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owledge of Employee Timecard 70-100 Risk

matrix electric Requirements JHAs Oversight Tech. Awareness meet Emergency Plan Satisfaction management report Score
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Safety &
Quality
Training
Were you given the proper training when you first started?
Would not training an employee have large consequences?
Are additional trainings offered?
Does this department require a training course before starting work and after a
year to refresh?
Does this departments jobs and activities need an understanding beyond basic
knowledge?
Is a training matrix used?
Name Prob. Score(1-5) Impact Score(1-5) average probabilityaverage Impact Risk Risk Level
Bob 1 5 2 4 Training Yellow
Joe 2 2
Jim 3 4
PPE(Safety Standards)
Are you in your area aware of the possible hazards on the job?
Do you understand the preventive equipment needed to stay safe and
healthy?
Do you own safety equipment such as shoes, gloves, goggles?
Do you wear safety shoes and gloves?
Are using PPEs enforced?
Have you ever chosen not to wear/use PPE?

Name Prob. Score(1-5) Impact Score(1-5) average probability average Impact Risk Level
Mike 3 5 4 4 Red
James 5 4
Alex 4 4
Hazard Communication(Safety Standards)
If you see hazards do you report them immediately?
If you see hazards do you know who to call? (301-286-9111)?
Are You aware of some common hazards that should be reported?
Do you know the proper procedure to eliminate hazards?
Has there been a hazard that has gone untreated for a long period of
time in your work area?

Name Prob. Score(1-5) Impact Score(1-5) average probability average Impact Risk Level
Beth 3 4 3 4 Yellow
Ken 2 2
Charles 3 5
Safety Meetings(Safety Standards)
Do you or someone attend safety meetings in your department?
If so can I have their name and if it is you, do you contribute in a
meaningful way?
If you are on the safety committee and dont attend, is there a
reason?
Do you listen during the meetings?
Did you choose to attend or was it recommended/required?
Name Probability score (1-5)Impact score(1-5) Average Prob. Average Impact risk level
John 4 2 2 1 Green
Anne 1 1
Chris 2 1
 Overall Safety Stats
name Average Prob. Score(1-5) Average Impact Score(1-5)
Overall probability Overall Impact Overall Risk Score
PPE 4 4 3 3 Yellow
Hazcom 3 4
safety meetings 2 1
Employee Retention
Are there a large number of this departments employees leaving?
Is there a common factor behind the departures?
Is an increase of flexibility and salary available for these workers?
Has This been common in your department?
Is it difficult to fill these roles?
Are the workers nearing the age of retirement?
Are you planning on leaving sometime in the very near future?
Name Probability score (1-5) Impact score(1-5) Average Prob. Average Impact risk level
Brad 4 4 3 4 Yellow
Nancy 3 4
Nick 2 4
Machine Safety
Do you frequently use machines and other heavy objects?
Do you understand the risk to yourself and to others when operating a machine?
Do you maintain focus during machine operations?
Does your department use machine safety guards to operate safely?
Do you remove these guards with authorization?
Name Probability score (1-5) Impact score(1-5) Average Prob. Average Impact risk level
Do you listen to music while operating a machine? Tim 3 5 2 5 Yellow
Ben 1 4
Do you use, look for, and understand hand singles? Pat 2 5

Are Pre operational inspections performed?

Are employees Retrained every few years?
Has someone been injured by machines in your department?
Are you trained for the machine you are operating?
Electrical Safety
Are you aware of the type of materials that are conductors/ insulators
Are you aware of the two types of electric disturbances(electric shock & arc flash)?
Are GFCI(ground fault circuit interrupters) used to monitor electrical current?
Do you work in a well lighted area?
Name Probability score (1-5) Impact score(1-5) Average Prob. Average Impact risk level
Are you working around exposed wire? Jamie 2 5 2 4 Yellow
Richard 1 4
Pre work tool inspections? Cameron 4 4

Are you aware of the fire extinguishers in the work space?

Do you refer to the occupational health and safety handbook before working near high voltage sources?
Do you offer/take Electrical Hazard training?
Do you Work on live equipment?
Do you monitor and label electrical equipment and substations while working?
Do you have a mechanism for keeping updated service drawings and installation changes?
Do you use appropriate signage?
Means of removing people in contact with electric?
Machine & Electrical Safety Overall
Name Average Prob. Score(1-5) Average Impact Score(1-5) Overall probability Overall Impact Overall Risk Score x Risk Priority
Machine 3 5 3 5 Red x Safety meetings Green
Electrical 2 5 x Training yellow
x Employee Retention yellow
Etis II Safety standards yellow
Machine & Electrical Safety Red
Updated Job Hazard Analysis

Are you familiar with the two types of job hazards(health, safety)
Do you use the JHAs when on the job
Are you familiar with three kinds of hazard controls(Engineering,
Admin, PPE).
Are all hazards and recommendations listed on the Job Hazard
Analysis?
Are experts involved in the identification of this process?
Quality Oversight
Do you monitor your employees or are you monitored while working
to ensure excellence and decrease threats?
Are there programs in place to improve the mistakes of workers?
Do you discipline employees but do not have a formal program for
improvement?
How do you respond/implement them?
Do you perform self inspections while working?
Are these inspections enforced by management?
Do you understand the need for self inspections?
Meeting the Deadlines
Does your department complete its tasks on time?
Are meeting deadlines your top priority?
Do you know the tasks you are responsible for?
Are deadlines scheduled for multiple activities or just the overall
project?
Do you focus on one task at a time?
Do you set reminders for deadlines?
Are tasks scheduled in multiple sources (print and technology)?
Obsolete technology
Do you update your computers operating system when prompted to?
Is your technology not receiving updates anymore?
Have your experienced data loss at some point of your work?
Does your hardware/ software appear to be old and not working as
good as it once did?
Can the technology be affordably replaced?
Situational Awareness
When on the job are you aware of your surroundings and possible
threats to safety?
On a daily basis do you look for things out of the ordinary?
Do you notice the signs, machines, equipment, and barricades when
walking through the facility?
Are you distracted throughout the day?
Are you walking while looking down at your phone?
Do you acknowledge others as you pass them?
Emergency Plan
Have you familiarized yourself with the building Emergency Plans?
Do you know where to evacuate to in the event of an emergency?
Do you know the method by which your companys facility uses to
communicate emergencies?
What would your first response be if an emergency occurred at work?
(Safely stop work, turn off equipment, secure hazardous materials)

After how long would you wait until you returned to the building?
Project Management
What are you thoughts on the Project management of your project?
Do you believe it is acceptable or needs improvement?
On a scale of 1-10 how good is the management doing on your
project?
Do you believe a different Project manager would impact the project
in a positive way?
How do you feel you manage yourself in a project?
70-100 Report
Do you complete the 70-100 report?
Do you know what the 70-100 report is?
Does anyone in this department complete the report?
What can you do to improve the rating achieved on this report?
Are you interested in improving?