Write company name here
BASE
Submission
Version 3
Administrative
With guidelines
Write audit year here
Write lead auditor name here
Table of Contents
Purpose
Application
Executive Summary......
Audit Questions......
A. Management Leadership......
B. Hazard Identification and Risk Control......
C. Standards, Procedures and Work Instructions......
D. Training, Education and Certification......
E. Health and Safety Communication Systems......
F. Incident Reporting and Investigating Systems......
G. Contractor Management......
H. Prime Contractor Management......
Administrative Audits of Injury Management Programs......
I. Injury Management/Return-to-Work Programs (optional)......
Scoring Summary – OH&S Elements......
Scoring Summary - Injury Management/Return-to-Work Programs......
Purpose
A company may not have sufficient work activities to be audited due to the inability to perform interviews and observations, but may need to perform an audit within the calendar year or in order to be eligible to bid on or perform work. In these situations a company may conduct an Administrative audit. The audit will be performed by a certified external (for certification and recertification) or internal (for maintenance only) auditor and submitted to Council to undergo the same rigours of quality assurance as a “normal” audit. This audit will act as a bridge only, until such time that the company returns back to work. Once the company is at 70% of their intended operating size for the current calendar year, they are required to undertake a Re-certification or maintenance (as applicable for their normal cycle) audit to maintain their SAFE Certification. As such, an external Administrative audit has a maximum 1-year expiry date. Administrative audits are not typically eligible for the COR incentive cheque. Each company needs to contact the Council in advance to determine specific COR eligibility scenarios.
Application
Some questions and parts of questions in the Administrative audit refer to company records, as opposed to standards. If the company has not worked since the last audit, the auditor must score all those records-based questions as ‘Not Applicable’ and adjust each element’s available score accordingly. Otherwise, the auditor should evaluate a sample of the necessary records.
Notice of Audit Activities - NOAA
Complete all fields – an incomplete NOAA cannot be processed
Company’s audit due date: / This form is a Pre-Audit NOAAThis form is a Post-Audit NOAA
- Type of Audit – check all that apply (double-click each box to activate)
Certification / Student / Verification / Administrative
Maintenance / Gap Analysis / IM/RTW only / Limited Scope
Recertification / Team / A.M.A.P. / Phased – part / of
Combined - Must use Joint NOAA / Version 3 / W.I.V.A. / Targeted Operations
(SAFE Only – not COR)
- Company Information
Legal Company Name: / Company Trade Name/dba:
WorkSafeBC account / SAFE Certification #
Address: / City: / Province / Postal Code
Company Contact: / Position:
Phone: / Email
Combined (Joint) Submission Audit – list name and WorkSafeBC account for the other company(s) (complete separate Notice of Audit Activities for each company being audited)
Name: / WorkSafeBC #
Name: / WorkSafeBC #
- Audit Period
Estimated
Actual
- Company Activity Types
Check all that apply
Lockout / Camps and Remote Accommodations
Confined Space / Working near High Voltage Power Lines
Work at Heights / Chemicals and Asbestos
Hot Work / Manual Tree Falling
Respiratory Protection / Combustible Dust
- Personnel Count
Total personnel count per month for last 12 months:
(Total = owners + management + supervisors + workers + workers of dependent contractors)
1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
Year
(yyyy)
Month
(mmm)
Count
Attach an Organizational Chart or other description of the structure of the company.
- Operation Details
Has the Organization hired any Contractors during the past 12 months?
This applies to any contractors, not just forestry contractors. / Yes
complete Element G
No
do NOT complete Element G
Has the organization assigned Prime Contractor Status to any other company(s) during the past 12 months? / Yes
complete Element H
No
do NOT complete elementH
Does the company have an implemented Injury Management / Return to Work program that they wish to include in the audit scope.
This audit element is optional and does not affect SAFE certification. / Yes
complete Element I
No
do NOT complete element I
- Audit Sampling Plan (IM/RTW)
Injury Management not attempted in audit
Scope of IM/RTW Records / Number of case files in organization / Number of cases sampled in audit
Last 6 months
Last 12 months
Current Calendar Year / Since last audit
Other:
- Auditor Information
Audit Completed by: / Auditor Number (or ‘Student’):
Contact Telephone: / Email address:
Form date: 23 May 2013Page 1 of 82
- Scope of audit
List all WorkSafeBC CUs, their fixed locations, and operating sites. Indicate if work activity is intended (pre-) and actually present in the audit.
Payroll & Activity - means payroll is present at the site for the classification during the audit year and the activity is included in the audit
Payroll & NO Activity - means payroll is present at the site for the classification during the audit year, however the activity is not included in the audit
No payroll– means there was no payroll for that classification at that site during the audit year
If the company contact is unsure of their CU’s or locations, please contact the Council Registrar.
Insert additional rows above the total line if necessary
Total personnel and interviews are automatically calculated with <CTRL-A<f9> (or when opening or printing)
C U / LOCATION
WSBC fixed location name or address
(list separately for each CU) / SITE
Audit site name
(if more than one site per location) / COUNTTotal personnel at each site / Activity during audit year / Sites Selected for Audit / Number of personnel interviewed for current audit / Scheduling for Current Audit
Payroll & Activity / Payroll & NO Activity / No Payroll / Currentyear / 1 yr ago / 2 yrs ago / 3 yrs ago / Pre-NOAA = planned interviews
Post-NOAA = actual interviews / Auditor / Start Date / End Date
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
M / S / W
Total personnel / 0 / Min. interviews / Total interviews / 0 / M / 0 / S / 0 / W / 0
Comments, notes, descriptions regarding sampling plan (pre- or post-): (Attach additional pages for proposals for and/or outcomes of special time frames, unique sampling protocols, etc. This space can be used on the post-audit form for justifying why a particular plan was not met)
Describe the overall scope (nature and type) of the company’s activities. Include reference to the company’s locations as they relate their WorkSafeBC classification unit(s) making mention of locations and sites included in this audit:
Form date: 23 May 2013Page 1 of 82
- Post Audit Signatures
Complete and submit with your post-audit NOAA. Leave blank for pre-audit NOAA
Company Management Representative (for internal and external audits)I hereby acknowledge that I have provided true and accurate information to the auditor to the best of my abilities and agree that the audit sampling was completed as stated above.
Name / Signature / Date
External Auditor
I affirm that I have read, understood, and agree to abide by the terms and conditions of the British Columbia Forest Safety Council Auditor Code of Ethics.
I have not violated the Auditor Code of Ethics during this audit, and have not received any economic benefit from OH&S consulting activities from this company in the 12 months preceding the audit.
In addition, I have not been in a position which could be perceived as a conflict of interest by either the current BASE Auditor Manual or the current COR Standards and Guidelines.
Name / Signature / Date
Internal Auditor
I affirm that
- I have not violated the Auditor Code of Ethics during this audit;
- I have done my best to be objective in conducting this audit
- I have followed the current BASE Auditor Manual.
- I am a permanent employee of the company
Name / Signature / Date
- Submission
Submit completed NOAA to:
Receipt of your pre-audit NOAA will be acknowledged by return e-mail within one business day.
DO NOT PROCEED with the audit until NOAA is approved (not just acknowledged) by the Council.
Approval will be sent by email to the auditor and to the company contact indicated on page 1, within 5 business days of receipt of the NOAA.
If you have not received approval within one (1) week of submission, please contact the Council.
Executive Summary
Please delete this description of the Executive Summary from the final report and replace with the actual Executive Summary that meets requirements.
The Executive Summary must be presented with each submission and gives an overview of the audit activities. The following requirements should be presented:
□State the type(s) of audit (Student, Certification, Maintenance, Joint, Phased, etc.).
□State when and where audit occurred and number of site days.
□Ensure the last day of onsite activities is clearly stated.
□List all the CU’s the company has and all the CU’s included in the audit activities.
□Provide a brief statement of the audit process, specifically justifying why an Administrative Audit was required and was the only practical option..
□Give actual score and score of lowest element and state the requirements of achieving >80% overall and >50% in every element.
□Clearly state whether company meets requirements.
□Clearly state which audit elements apply.
□Give bullet list of major (3-5) strengths that logically flow from the notes.
□Give bullet list of major (3-5) areas for improvement that logically flow from the notes.
□Written in professional style and grammar, in third person and with no spelling errors.
□Include statement that there are more recommendations included in the audit report that gives the company further guidance to improve on their health and safety program.
□Scoring Summary should include a clear table with at least the minimum row and column headings in order from the BASE Audit template
□Provide correct numbers and scores based on the auditor notes.
□Signed by the Auditor.
Audit Questions
A. Management Leadership
A1. Company Health and Safety PoliciesA1.1 / Does the company have a written health and safety policy that discusses health and safety responsibilities of management, supervisors and workers? / O / D / I / Total
0
0,15 / /15
D - If the policy contains:
- A statement of intent or a safety objective;
- Responsibilities of management;
- Responsibilities of supervisors; and
- Responsibilities of workers.
The responsibilities may partially overlap, but cannot be wholly duplicated to award points unless all the company managers are supervisors and there are no supervisors that are not also managers.
Ref: WCA 3.3 (a) a statement of the employer's aims and the responsibilities of the employer, supervisors and workers.
Audit Note:
Recommendation:
A2. Health and Safety Responsibilities
A2.1 / Have specific safety responsibilities for all occupations been written and communicated to relevant workers? / O / D / I / Total
0
0,7 / /7
D - If the company has written specific safety roles and responsibilities for at least 70% of all occupations, award 7 points.
Ref:WCA 3.3 (c) appropriate written instructions, available for reference by all workers, to supplement this Occupational Health and Safety Regulation.
Audit Note:
Recommendation:
A2.3 / Do supervisors know the applicable standards and required control measures when evaluating safety of work activities? / O / D / I / Total
0
0-5 / /5
D- Award up to 5 points based on % of completed supervisor records that contain appropriate depth and breadth of information to show that supervisors understand the legal requirements, company safety standards and control measures required to ensure the safety of work activities. Potential records include, but are not limited to, supervisor diaries, notes, inspections and assessment reports, 23-page faller assessments.
Ref: General duties of supervisors, WCA 117
(1) Every supervisor must:
(a) ensure the health and safety of all workers under the direct supervision of the supervisor.
Audit Note:
Recommendation:
A2.7 / Has a management review been conducted to identify opportunities for improvement and changes needed for the safety program? / O / D / I / Total
0
0-10 / /10
D- Award up to 10 points based on the % of topics covered in the annual management review. A comprehensive plan will include at least review of:
a)results of inspections;
b)results of audits;
c)corrective / preventive action completion and status reports;
d)completion level of safety program objectives (as defined in annual plan);
e)changing business and legal/regulatory circumstances; and
f)safety improvement from previous year.
Award points based on the % of topics covered.
Ref: WCA 3.3 (d) provision for holding periodic management meetings for the purpose of reviewing health and safety activities and incident trends, and for the determination of necessary courses of action.
Audit Note:
Recommendation:
A. Management Leadership
Awarded / Available / N/A / Available – N/A / % awarded
Total / 0 / 37 / 37 / 0%
Min 50%
Note: auditor to only enter numbers in white fields.
Coloured fields auto-calculate with <ctrl-a>,<F9>
B. Hazard Identificationand Risk Control
B1. Hazard IdentificationB1.1 / Is there a process to determine what the hazards and risks are in the work place before the job starts for routine, modified and non-routine job tasks? Does this include ergonomic issues? / O / D / I / Total
0
0-20 / /20
D- If the program documentation includes a detailed risk assessment process, award 5 points.
The process needs to include:
- when hazard identification and risk assessment should be conducted;
- the people or groups responsible for the process; and
- the method, format and/or form to be used.
If the process includes prioritization of risks, award a further 5 points.
If the process includes an evaluation of ergonomic / MSI risk factors, award a further 5 points.
If the process requires that control measures be developed based on the following hierarchy:
- Elimination
- Substitution
- Engineering controls
- Signage/warnings and/or administrative controls
- PPE
Ref: OHSR 4.1 Safe Workplace
A workplace must be planned, constructed, used and maintained to protect from danger any person working at the workplace.
Audit Note:
Recommendation:
B1.2 / Are hazard identifications and risk assessments being conducted prior to starting job tasks or when there are work process changes impacting on safety? / O / D / I / Total
0
0-5 / /5
D- Award up to 5 points based on the completeness and timeliness of assessments conducted.
Assessments need to be conducted for routine, non-routine and modified tasks for both operational and maintenance activities in field and shop settings. If relevant check for block falling plans and danger tree assessments.
A typical assessment of maintenance activities may be captured in a JSA or JSB for those activities.
Ref: OHSR 26.2 (4), 4.1.1, 4.13, 4.48, 5.53, 9.9 and others
Audit Note:
Recommendation:
B1.5 / Is there a process in place to ensure that risks associated with new products, equipment and tools are assessed before they are purchased? / O / D / I / Total
0
0,3 / /3
D-If records support that pre-purchase assessments are occurring in at least 70% of cases, award 3 points.
If there have been no purchases requiring assessment in the scope of the audit timeframe, award the points if a written process exists.
Ref: OHSR 26.2 (4), 4.1.1, 4.13, 4.48, 5.53, 9.9 and others.
Audit Note:
Recommendation:
B2. Risk Controls
B2.1 / Is there a maintenance program in place for facilities, tools and equipment meeting the manufacturer, regulatory and company safety requirements? / O / D / I / Total
0
0-15 / /15
D-Award up to 15 points based on the % of sampled tools and equipment covered by the maintenance program in a manner that meets manufacturer, regulatory and company safety requirements.
Potential sources of records include, but are not limited to:
- Equipment inventory lists;
- Maintenance schedule;
- Equipment inspection records (whether user or maintenance personnel inspections); and
- Computer-based maintenance management systems.
Audit Note:
Recommendation:
B2.4 / Have the risk control measures and safe work procedures been reviewed and updated on a regular basis and when there are changes in work conditions? / O / D / I / Total
0
0-5 / /5
D-Award up to 5 points based on records showing that risk control measures and safe work procedures are reviewed at least every 2 years and/or updated when necessary.It is not necessary to show that the procedures change every 2 years, only that they are examined to determine if they are still applicable.
Ref: OHSR 3.16, 5.5, 7.5, 8.6 and others
Audit Note:
Recommendation:
B2.6 / Does the company have a progressive enforcement policy to address safety non-compliance and is it being used by managers and supervisors where required? / O / D / I / Total
0
0,5 / /5
D-If the discipline process includes progressive steps, award 5 points.
Ref: Guideline G-D3-116
Audit Note:
Recommendation:
B3. Inspections
B3.1 / Does the company have a site inspection program? / O / D / I / Total
0
0,5 / /5
D-If the written company inspection program exists and contains a statement guiding the intent of inspections, award 5 points.
Ref: OHSR 3.3 (b)
Audit Note:
Recommendation:
B3.2 / Does the inspection program outline what is to be inspected and the inspection frequency? / O / D / I / Total
0
0-10 / /10
D-Award 2 points for each of the following topics covered in the inspection program:
- Equipment;
- Facilities, including camps and other remote accommodations under company control
- Materials (i.e. supplies such as explosives, fuels and raw materials);
- Worker activities and practices;(specifically including lockout, confined space entry, manual tree falling and working at heights as appropriate to company activities) and
- Site conditions (specifically including combustible dust buildup as appropriate).