Signed_____________________________
Date_______________________________
INSPECTIONS
A supervisor and a worker will conduct regular
inspections to identify hazards and recommend
how to eliminate or minimize the hazards. The
inspection will also look at how work is performed.
Serious hazards or unsafe work practices
discovered during inspections or observed by
workers, supervisors, or the employer will be dealt
with immediately. Other hazards will be dealt with
as soon as possible.
Inspections will take place every month before
staff meetings so that results can be discussed
with staff.
FIRST AID
This workplace keeps first aid kit in the cabinet
attached to the wall on the corridor. First aid kits
will be taken on all field trips. In case of emergency
you can contact:
Ambulance:
Helicopter:
Hospital:
EMERGENCY PREPAREDNESS
Fire – see fire plan located at the entrance to the
main office hall
Field accident – written emergency response
plans have been developed for all trips. They are
located on the book shelf at the entrance to main
office hall.
INVESTIGATING ACCIDENTS
A supervisor and a worker must investigate any
injuries or close calls on the same day the incident
occurs. Any incident that results in an injury
requiring medical treatment, or that had the
potential for causing serious injury, must be
investigated immediately. The purpose of an
investigation is to find out what went wrong,
determine if our health and safety practices were
faulty, and most importantly, recommend actions
that will prevent a recurrence of the problem.
PURPOSE
The purpose of reviewing health and safety
program is to make sure it’s up-to-date and
effective. A program review helps us identify the
strengths and weaknesses of our program and
allows us to focus on the areas that need
improvement. We involve employees in the review
process.
Company name
____________________________________ Date of Review
____________________________________ Conducted by
_____________________________________
Hazardous Materials
28. Do you have a written inventory of
controlled products used in your
workplace?
29. Does each controlled product have a
corresponding MSDS?
30. Are MSDSs readily available to workers
and do they know where to get them?
31. Do you have a way to check that new
controlled products are accompanied by
MSDSs?
32. Do workers understand how to read
MSDSx and know what they mean?
33. Do workers understand how to read
MSDSx and know what they mean?
34. Are decanted products labelled?
35. Do workers know what hazardous
materials are used in your business?
36. Do workers know how to safely handle,
store, and dispose of hazardous materials
used in your workplace?
Operating location_____________________
Employer’s name ________________________________
Mailing address _______________________
Type of business ______________________
Employer’s phone number _____________
Accident/injury site address or
location_____________
Worker’s occupation __________________
Worker’s last name ____________________
First name ____________________________
Mailing address _______________________
Social insurance ______________________
Date of Birth __________________________
Gender □ Male □ Female
Weight ______ Height _______
Date and time of accident/injury M____ D____ Y___
at _____Hr _____Min □ AM □ PM
Nature of reportable event
□ Dangerous occurrence (no injury) □ First aid
□ Worker injury (with time loss) □Medical
treatment only (no time loss)
□ Fatal (date of death) M_____ D_____ Y_____
Description of the incident (Where applicable,
please give detailed description of location,
activity, accident scene, equipment and tools
involved in this accident. Include names of
witnesses. Use a separate sheet if necessary.)
Contributing factor(s):________________________
Corrective action(s) to avoid recurrence
______________________________________________
Patient’s
signature____________________________________
Names of witnesses____________________________
Referral of case and remarks
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
_________
Company name:
___________________________________________________
___________________________________________________
_____________________________________
Date: _______________________________
Participants:
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
4. Other concerns
List other health and safety concerns discussed
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
5. Next meeting
Date and time of next meeting
___________________________________________________
List any matters that need to be followed up at the
next meeting
___________________________________________________
___________________________________________________
___________________________________________________