
III. Responsibilities.
A. The Regional Administrator is responsible for ensuring that:
1. Managers set and track appropriate safety and health goals and
objectives each year;
2. Managers complete all required safety and health-related training
and other activities for their staff as required by this Safety and Health Management System;
3. Managers report and investigate all incidents, and complete all
recommendations resulting from these investigations in a timely manner.
B. Area Directors and Assistant Regional Administrators are responsible for:
1. Setting, pursuing, and tracking safety and health goals on an
annual basis;
2. Tracking and completing all required safety and health-related
training and other activities for their staff as required by this Safety and Health Management System;
3. Reporting and investigating all incidents, and completing all
recommendations resulting from these investigations in a timely manner utilizing the Hazard and Incident Investigation Worksheets.
C. The Regional Safety and Health Manager with the assistance of the
Regional Safety and Health Committee is responsible for:
1. Compiling and maintaining injury and illness records, incident
reports, investigations for the Region and analyzing trends.
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
2. Provide safety and health performance updates on a semi annual basis to the Regional Administrator which includes the status of:
a. Progress towards safety and health goals;
b. Percent completion of mandatory training;
c. Percent completion of annual physicals;
d. Percent completion of respirator fit tests;
e. Percent completion of required annual exercises (i.e.
Continuity Of Operations Plan, Shelter In Place Plan, Occupant Emergency Plan, Local Contingency Plan);
f. Percent completion of required inspections (i.e. office
inspections, vehicle inspections, SCBA inspections, etc.);
g. Number of incidents investigated and percentage of timely
reporting (within 5 days);
h. Number of "open" versus "closed" action items list on the
"Corrective Action Items" listing;
3. Sharing recommendations and success stories on a quarterly basis
to the Regional Administrator.
4. Compiling information and data from the Hazard Report and
Incident Investigation Worksheets from each office and providing updates on a quarterly basis to the Regional Administrator.
IV. Procedure.
A. Each office in the Region will be evaluated annually on the following
metrics:
1. Progress towards safety and health goals;
2. Percent completion of mandatory training;
3. Percent completion of annual physicals;
4. Percent completion of respirator fit tests;
5. Percent completion of required annual exercises (i.e. Continuity Of Operations Plan, Shelter In Place Plan, Occupant Emergency Plan, Local Contingency Plan);
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
6. Percent completion of required inspections (i.e. office inspections,
vehicle inspections, SCBA inspections, etc.);
7. Number of incidents investigated and percentage of timely
reporting (within 5 days);
8. Number of "open" versus "closed" action items list on the
"Corrective Action Items" listing.
V. Revision History.
The table below lists all changes made to this chapter since the implementation of the program:
Revision Reason for Change Effective Date
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
APPENDIX A Safety and Health Management System (SHMS) Self-Evaluation
Note: Completion of this self audit must include input from a team consisting of management and non- management employees. During the evaluation process, input from additional employees should be encouraged, and comments / recommendations / corrective actions noted. Upon completion, the evaluation shall be sent to the Regional Administrator and the Regional Safety and Health Manager.
SECTION 1
INJURY & ILLNESS RECORDS
A. Who maintains the OSHA 300 and 301 forms?
B. Was the OSHA 300-A completed and posted in the workplace?
C. Was the OSHA 300-A signed by the Area Director/Regional Administrator?
D. Last Year's Total Case Incident Rate (TCIR):
Office___________ BLS NAICS Code – 541350____________
E. Last Year's Days Away Restricted Transfer Rate (DART):
Office___________ BLS NAICS Code – 541350____________
Comments, Current Recommendations / Corrective Actions:
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
SECTION 2 - SAFETY & HEALTH MANAGEMENT SYSTEM
Element A: Management Leadership / Employee Involvement
A-1. Commitment
a. Is a signed U/M SHMS Commitment statement posted in your office for all employees to
view?
A-2. Communication / Employee Notification
a. How is your overall safety and health policy communicated to employees?
b. Do you have a designated safety and health coordinator(s)?
c. If so, what are their responsibilities?
d. Has a safety and health committee that includes management and employees been
established?
e. How are comments or concerns regarding safety and health issues:
- communicated / submitted by employees?
- addressed or resolved by management?
f. How is the resolution of an issue communicated to employees?
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
g. How do you make employees aware of:
- the SHMS Program?
- Results of self-inspections, evaluations, S & H audits, near misses, accident
investigations, etc.?
A-3. Participation / Responsibility / Accountability
a. Give examples of managers' and employees' participation in safety and health related
activities such as training, quarterly S&H inspections, staff/team meetings, etc.
b. How are safety and health responsibilities, including specific tasks, assigned and
communicated to employees?
c. Give examples of delegated duties and the process to assure completion / accountability.
A-4. Resources
a. For the past year, give examples of resources, including time and money, devoted to the
safety and health program.
b. For the upcoming year, do you think these resources will increase, decrease, or remain about
the same?
A-5. Goals
a. List next fiscal year's goals for your safety and health program.
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
b. Have action plans been developed to accomplish these goals?
c. List last fiscal year's goals and indicate if each goal was Completed (C), is in Progress (P), or
was Withdrawn (W).
d. Describe how employees are involved in the goals setting process.
e. Once established, how are the goals communicated to employees?
Recommendations & Follow-up Items for: Element A: Management Leadership / Employee Involvement
List last fiscal year's recommendations and current status [(N/A), Completed (C), In Progress (P), or Withdrawn (W)]
Question Number Recommendation Corrective Action Status
List any Comments, Current Recommendations and Corrective Actions for Element A:
Question Number Recommendation Corrective Action Due Date
Comments:
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
Element B – Worksite Analysis
B-1. Routine Audits
a. Describe the process for conducting and documenting routine safety audits of the office.
b. How many safety audits of your office were conducted last year?
c. What procedures are in place to assure identified hazards are corrected?
d. What system is in place to identify and document routine safety and health hazards to
CSHOs in the field?
e. What are the steps that have been taken to ensure a preventative/predictive maintenance
system is in place for the following:
GSA Vehicles?
Technical Equipment?
f. When was your office's safety and health program last audited by the Regional Office?
Date of last audit?
Were there recommendations?
If so, how were they addressed?
g. Describe the annual review of programs such as lockout/tagout, bloodborne pathogens,
respirators, etc.
h. Approximately how many CSHO monitoring samples were collected last year for your
office?
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
B-1. Hazard Review – Significant Changes / Contractor Activities
a. Has a process been developed to review safety and health considerations when:
Purchasing new equipment (field or office), furniture, PPE, etc.?
Relocating office space?
Developing new emphasis program(s)?
b. Describe the procedures to oversee the activities of service / nested contractors who perform
work in your office or building.
B-2. Accident/Incident Investigations
a. What is the procedure for conducting, documenting and tracking accident investigations, near
misses, first aid and recordable incidents?
b. How are employees aware of these procedures and the importance of communicating these
incidents to management?
c. How are the results of the investigations communicated to employees?
d. Are near misses submitted to the Regional Office by the end of each quarter?
B-3. Pattern Analysis
a. Which of the following does the office use to determine and analyze any the patterns of near
misses, injuries and illnesses?
_____ Results of accident and near miss investigations? _____ Employee concerns? _____ Quarterly office inspections? _____ SHMS self evaluations? _____ Regional audits?
b. Have there been any injury / illness or near miss patterns over the last three years?
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
c. If so, what corrective actions were taken?
d. Was the data shared with the employees and the Regional Office?
Recommendations & Follow-up Items for: Element B: Worksite Analysis
List last fiscal year's recommendations and current status [(N/A), Completed (C), In Progress (P), or Withdrawn (W)]
Question Number Recommendation Corrective Action Status
List any Comments, Current Recommendations and Corrective Actions for Element B:
Question Number Recommendation Corrective Action Due Date
Comments:
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
Element C – Hazard Prevention and Control
C-1. Engineering / Administrative Controls
a. What feasible engineering controls are in place such as ergonomics, lighting,
walking/working surfaces, etc.?
b. What administrative controls are in place such as work policies?
c. What work practices controls are in place?
C-2. Personal Protective Equipment
a. Who conducted and certified the personal protective equipment assessment?
b. Are employees involved in the assessment?
c. Are appropriate types and sizes PPE available?
d. Is PPE properly used?
e. Is there a written PPE inventory?
f. If so, how often is the inventory reviewed and restocked?
g. How does the office verify that employees are using appropriate PPE?
C-3. Emergency Preparedness / Health Care
a. Does the Office have written procedures for and conducted annual training on:
Emergency Action Plan?
COOP?
REMP?
SIP?
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
b. Are CSHO physicals and respirator fit testing up to date?
c. How many staff members in the office are currently certified in:
CPR? _____
First Aid? _____
AED? _____
d. Does the office have a system to ensure the proper location, and availability (i.e. battery
checks) of the AED?
e. Describe any additional health care initiatives undertaken by the office.
f. Describe the on-site and off-site access to First Aid and emergency treatment.
g. Where is the first aid kit kept in the office?
h. Are first aid kits in each government vehicle?
i. Is there a system in place to maintain and restock the first aid supplies?
Recommendations & Follow-up Items for: Element C – Hazard Prevention and Control
List last fiscal year's recommendations and current status [(N/A), Completed (C), In Progress (P), or Withdrawn (W)]
Question Number Recommendation Corrective Action Status
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
List any Comments, Current Recommendations and Corrective Actions for Element C:
Question Number Recommendation Corrective Action Due Date
Comments:
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
Element D – Safety and Health Training
D-1. SHMS Training
a. Which of the following describes your office's SHMS training? (Mark all that apply)
_____ Every chapter of the SHMS manual is reviewed annually _____ All chapters with annual training requirements are reviewed annually _____ New and updated chapters are reviewed annually _____ Specific (non required) chapters were included in last year's training, including ______________________________________.
b. Who maintains and tracks safety and health training records?
c. Describe how employees are involved in the training process.
d. Has the office completed all the mandatory training requirements? (Attach
copy of tracking sheet.)
e. Describe additional safety and health or related training initiatives completed
during the past year.
Recommendations & Follow-up Items for: Element D – Safety and Health Training
List last fiscal year's recommendations and current status [(N/A), Completed (C), In Progress (P), or Withdrawn (W)]
Question Number Recommendation Corrective Action Status
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
List any Comments, Current Recommendations and Corrective Actions for Element D:
Question Number Recommendation Corrective Action Due Date
Comments:
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
This evaluation Report was prepared by:
Management Representative
Employee Representative
Date:___________________________
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
* OSHA ARCHIVE DOCUMENT * This document is presented here as historical content, for research and review purposes only.
APPENDIX B SHMS Mid Year Summary
* OSHA ARCHIVE DOCUMENT * NOTICE: This is an OSHA ARCHIVE Document and may no longer represent OSHA policy.
