Management Info

Incident

Management

Safe Work

Procedures

Notifiable Works

SDS sheets

Training Register

Procedures

Safety Performance

Monitoring

Full range of Safety

and Hazard Registers

PPE register and

issuing form

Employee Induction

& Training

Assessment & Control

Plant & Equipment

Registers

Evacuation Plan

Supervision

Employee Health

Just some of the additional information in this file to consider:

General Hot

Works

Induction/Visitor Register

Task Analysis

Notifiable Works

Accident/Incident

Register

Full range of Safety and Hazard Registers

Toolbox Safety

Tips and Meetings

Accident Investigation

Inspection Form

A Safety Plan to Suit Your Job

Your Specific Safety Plan Checklist contains Yes or No check boxes.

Where there is a Yes/No option, a response must be given.

Tick the Actioned box when the subcontractor has completed the required action.

All items must be responded to in order to sign off the Site Specific Safety Plan

(SSSP).

Once the SSSP is signed off, site access can be granted to the subcontractor.

The person who is designated to act on behalf of your business for safety on site may be a dedicated safety representative, your supervisor, or one of your employees.

Definition of a Principal

A person who engages any person (other than as an employee) to do any work for

gain or reward. A principal can be a:

• client who directly contracts a main contractor or subcontractors

• a main contractor who engages subcontractors • subcontractors who engage other subcontractors • self-employed persons who engage subcontractors.

Definition of a Person Who Controls a Place of Work A person who controls a place of work can be a person who:

• owns, leases, subleases or is in the possession of/occupies a place of work

• owns, leases or subleases plant or equipment used in the place of work.

Definition of a Person A person can be a legal person such as an employer or a natural person such as

an employee.

A person can be:

• the Crown

• a group of people who act as an individual such as a company, a body

corporate or the Crown • an employee

• a self-employed person.

Persons in control of the workplace. The subcontractor must identify the person

who has control of the workplace and confirm this on form 1 of this SSSP. This

will often be the project’s principal, but if the work is being done directly for a

client on their premises, then the employer in control of the site may be the client or building owner. The people in control of the workplace, and their site representative, have the overall responsibility for health and safety management

for the site, which will include managing most of the items in the SSSP Checklist

and co-ordination of all trades’ health and safety.

All hazards to be brought onto the site or created during the course of the work

must be identified and controlled. The standard Task Analysis Worksheet may be used to analyse the various tasks within your trade work, identify the significant safety hazards and detail the method of control. These sheets must be attached and forwarded with your SSSP.

A Hazardous Substance/Dangerous Goods Register must be maintained with the

appropriate Safety Data Sheet (SDS). If specific emergency processes need to be set up, this will be addressed on the Task Analysis Worksheet to be incorporated into the project emergency planning and evacuation processes.

Communication/Employee Participation (Toolbox Safety Meeting Minutes)

On-site safety requirements must be communicated to all site personnel. This

will include the notification of hazards brought onto the site or created during the

course of the work. Do this by posting hazards on the main site hazard board, or advising staff during regular safety meetings. The aim is to ensure that all workers on site are aware of the hazards as they arise and are advised when they

no longer exist. If English is the second language of any of your employees, then you must maintain a liaison person on site who can effectively communicate between them and the site management team.

Toolbox meetings should be run on a regular basis and run for 10-15 minutes. The

frequency of meetings will depend on the size, nature and location of the site. Some hazardous activities could require daily meetings, while often a

weekly/fortnightly meeting will suffice. Safety meetings for workers should be short and to the point.

Why do we run Safety Meetings?

• Inform workers of changes to company procedures

• Identify new hazards and review existing hazards

• Develop/review hazard controls

• Discuss/review accident and incident data

• Employee participation

• Communication

• Discuss programs

• Develop/review work processes

• Short training sessions

Record Meetings

Details of meetings should be recorded and kept on file. Record meeting dates,

attendees and discussion items. Show follow-up items from previous hazards, accidents and incidents.

Emergencies(Emergency Plan; Emergency Evacuation Plan)

In the event of a site evacuation, the Emergency Evacuation Alarm will be sounded and your employees must promptly evacuate the site. The site

management team will notify you of your assembly point at the time of your

induction onto the site.

Some emergencies that you may need to prepare for, and have a procedure to deal with, include spillage of hazardous substances, serious harm accidents to

your staff, and rescue of a fall arrest victim. Each potential emergency you

identify under your hazard management process must have an emergency plan and procedure prepared and included with the hazard management information submitted so that any effect it may have on the Emergency Evacuation Plan can

be identified and rectified.

You must have a person on site trained in First Aid, with a current valid

certificate, in case of an injury or accident.

Accident/Incident Reporting

All accidents and incidents must be reported immediately to site management.

Accident and Incident Investigation Reports are to be given to site management as soon as is practicable. You must also report serious harm accidents directly

to Provincial or State agencies. In the case of serious harm accidents, the scene

must not be disturbed until a full and complete accident investigation has been undertaken.

Safety Inspections and Safety Reviews

You are required to carry out regular, documented safety inspections of your own

work areas while on site, at the intervals and as per the prime contractors safety manual. Copies of the Accident and Incident Investigation Report must be given

to site management for discussion at safety meetings. Any recommended/completed corrective action will be advised at these meetings.

Training/Induction

All persons starting work on this site must go through a formal induction process. During this process, safety rules and various site specific issues will be discussed.

Please supply a list of all your employees working on this site, along with their access card numbers and expiry dates at the time of the induction. All employees will be expected to show their Site Safe access cards at induction.

You will need to provide and maintain evidence of your employees’ skills training, e.g. trade qualifications, certificate of competency, etc.

Sign-off/Approval

Before any work commences on site, the subcontractor will sign off their SSSP and submit it with all attachments to the principal/site management for approval.

The principal/site management will review the plan using the Site Specific Safety

Plan Evaluation and return it to the subcontractor if not complete, or request a

meeting with the subcontractor to review and action any deficiencies.

Once all the evaluation checks have been satisfactorily agreed, the principal/site

management will sign and date the SSSP confirming approval and return a signed

copy to the subcontractor for their record.

Subcontractors

The subcontractor must have a process in place for approving their own

subcontractors’ safety systems. If the subcontractor contracts out some of their

work to another subcontractor, then the site management must be notified in a schedule attached to the subcontractor’s SSSP of the names and contact details

for all their subcontractors.

Hazard Register

PROJECT/SITE

IDENTIFIED

HAZARD

POTENTIAL

HARM

SIGNIFICANT

HAZARD E I M

HAZARD

CONTROLS

REGULAR CHECK OF HAZARD CONTROLS IN

PLACE

Yes No Training Required

Date Checked

Date Checked

Date Checked

Date Checked

Hazardous Substance/Dangerous Goods Register (Safety Data Sheets – SDS)

PROJECT/SITE EMPLOYER

“SDS” records concise health, safety and technical information held for all products used and stored by the organisation

Date

Substance,

Chemical, Material or

Solvent

Supplier

SDS Report

Held Y/N

Hazard Potential Safer Alternative Protective

Clothing Required

Action

Recommended

Action

Review Date

Completion guide and action sign-off

Completed Safety Data Sheets are held for all products and the information, health risks and the directive to use protective

equipment have been conveyed to employees and recorded in the Safety Training and Competency

Register……………..……………………..…………….……signed (Site management) ………………………..….(Date)

Task Analysis Worksheet

JOB DESCRIPTION PROJECT/SITE EMPLOYER DATE

PPE required: Task Analysis completed by:

Date:

Plant required:

Signage required:

SEQUENCE OF BASIC STEPS POTENTIAL SIGNIFICANT HAZARDS HAZARD CONTROL METHOD

List the 4 to 8 steps required to complete the job

(Follow the flow of the product or the process)

List the potential SIGNIFICANT hazards beside each step. Focus on what can cause harm and

what can go wrong (Use the Seven Point Analysis as a guide)

List the control methods required to ELIMINATE, ISOLATE or MINIMISE

each SIGNIFICANT hazard

Step

No.

Step

No.

E/I/M

Seven Point Analysis

To help identify hazards, for each step ask – Can I?: � strain or sprain my back or other muscle � be caught in, on or between anything � slip, trip or fall from height, on the same or

lower level � be injured by poor plant/job design

� be struck by or against anything � come in contact with a hazardous substance

� come in contact with an energy source

SEQUENCE OF BASIC STEPS POTENTIAL SIGNIFICANT HAZARDS HAZARD CONTROL METHOD

List the 4 to 8 steps required to complete the job (Follow the flow of the product or the process)

List the potential SIGNIFICANT hazards beside each step. Focus on what can cause harm and what can go wrong

(Use the Seven Point Analysis as a guide)

List the control methods required to ELIMINATE, ISOLATE or MINIMISE each SIGNIFICANT hazard

Step

No.

Step

No.

E/I/M

Task Analysis Sign-off

All persons involved in Task Analysis have been trained in the processes

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

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Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Name………………………………………Signature…………………………………….……….

Toolbox Safety Meeting Minutes


FOREMAN/SUPERVISOR

PRINCIPAL

DATE

Attendees: Signatures of attendees:

Site activity/safe work practices/accident/incident investigations discussed:

Employee issues raised:

Date to be resolved by:

Safe observations reviewed/discussed:

Pre-start Site Assessment

PROJECT/SITE ASSESSOR SIGNED

DATE

Hazards √ Controls

Height/Overhead Work:

Falling material

Ladders

Scaffolds

Roofs

Cranes

Elevated work platforms

Trenches/Confined Spaces:

Pits and trenches

Tanks

Shafts

Confined spaces

Plant:

WoF/current test tag

Machine guards

RCDs

Leads

Vibration

Task Analysis completed/reviewed:

Date:

General Environment:

Public access/protection

Signage/barriers

Organisation/housekeeping

Wet/slippery environment

Hazardous materials

Chemicals

Services (gas/water/power)

Exposure to weather

Extreme temperatures

Traffic

Noise

Dust and debris

Explosion/fire

Machinery

Mobile plant

Personal Protective Equipment:

Safety boots

Hearing protection

Eye protection

Hi viz clothing

Safety helmet

Respiratory protection

General Comments and Observations:

Self Safety Inspection Checklist


Safety representative: Inspection by: Date:

Remedial complete (sign/date):

1 Site Control ��/x 9 Welding/Gas Cutting ��/x 1. Hazard board and signage up-to- 9.1 Hot work permits being issued 1. Environmental plan – issues 9.2 Fire extinguishers on hand 1. Toolbox Talk last date / 9.3 Operators using PPE 1. Safety inductions for all on site 10 Electrical Equipment 1. Safety notice board current 10. Main board 2 Site Facilities 10. Current tagged and damage- 2. Offices – clean, adequate and 10. Current tagged plant 2. Smoko sheds – clean, potable 10. Current tagged lifeguards 2. Toilets – clean, washing water 10. Leads safely placed 2. Tool/equipment sheds adequate 10. Equipment in good condition 3 General Site Tidiness and 10. Appropriate guards on 3. Clear, safe access to work areas 10. Adequate temporary lighting 3. Stairways and accessways clear 11 Chemicals 3. Hoardings/fence and gates 11. Correctly stored 3. Loose materials secure from 11. Safety Data Sheet (SDS) 4 Personal Safety Equipment 11. Operators using PPE 4. Signage displayed and legible 12 Tools 4. Hardhats being worn 12. PAT tool current and secure 4. Correct footwear being worn 12. Staff trained in tool use 4. Glasses/ear muffs/vests/masks 12. PAT signage on site 5 First Aid/Fire Prevention 13 Scaffolding 5. First Aid box Availabl Curre 13. Notifiable weekly 5. Accident register 13. Handrails/mid-rails 5. Fire Available 13. Toe boards 5. Current (12 mth) 13. Platforms 5. Sufficient 13. Ladders/stairs 5. Evacuation Procedure 13. Base sound 5. All emergencies 13. Work platforms clear 6 Cranes/Hoist/Lifting Equipment 13. Platforms trip free 6. Proper lift assessment plan done 13. Planks tied down 6. Crane certification current 13. Headroom clear 6. Slings/chains certified 13. Ties/bracing adequate 6. Operator procedures in place 14 Ladders 6. Inspections being done 14. Good condition 6. Man cage available 14. Secured top and bottom 6. Emergency plan in place 14. Stays to step ladders 7 Compressed Air Equipment 14. Working 2 steps down 7. In good condition 15 Fall Hazards 7. Appropriate guards fitted 15. Floor edges Floor 7. Trained user 15. Lift shafts Stairs 8 Excavations correctly shored Excavations

Remedial Action Schedule

ITEM COMMENTS/ACTION DESCRIPTION PERSON TO ACTION

COMPLETE

Emergency Plan and Procedures for Hazardous Work


Potential Emergency Situations

List separately: Procedure:

Responsibilities

Personnel: Key responsibilities:

Evacuation Procedures

Visitors:

Assembly areas:

Alarms:

Medical Treatment

First Aiders:

Location of nearest

medical centre:

Emergency services:

Key subcontractors’ telephone numbers:

Training and Procedure to advise site staff:

Communication

Emergency Evacuation Plan

In the case of emergency requiring evacuation of the project, either:

FIRE, EARTHQUAKE, SERIOUS ACCIDENT, STRUCTURAL COLLAPSE, TSUNAMI, EXPLOSION, AVIATION INCIDENT, HAZARDOUS SPILL OR PRACTICE

EVACUATION

The following warning will sound:

______________________________________________________________________________

If this warning sounds, SHUT DOWN all plant and equipment. All personnel on the project are to proceed IMMEDIATELY by the

SAFEST IDENTIFIABLE ROUTE to the SAFE ASSEMBLY POINT

And REMAIN there, so ALL personnel can be ACCOUNTED FOR

DO NOT RETURN to the project until the project manager has given the

OFFICIAL CLEARANCE

MEDICAL FACILITIES LOCATED AT:

When calling 911, READ THE FOLLOWING TO THE DISPATCHER:

We have an emergency at…

We need help from Ambulance/Fire…

Directions to the emergency are…

Our phone number is…

The medical problem seems to be…

Send someone outside to meet the emergency services

EMERGENCY TELEPHONE NUMBERS:

Dial 111 for: FIRE, AMBULANCE, POLICE, GAS, CHEMICAL SPILLS

PHONE NUMBERS MAY DIFFER – CHECK YOUR LOCAL DIRECTORY

HOSPITAL ( ) WORKSAFE Safety ( ) ________________________

Emergency Evacuation Plan

POISON CENTRE (_______) _____-__________

POWER (Customer Service) ( ) 24hr Faults ( ) Subcontractors on site: ( )

SAFETY MANAGER IS:

TRAINED FIRST AIDER IS: FIRST AID KIT AND FIRE EXTINGUISHER LOCATED AT SITE OFFICE

OR:

Accident/Incident Register


Date

and Time

Details:

Name of person (injured or observer): • Description of accident/incident/near miss

• Cause of harm (if any)

• Type of injury/disease (if any)

Immediate action

taken: • First Aid

• Corrective

action • Review Hazard

Register

Serious

Harm Y/N

WORKS

AFE Notified

Y/N

Date

Investigation actioned and

documented Y/N

Investigation outcomes

discussed at safety meeting

on:

1. Particulars of employer, self-employed

person or principal: (Business name, postal address and telephone number)

2. The person reporting is: � an employer � a principal � a self-employed person

3. Location of place of work:

(Shop, shed, unit nos., floor, building, street nos. and names, locality/suburb, or details of vehicle, ship or aircraft)

4. Personal data of injured person:

Name

Residential address

Date of birth Sex (M/F)

5. Occupation or job title of injured

person:

(Employees and self-employed persons only)

6. The injured person is:

� an employee � a contractor

(self-employed person) � self � other

7. Period of employment of injured

person:

(Employees only) � 1st week � 1st month � 1-6

11. Agency of accident/serious harm:

� Machinery or (mainly) fixed plant

� Mobile plant or transport � Powered equipment, tool or appliance � Non-powered handtool, appliance or

equipment

� Chemical or chemical product � Material or substance � Environmental exposure (e.g. dust,

gas)

� Animal, human or biological agency (other than bacteria or virus)

� Bacteria or virus 12. Body part:

� Head � Neck �

Trunk � Upper limb � Lower limb � Multiple locations

� Systemic internal organs

13. Nature of injury or disease: � Fatal

(Specify all) � Fracture of spine � Puncture wound � Other fracture � Poisoning or

toxic effects

� Dislocation � Multiple injuries � Sprain or strain � Damage to

artificial aid � Head injury � Disease, nervous system � Internal injury of trunk � Disease,

musculoskeletal system � Amputation, including eye � Disease, skin � Open wound � Disease,

digestive system � Superficial injury � Disease, infectious or parasitic � Bruising or crushing � Disease,

respiratory system

Notice or Record of Accident/Serious Harm

months � 6 months-1 year � 1-5 years � Over 5 years

� Non-employee

8. Treatment of injury: � None � First Aid only

� Doctor but no hospitalisation � Hospitalisation

9. Time and date of accident/serious

harm:

Time am/pm

Date

Shift � Day � Afternoon � Night

Hours worked since arrival at

work

(Employees and self-employed persons only)

10. Mechanism of accident/serious

harm: � Fall, trip or slip � Hitting objects

with part of the body

� Sound or pressure � Being hit by moving objects � Body stressing � Heat, radiation

or energy

� Biological factors � Chemicals or other substances � Mental stress

� Foreign body � Disease, circulatory system � Burns � Tumour

(malignant or benign)

� Nerves or spinal chord � Mental disorder

14. Where and how did the

accident/serious harm happen? (If not enough room, attach separate sheet or sheets)

15. If notification is from an employer: (a) has an investigation been carried

out? � Yes � No (b) was a significant hazard involved? � Yes � No

Signature and date: ________________________ ___ / ___ / ___

Name and position:

(Use capitals)

Check that the details on this copy are complete and forward it to your nearest WorkSafe office

Accident and Incident Investigation Report

EMPLOYER BRANCH/DEPARTMENT

NAME OF INVESTIGATOR

PARTICULARS OF INCIDENT

Day of Incident

(circle)

M T W T F S

S

Time Project/Site Date Reported

INJURED PERSON

Name: Address:

Age: Phone number:

Reported date of incident: Length of employment: Time on job:

TYPE OF �� Bruising �� Dislocation

�� Other

(specify)

Remarks: �� Strain/sprain ��

Scratch/abrasion �� Internal

�� Fracture �� Amputation �� Foreign Injured part of body: ��

Laceration/cut �� Burn scald �� Chemical

DAMAGED PROPERTY

Property/material damaged: Nature of damage:

Object/substance inflicting damage:

INCIDENT

Description

Describe what happened (space overleaf for diagram – essential for all vehicle incidents):

Analysis

What were the causes (root and contributing causes) of the incident?

Root causes – safety system failures:

Contributing causes – unsafe acts and conditions:

Prevention

What action has or will be taken to prevent a recurrence? Tick items already actioned (use space overleaf if required)

Completed �� X

By whom

When

TREATMENT AND INVESTIGATION OF INCIDENT

Type of treatment given: Name of person giving

First Aid:

Doctor/Hospital:

Incident investigated by: Date: WORKSAFE

advised: Yes /

No

Date:

Signed by: Employer…….…………..…………..……..……and Employee………….….………….…………………

NOTES:

Safety Training and Competency Register This register is a record of training, qualifications, experience and competencies for your employees. Complete the register for each employee, noting Site Safe

training that has been completed, along with other safety and trade training

undertaken. List certificates, licences and other formal qualifications in the column to the right of the training section.

Name Site

Induction

Date

Current Site Safe

Card Type

and Number

(See

key below)

Current

Site Safe

Card Expiry Date

Other Site

Safe Training

(See key

below)

Training, Qualifications,

Experience Competence

Trade and

Skills

Training

(Specify all

types)

Formal Qualifications, Certificates,

Licences, and Unit

Standards (Specify all

types)

No

. Y

ea

rs’

Exp

eri

enc

e in

Le

ve

l of

Co

mpe

ten

ce

in

Cu

rre

nt

Job

(use

LU

LU

)

Key:

Site Specific Safety Plan Evaluation This evaluation process assumes that the contractor has already submitted their

health and safety systems to the client and that the client has approved these systems. The purpose of this evaluation is intended to provide the client with confidence that the contractor is aware of their responsibilities and has

procedures in place that meet these responsibilities on this specific project.

Site specific safety plan master

Law

Transcript of Site specific safety plan master