Challenge Participant

Voluntary Protection Program Information

OSHA Challenge - Construction Track Summary Status Report.xls

Challenge Participant

OMB: 1218-0239

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Overview

Overview
1 - Summary Page
2 - Stage I Status
3 - Stage II Status
4 - Stage III Status

Sheet 1: Overview

OSHA Challenge - Construction Track
Site OCTPS Form Instructions

*This form is to be completed by Challenge participants.*

Included in this spreadsheet are:

Tab 1. Challenge participant Status Summary
Tab 2. Stage I Status Report
Tab 3. Stage II Status Report
Tab 4. Stage III Status Report



To access these worksheets, please click on the tabs at the bottom of this form.

Sheet 2: 1 - Summary Page

OSHA Challenge - Construction Track
Summary Status Report

Participant Name		Administrator Name					Report Period
							Time Period
							Year


Stage I

		Mgt. Leadership				Hazard		Safety and
		and Worker		Worksite		Prevention and		Health		Documentation
Participant Summary		Involvement		Analysis		Control		Training
Stage I Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	22	100%	20	100%	22	100%	19	100%	22	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	22	100%	20	100%	22	100%	19	100%	22	100%

Stage I Status Summary	No Action Taken/In Progress

Administrator Summary
Stage I Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	22	100%	20	100%	22	100%	19	100%	22	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	22	100%	20	100%	22	100%	19	100%	22	100%

Stage I Status Summary	No Action Taken/In Progress

Stage II

		Mgt. Leadership				Hazard		Safety and
		and Worker		Worksite		Prevention and		Health		Documentation
Participant Summary		Involvement		Analysis		Control		Training
Stage II Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	25	100%	28	100%	25	100%	9	100%	19	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	25	100%	28	100%	25	100%	9	100%	19	100%

Stage II Status Summary	No Action Taken/In Progress

Administrator Summary
Stage II Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	25	100%	28	100%	25	100%	9	100%	19	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	25	100%	28	100%	25	100%	9	100%	19	100%

Stage II Status Summary	No Action Taken/In Progress

Stage III

		Mgt. Leadership				Hazard		Safety and
		and Worker		Worksite		Prevention and		Health		Documentation
Participant Summary		Involvement		Analysis		Control		Training
Stage III Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	22	100%	14	100%	8	100%	3	100%	5	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	22	100%	14	100%	8	100%	3	100%	5	100%

Stage III Status Summary	No Action Taken/In Progress

Administrator Summary
Stage III Outcome Completion Status	Status	#	%	#	%	#	%	#	%	#	%
	No Action Taken	22	100%	14	100%	8	100%	3	100%	5	100%
	In Progress	0	0%	0	0%	0	0%	0	0%	0	0%
	Completed	0	0%	0	0%	0	0%	0	0%	0	0%
	Total Outcomes	22	100%	14	100%	8	100%	3	100%	5	100%

Stage III Status Summary	No Action Taken/In Progress

Sheet 3: 2 - Stage I Status

OSHA Challenge - Construction Track
Stage I Tracking Form

Participant Name	Administrator Name	Report Period
[Enter Participant Name]	[Enter Administrator Name]	Time Period	[Enter Time Period]
		Year	[Enter Year]

Stage I -- Management Leadership and Worker Involvement
1. Management Commitment - Actions Required			Participant Status	Administrator Status
1. Safety and Health Vision Statement. Develop, issue, and communicate a Safety and			No Action Taken	No Action Taken
Health Vision Statement (i.e., defining where the company wants to be). This Vision statement should
address the company’s desire to participate in OSHA Challenge. This process may include involving permanent
workers in the development of these documents.

Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Safety and Health Policy Statement. Develop, issue, and communicate a Safety and Health			No Action Taken	No Action Taken
Policy Statement (i.e., what the site commits to doing).
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Leadership. Company establishes a policy requiring managers to participate and demonstrate			No Action Taken	No Action Taken
leadership in safety and health management system activities. Managers set an example and behaviors that
demonstrate a commitment to safety and health, such as attending training, participating in planning
meetings, wearing PPE, encouraging workers to report hazards, injuries
and illnesses, enforcing the “if it’s not safe, we’re not doing it” principle, and performing other safety
and health-related actions that are required of workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Adequate resources and safety and health integration. Develop a safety and health budget for the			No Action Taken	No Action Taken
present and for the future, including a plan for covering typical safety and health expenditures,
as well as unusual or emergency expenditures such as requirements for prompt correction of
uncontrolled hazards Commit and ensure utilization of adequate resources to achieve this for OSHA
Challenge. Take management action to begin integrating safety and health into other aspects of
planning, such as planning for new equipment, processes, building materials, etc. Company
establishes a policy/requirement that safety and health will be integrated into the overall
planning and budgeting processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Safety and health goals and objectives. Establish, document, and communicate to workers			No Action Taken	No Action Taken
the annual safety and health goals and objectives that are clear, attainable, measurable, and relevant to
bringing about a safe and healthy work environment, as well as the policies and procedures that will help
achieve these goals and objectives. Goals should be based on outcome of baseline and trend analysis.
Establish a policy/requirement that subcontractors will develop their goals and objectives supportive
of the company goals in an equivalent manner.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Clear lines of communication with workers and worker access. Take action to establish clear			No Action Taken	No Action Taken
lines of communication with all workers and ensure that they have reasonable access to top
management with regard to safety and health issues Address issues of worker language barriers by
providing safety and health information in languages spoken and understood by workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Clear responsibilities, authority, and accountability for safety and health. Clarify the safety
and health responsibilities of each company worker and contractor working on the site/project:
a. Identify who will be responsible for achieving safety and health goals and objectives.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Identify specific persons to be accountable for meeting safety and health goals, including,			No Action Taken	No Action Taken
at a minimum, managers, supervisors, and specific safety and health staff; assign adequate
authority, as appropriate to their level of responsibility; and explain their accountability and
authority to all workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Develop a safety and health accountability plan to hold managers, supervisors, and non-supervisory			No Action Taken	No Action Taken
workers accountable for meeting their responsibilities through a documented performance
standards and appraisal system.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. Establish a policy/requirement that subcontractors will adopt the company process for accountability			No Action Taken	No Action Taken
plans and defining responsibilities or establish equivalent processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Disciplinary plan. Establish a company policy/requirement for all workers that disciplinary action			No Action Taken	No Action Taken
will be taken against any worker who does not comply with company rules, regulations, etc.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Annual Self-Evaluation. No Action Required
2. Worker Involvement - Actions Required			Participant Status	Administrator Status
1. Worker Safety and Health Perception Survey. Evaluate the current safety and health practices			No Action Taken	No Action Taken
at the total site and establish a baseline in the following areas for each of the following categories of
personnel – managers, supervisors, and non-supervisory workers:
a. Levels of involvement in the safety and health management system
b. Values regarding the importance of worker safety and health
c. Perceptions of the effectiveness of the total company’s safety and health management system
d. Perceptions of how well the culture encourages and supports reporting
on hazards, accidents, and injuries
e. Levels of compliance with rules or unwritten safety and health standards
f. Perceptions regarding their roles, responsibilities, and accountability in ensuring safety
and health on the total project/site
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Safety and Health Perception Survey Action Plan. Develop an action plan to address the			No Action Taken	No Action Taken
findings from the survey and begin implementation of the plan.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Worker notification. Notify company and subcontractor workers as follows:
a. Inform managers, supervisors, non-supervisory workers of their rights under the Occupational			No Action Taken	No Action Taken
Safety and Health (OSH) Act. Take steps to encourage them to freely exercise their rights, especially that
of freely reporting hazards in the workplace.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Inform all workers, including new hires, of the company’s participation in OSHA Challenge.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Meaningful worker involvement. Develop a plan, including an implementation schedule, for			No Action Taken	No Action Taken
how to bring about the meaningful involvement of all managers, supervisors, and
non-supervisory workers through participation in various safety and health related activities.
Specifically, for this OSHA Challenge:
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
a. Consistent with applicable labor laws, initiate the establishment of a few key teams			No Action Taken	No Action Taken
(e.g., a safety and health planning team) representing different sectors of the site's staff, to bring about
meaningful change.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Begin to involve some workers in safety and health activities such as accident investigations.			No Action Taken	No Action Taken
Note: ensure that proper training is provided before workers conduct such activities.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontract Worker Coverage - Actions Required			Participant Status	Administrator Status
1. Subcontractor oversight and management system. Develop, document, and begin implementing the
following basic elements of an oversight and management system covering subcontractors:
a. Equal safety and health protection. Develop and begin implementing a plan for how to provide			No Action Taken	No Action Taken
subcontractor workers with safety and health protection equal in quality to that provided to
company workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Adherence to safety and health rules. Inform all subcontractors and their workers that they			No Action Taken	No Action Taken
are required to adhere to all of the company’s safety and health rules, regardless of their status or the
length of time they perform work on the site/project.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Hazards in subcontractor work areas. Establish a requirement that subcontractors provide			No Action Taken	No Action Taken
timely identification, correction, and tracking of uncontrolled hazards in their work areas.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Subcontractor Selection Criteria. Establish and begin implementing a policy/requirement defining			No Action Taken	No Action Taken
the company’s subcontractor selection criteria that includes as a minimum, review of the previous three
years of injury and illness records, and review of written safety and health management systems.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Removal Policy. No action required
Stage I -- Worksite Analysis
1. Baseline Safety and Industrial Hygiene Hazard Analysis - Required Actions			Participant Status	Administrator Status
1. Conduct a baseline safety and industrial hygiene hazard analysis to establish initial levels of company			No Action Taken	No Action Taken
and subcontractor worker exposure ( baselines) for comparison to future levels, so
that changes can be recognized. This study should include a review of previous accidents, injuries, and
illnesses; complaints of workplace hazards; previous studies, etc.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Ensure that the baseline survey accomplishes the following:			No Action Taken	No Action Taken
a. Identifies and documents common safety hazards on the project/site and how they are controlled.
b. Identifies and documents common health hazards on the project/site and determine if further
sampling is needed.
c. Identifies and documents safety and health hazards that need further study.
d. Adequately covers the entire worksite and indicates who conducted the survey and when it was completed.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Repeat the baseline survey only if warranted by significant changes (e.g., changes in processes,			No Action Taken	No Action Taken
equipment, hazard controls, etc.).
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard Analysis of Routine Jobs, Tasks, and Processes - Required Actions			Participant Status	Administrator Status
1. Review and ensure that programs developed and/or implemented are in compliance with local, state,			No Action Taken	No Action Taken
and Federal safety and health regulations based on routine tasks performed.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Begin to formalize a system to ensure workers are properly trained in the procedures implemented.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard Analysis of Significant Change - Required Actions			Participant Status	Administrator Status
1. Company has established and has begun implementing a policy/requirement to identify and document			No Action Taken	No Action Taken
safety and health hazards of significant changes, new processes, and significant changes in design or
engineering plans, materials, equipment, and facilities to identify uncontrolled hazards prior to the activity
or use and recommend adequate hazard controls.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Establish a policy/requirement that subcontractors will adopt the company process for hazard analysis			No Action Taken	No Action Taken
of significant changes, participate in company hazard analysis activities, or establish equivalent processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Pre-Use Analysis - Actions Required			Participant Status	Administrator Status
1. If the company is considering new equipment, chemicals, facilities, or significantly different operations or			No Action Taken	No Action Taken
procedures, conduct a pre-use analysis to review the potential safety and health impact on the workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Develop and begin implementing a plan for how to integrate this practice into the procurement/design			No Action Taken	No Action Taken
phase to maximize the opportunity for proactive hazard control.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Take proactive steps to ensure pre-use analysis continues to be integrated into the procurement/			No Action Taken	No Action Taken
design phases.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Establish a policy/requirement that subcontractors adopt the company process for pre-use analysis,			No Action Taken	No Action Taken
participate in company activities, or establish equivalent processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Industrial Hygiene Program - Required Actions			Participant Status	Administrator Status
1. No action required.
6. Routine Self-Inspections - Required Actions			Participant Status	Administrator Status
1. Establish a routine self-inspection program and perform safety and health inspections on a regular basis.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Train company workers in the recognition and avoidance of hazards in their work environment and			No Action Taken	No Action Taken
begin having them routinely inspect their work areas, materials, and equipment on a regular basis.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Accident Investigations - Required Actions			Participant Status	Administrator Status
1. Company establishes a documented policy/requirement on reporting and investigating accidents.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company investigates accidents and maintains written reports of the investigations. Investigations should			No Action Taken	No Action Taken
follow the following guidelines:
a. Identify all contributing factors.
b. Document the entire sequence of relevant events.
c. Recommend actions to prevent recurrence.
d. Assign timeframes and responsibility for implementing recommended controls.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Establish a policy/requirement that subcontractors adopt the company process for accident			No Action Taken	No Action Taken
investigation, or establish equivalent processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Hazard Reporting System for workers - Required Actions			Participant Status	Administrator Status
1. Use data collected on accident incident reports (e.g., Employers First Report of Injury), insurance			No Action Taken	No Action Taken
loss runs, etc. to determine the areas that should be concentrated on.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Share information and seek supervisor and worker input for a suggested plan of action for			No Action Taken	No Action Taken
developing a hazard reporting system, using model programs (e.g., from insurance carriers,
peer groups, OSHA Challenge Coordinator) for guidance.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Trend Analysis - Required Actions			Participant Status	Administrator Status
1. Conduct a trend analysis of previous three complete calendar years’ injury and illness history, based			No Action Taken	No Action Taken
on a thorough review of OSHA 300 logs, workers' compensation claim forms, and accident reports.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Begin developing a plan for conducting an analysis of other safety and health-related information			No Action Taken	No Action Taken
(e.g., hazards identified during inspections, worker reports of hazards, accidents, near-misses, etc.)
for the purpose of establishing or detecting trends, planning, and setting goals.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage I -- Hazard Prevention and Control
1. Certified Professional Resources - Actions Required			Participant Status	Administrator Status
1. Ensure that outside sources are available if needed to conduct baseline hazard analysis, and that they			No Action Taken	No Action Taken
are certified, competent, and qualified to perform baselines pertinent to the work activity involved.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard Elimination and Control Methods - Actions Required			Participant Status	Administrator Status
1. Company establishes and implements a system that prioritizes hazards identified in this stage based on			No Action Taken	No Action Taken
the potential seriousness of injury, illness, property loss, frequency of exposure, and long- term effects.
Establish an action plan for correction.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Identify options and select the most appropriate option or combination of options for hazard elimination			No Action Taken	No Action Taken
and control methods, including engineering controls, administrative controls, work practices, and
PPE.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Take steps to ensure that the selected controls are appropriate to the project/site’s hazard(s); understood and			No Action Taken	No Action Taken
followed by all affected parties; equitably enforced through the disciplinary system; written, implemented,
and updated as needed; used by workers; and incorporated into training, positive reinforcement,
and correction programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Require subcontractors to adopt company hazard elimination and control system or implement			No Action Taken	No Action Taken
an equivalent system.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard Control Programs - Actions Required			Participant Status	Administrator Status
1. Conduct an inventory of existing hazard control programs required by OSHA standards			No Action Taken	No Action Taken
(e.g., PPE, Hazard Communication, Respiratory Protection, Lockout/Tagout, Confined Space
Entry, Process Safety Management, or Bloodborne Pathogens).
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Review existing programs to identify what is missing or unsatisfactory.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Develop missing programs and modify existing programs, as needed, to meet all OSHA guidelines,			No Action Taken	No Action Taken
including training requirements.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Develop and distribute to workers appropriate company safety and health rules, requirements,			No Action Taken	No Action Taken
procedures, manuals, etc., necessary to define and communicate company hazard control programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Require subcontractors to adopt and implement company hazard control programs or establish			No Action Taken	No Action Taken
equivalent programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Occupational Health Care Program - Actions Required			Participant Status	Administrator Status
1. Records Review. Conduct a thorough review of injury/illness records (see above) and ensure			No Action Taken	No Action Taken
they are in order.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Licensed health care professionals. Provide workers access to licensed health care professionals			No Action Taken	No Action Taken
who can provide onsite or offsite services and emergency services.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontractor Health Care. Require subcontractors to provide access to health care services, as			No Action Taken	No Action Taken
required, based on results of the baseline safety and health analysis including physician and
emergency medical care.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Preventative Maintenance of Equipment - Actions Required			Participant Status	Administrator Status
1. Conduct an inventory of equipment that requires preventive maintenance and develop a preventive			No Action Taken	No Action Taken
maintenance schedule.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Require subcontractors to adopt and implement the company preventive maintenance process,			No Action Taken	No Action Taken
participate in the company if necessary, or establish an equivalent system.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Tracking of Hazard Correction - Actions Required			Participant Status	Administrator Status
1. Develop and begin using a documented system to record hazards identified in this stage through the			No Action Taken	No Action Taken
baseline study, trend analysis, and accident investigations. The system must document priority, assign
responsibility for correction, establish timeframes for correction, and follow up to ensure total abatement.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Require subcontractors to adopt and implement the company tracking system or establish an			No Action Taken	No Action Taken
equivalent system.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Emergency Preparedness and Response - Required Actions			Participant Status	Administrator Status
1. Establish and communicate company written procedures to company and subcontractor workers for			No Action Taken	No Action Taken
responding during all shifts to all types of emergencies (fire, chemical spill, accident, terrorist threat,
natural disaster, etc.).
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Conduct at least one evacuation drill and assess how well the procedures worked.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Make available and explain to all workers emergency procedures and services, including			No Action Taken	No Action Taken
provisions for physician care and emergency medical care, ambulances, emergency
medical technicians, emergency clinics, or hospital emergency rooms, available for all shifts
within a reasonable time and distance.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Conduct at least one training class on first aid and CPR so that there is at least one trained worker			No Action Taken	No Action Taken
for each shift .
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Require subcontractors to adopt the company emergency procedures or equivalent procedures, and			No Action Taken	No Action Taken
participate in company emergency drills and activities listed above.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage I -- Safety and Health Training
1. Safety and Health Training - Required Actions			Participant Status	Administrator Status
1. Provide training to managers, supervisors, non-supervisory workers following the general
guidelines below:
a. Ensure OSHA required training is performed, documented, and up-to-date.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Document attendance.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Ensure that training is conducted by persons who have specific subject matter knowledge or expertise.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. Use findings of the various worksite analysis activities (e.g., baseline study, hazard analysis of			No Action Taken	No Action Taken
routine jobs, tasks, and processes, etc.) to develop training that is relevant to the company (e.g., training
on safe job procedures; modifying workstations, equipment, or materials; incorporating findings in future
planning efforts, etc.).
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. At a minimum, provide the following types of training to current or new managers, supervisors, and
non-supervisory workers:
a. Their rights under the OSH Act			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. OSHA Challenge			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Hazards in the workplace; how to recognize hazardous conditions; signs and symptoms of			No Action Taken	No Action Taken
workplace-related illnesses; protective measures; safe work procedures
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. What is required PPE, why it is required, its limitations, how to use it, and how to maintain it			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
e. Specific responsibilities for each type of emergency			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
f. Emergency evacuation procedures			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. At a minimum, provide the following types of training to managers and supervisors:
a. Specific safety and health responsibilities and how to carry them out effectively			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Methods for changing workplace safety and health attitudes and practices			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Requirements for OSHA Challenge Stage I			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. At a minimum, provide the following types of training to subcontractor workers:
a. Their rights under the OSH Act			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. OSHA Challenge			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Hazards in the workplace			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. What is required PPE, why it is required, its limitations, how to use it, and how to maintain it			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
e. Specific responsibilities for each type of emergency			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
f. Emergency evacuation procedures			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage I -- Documentation
1. Minimum Required Documentation			Participant Status	Administrator Status
1. Vision and policy statements			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. The most recent annual safety and health goals and objectives			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Accountability plan			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Budget documents showing allocated resources for Safety and Health			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Disciplinary Plan			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Contract selection requirements			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Accurate and up to date records of injury and illness for the previous three calendar years including:
• OSHA 300 logs			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
• Insurance claim forms			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
• Accident reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Baseline hazard analysis results, including IH reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Written hazard control programs			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
10. Accident investigation forms and reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
11. Written contractor policies for this stage			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
12. Safety and Health Perception Survey form			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
13. Results of Safety and Health Perception Survey and plan for addressing changes			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
14. Trend analysis results			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
15. Accident Investigation procedure			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
16. Hazard correction action plan			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
17. Hazard correction tracking system			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
18. Preventive maintenance inventory			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
19. Written emergency procedures			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
20. Training records			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:

Sheet 4: 3 - Stage II Status

OSHA Challenge - Construction Track
Stage II Tracking Form


Participant Name	Administrator Name	Report Period
[Enter Participant Name]	[Enter Administrator Name]	Time Period	[Enter Time Period]
[Enter Participant Name]	[Enter Administrator Name]	Year	[Enter Year]

Stage II -- Management Leadership and worker Involvement
1. Management Commitment - Required Actions			Participant Status	Administrator Status
1. Safety and Health Mission and Policy Statements. Continue to communicate the company’s			No Action Taken	No Action Taken
Safety and Health Vision and Policy Statements to Company and subcontractor workers. Incorporate
appropriate information about the Safety and Health Vision and Policy Statement into the company’s
orientation training for new workers and subcontractors. Include the company’s vision and policy in
contract bid documents.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Leadership. Company managers continue setting an example through behaviors that demonstrate			No Action Taken	No Action Taken
total commitment to safety and health. Ensure increased participation by top executives and managers in
safety and health related activities, including examples of activities established in Stage I. Require
subcontractors to begin implementing a policy/requirement on leadership and participation or follow
established policies and requirements of the subcontractor.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Adequate resources and safety and health integration. Continue committing and ensuring the			No Action Taken	No Action Taken
utilization of adequate resources to support safety and health activities and programs
including of certified safety and health and licensed health care professionals. Improve the integration
of safety and health into other planning and budgeting processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Safety and health goals and objectives. Review progress towards achievement of the company			No Action Taken	No Action Taken
safety and health goals and objectives, as well as the policies and procedures to meet them; revise and
communicate new annual goals and objectives, as appropriate. Require that subcontractors develop
goals and objectives that are consistent with and supportive of the Company’s overall goals related to
OSHA Challenge participation. Selected subcontractors begin implementing requirement.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Clear lines of communication with workers and worker access. Continue to take			No Action Taken	No Action Taken
necessary action to clarify lines of communication with Company and subcontractor workers and ensure
access to senior management regarding safety and health issues.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Clear responsibilities, authority, and accountability for safety and health. Continue			No Action Taken	No Action Taken
clarifying safety and health expectations for company and subcontractor workers on the site.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
a. Begin implementing the accountability plan for Company managers, supervisors, and safety and			No Action Taken	No Action Taken
health staff; incorporate performance, responsibilities, and standards for safety and health, as well as the
consequences for meeting or failing to meet expectations.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Communicate management expectations regarding everyone’s safety and health responsibilities.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Support the authority of designated staff members who are accountable for safety and health goals.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. Communicate which Company personnel are responsible for achieving safety and health goals and			No Action Taken	No Action Taken
objectives, with no unassigned areas, so that each worker and contract worker understands his/her
responsibility for safety and health.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
e. Monitor the performance of all Company managers, supervisors, and specific safety and health staff			No Action Taken	No Action Taken
members; giving them specific and timely feedback on performance; requiring corrective action plans if
needed; conducting performance appraisals; providing commensurate rewards and recognition for good
performance; and implementing consequences for poor performance.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
f. Require that subcontractors adopt and begin implementing the Company accountability planning process			No Action Taken	No Action Taken
or establish an equivalent process.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Disciplinary plan. Develop and begin implementing a disciplinary plan (policy, procedures,			No Action Taken	No Action Taken
consequences), with an implementation schedule. Ensure equitable enforcement among all
non-supervisory workers, as well across levels (e.g., management staff should not get better treatment
than non-supervisory workers). Demonstrate that workers will be held accountable for non-compliance
with rules and requirements. Require that subcontractors adopt and begin implementing the company
procedure or establish equivalent processes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Annual self-evaluation of safety and health management system. Develop a written company			No Action Taken	No Action Taken
procedure defining how annual self evaluations and other evaluations will be performed, including the
requirement for written narrative reports. Require that subcontractors adopt the company procedure or
establish an equivalent process.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Worker Involvement - Required Actions			Participant Status	Administrator Status
1. Safety and Health Perceptions Survey. Review and respond to the findings and conclusions of			No Action Taken	No Action Taken
the Safety and Health Perceptions Survey conducted in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Safety and Health Perceptions Survey Change Plan. Implement the company’s Safety and			No Action Taken	No Action Taken
Health Perception Survey Change Plan developed in Stage I. Require subcontractors to develop an action
plan that addresses findings related to them.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Worker notification. Notify new Company managers, supervisors, and non-supervisory			No Action Taken	No Action Taken
workers of their rights under the OSH Act, of the company’s participation in OSHA Challenge,
and any other pertinent information. Incorporate this information into the company's orientation for
new workers and subcontractors.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Worker involvement. Implement the company worker involvement plan, developed in Stage I,
such as:
a. The formation of new and/or greater participation in safety and health teams to meet the company’s			No Action Taken	No Action Taken
needs at this Stage of OSHA Challenge.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Increase worker participation as part of safety and health teams that conduct accident/			No Action Taken	No Action Taken
near-miss investigations, self-inspections, and job hazard analyses.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Require subcontractors to adopt and begin implementing the company worker involvement plan,			No Action Taken	No Action Taken
participate in activities per contract and/or agreement, or establish equivalent plans.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontract Worker Coverage - Required Actions			Participant Status	Administrator Status
1. Subcontractor oversight and management program. Company improves and fully implements the
following basic elements of an oversight and management system covering subcontractors:
a. Equal safety and health protection. Work with subcontractors to improve and continue			No Action Taken	No Action Taken
implementing the subcontractor program begun in Stage I to the point that provides protections
equal to company programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Adherence to safety and health rules. Improve process for requiring subcontract workers who			No Action Taken	No Action Taken
work onsite whether regular or temporary to adhere to all of the company’s safety and health rules,
regardless of their status or the length of time they perform work onsite. The process must include
advising subcontractor workers that disciplinary action will be taken against workers that do not
follow company rules and requirements.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Subcontractor selection and oversight. Implement a policy and process for addressing			No Action Taken	No Action Taken
safety and health performance of potential bidders, including the review of written safety and health plan
and injury and illness rates, in subcontractor selection and oversight.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. Hazards in subcontractor work areas. Ensure subcontractors improve and formalize their own			No Action Taken	No Action Taken
processes for the timely identification, correction, and tracking of uncontrolled hazards in their work				No Action Taken
areas and operations.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
e. Removal of subcontractor for violations. Company establishes and implements a penalty policy			No Action Taken	No Action Taken
and process for safety or health violations in subcontractor work areas including removal and/or
financial penalties.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage II -- Worksite Analysis
1. Baseline Safety and Industrial Hygiene Hazard Analysis - Required Actions			Participant Status	Administrator Status
1. Company requires as a contract requirement that subcontractors must perform a baseline safety and IH			No Action Taken	No Action Taken
hazard analysis for the work they are contracted and assigned to perform. Subcontractors begin performing
the required baseline safety and IH hazard analyses. (See IH Required Actions below)
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard Analysis of Routine Jobs, Tasks, and Processes - Required Actions			Participant Status	Administrator Status
1. Identify and document safety and health hazards of routine jobs, tasks, and processes and			No Action Taken	No Action Taken
recommend adequate hazard controls by conducting task-based or system/process hazard analyses
when the routine jobs, tasks, and processes have had injuries/illnesses associated with them or have:
experienced significant incidents or near-misses; are perceived as high-hazard tasks, i.e., they could
result in a catastrophic explosion, electrocution, or chemical overexposure; or are required by a regulation
or standard. Identify the steps of the task or procedure being analyzed, the hazard controls currently
in place, recommendations for needed additional hazard controls, dates conducted, and
the responsible parties.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Update the hazard analysis as appropriate, such as when the environment, procedures, or equipment			No Action Taken	No Action Taken
change or when errors are found that invalidate the most recent hazard analysis.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Require subcontractors to adopt and begin implementing the company hazard analysis of routine system			No Action Taken	No Action Taken
or establish equivalent plans. Subcontractors begin performing effective hazard analysis of routine work.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard Analysis of Significant Changes - Required Actions			Participant Status	Administrator Status
1. Company continues identifying and documenting safety and health hazards of significant changes, including			No Action Taken	No Action Taken
but not limited to: non-routine tasks (e.g., performed less than once per year) and new processes, materials,
equipment, and facilities. Company identifies uncontrolled hazards prior to the activity or use and recommends
adequate hazard control measures.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Subcontractors implement policy and begin identifying and documenting safety and health hazards of			No Action Taken	No Action Taken
significant changes in the work they are contracted to perform, including but not limited to non-routine tasks.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Pre-Use Analysis - Outcomes Achieved - Required Actions			Participant Status	Administrator Status
1. Company is continuing to consider new equipment, chemicals, facilities, or significantly different operations			No Action Taken	No Action Taken
or procedures, conduct a pre-use analysis to review the potential safety and health impacts on workers.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Subcontractors begin to perform pre-use analysis for work they are contracted to perform.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Industrial Hygiene (IH) Program - Required Actions			Participant Status	Administrator Status
1. The site develops a written IH Program to establish procedures and methods for identifying, analyzing,			No Action Taken	No Action Taken
and controlling health hazards to prevent occupational disease. The written program must address
sampling issues, including sampling methods, performed by whom, compared to what, required documentation,
and how communicated to workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company begins implementing the IH Program by doing the following:
a. Follow up on the results of the baseline study conducted in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Establish and implement sampling frequencies – a schedule for sampling identified hazards			No Action Taken	No Action Taken
– and conduct additional sampling as needed, based on findings of the baseline hazard analysis,
review of chemicals, worker reports of hazards, previous exposures, and reports of illnesses.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Begin implementing appropriate controls for hazards identified in Stages I and II.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company requires subcontractors to adopt and implement the company IH program for the work they			No Action Taken	No Action Taken
are contracted to perform or establish an equivalent program.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors establish and begin implementing IH program activities discussed above, follow up on			No Action Taken	No Action Taken
baseline IH study results, if appropriate, and perform more in-depth analyses to determine actual
worker exposures.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Routine Self-Inspections - Required Actions			Participant Status	Administrator Status
1. Company develops a documented system for routinely scheduled self-inspections of the workplace,			No Action Taken	No Action Taken
including a tool or checklist, the inspection schedule, the members of the regular self-inspection teams to
be created, recording of findings, responsibility for abatement, and tracking of identified hazards for
timely correction.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Start self-inspections, at a minimum, by competent persons and cover the entire site at least weekly.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company requires subcontractors to adopt and implement the company routine inspection program or			No Action Taken	No Action Taken
establish an equivalent program.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors have adopted an equivalent documented routine self-inspection system program and have			No Action Taken	No Action Taken
begun performing routine inspections of work areas and the activities they are contracted to perform.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Hazard Reporting System for workers - Required Actions			Participant Status	Administrator Status
1. Company develops and begins implementing a hazard-reporting system, which may be anonymous, that			No Action Taken	No Action Taken
allows workers to use specific tools to inform management staff without fear of reprisal, about
potential hazardous conditions, accidents, and near-misses.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Determine and communicate to workers how they will receive feedback on actions taken regarding			No Action Taken	No Action Taken
the hazards they report.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company requires subcontractors to adopt and implement the company worker hazard reporting system			No Action Taken	No Action Taken
or establish an equivalent system.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors begin to implement an equivalent worker hazard reporting system for work areas and			No Action Taken	No Action Taken
the activities hey are contracted to perform.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Investigation of Accidents and Near-Misses - Required Actions			Participant Status	Administrator Status
1. Company and subcontractors continue investigating accidents, following the guidelines established in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company and subcontractors expand their accident investigation procedures to include near-misses			No Action Taken	No Action Taken
and begin investigating near-misses, following the same guidelines established in Stage I for
investigating accidents.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company and subcontractors continue making findings and corrective actions available to workers			No Action Taken	No Action Taken
on request (although actual investigation records need not be provided).			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Trend Analysis - Required Actions			Participant Status	Administrator Status
1. Conduct a trend analysis of the other safety and health-related information not yet studied			No Action Taken	No Action Taken
(e.g., hazards identified during inspections, worker reports of hazards, accidents, and
near-misses, etc.) for the purpose of establishing or detecting trends, planning, and setting goals.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Conduct another trend analysis of injury and illness history if a year has gone by since the			No Action Taken	No Action Taken
initial trend analysis.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company requires subcontractors to adopt and implement the company systems for trend analysis or			No Action Taken	No Action Taken
establish an equivalent system.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage II -- Hazard Prevention and Control
1. Certified Professional Resources - Required Actions			Participant Status	Administrator Status
1. Company ensures adequate resources such as certified safety and health professionals, licensed			No Action Taken	No Action Taken
health care professionals, and other experts as needed, based on the risks at the site.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Subcontractors ensure the availability to certified safety and health professionals and licensed			No Action Taken	No Action Taken
health care professionals as needed.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard Elimination and Control Methods - Required Actions			Participant Status	Administrator Status
1. Company prioritizes hazards identified in this stage based on seriousness and frequency of injury or illness			No Action Taken	No Action Taken
or property loss, frequency of exposure, and long- term effects. Establish an action plan for correction.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company identifies options and selects the most appropriate option or combination of options for			No Action Taken	No Action Taken
hazard elimination and control methods, including engineering controls (including protective safety devices),
administrative controls, work practices, and PPE.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company takes steps to ensure that the selected controls are: appropriate to the site’s hazard(s);			No Action Taken	No Action Taken
understood and followed by all affected parties; equitably enforced through the disciplinary system; written,
implemented, and updated as needed; used by workers; and incorporated into training, positive
reinforcement, and correction programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors adopt equivalent hazard control methods and have begun implementing the controls listed			No Action Taken	No Action Taken
above in the work it has been contracted to perform.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard Control Programs - Required Actions			Participant Status	Administrator Status
1. Company continues implementing hazard control programs required by OSHA standards. Modify and			No Action Taken	No Action Taken
improve, as needed.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company continues training all workers on these programs, as needed.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company establishes necessary hazard control programs in compliance with new OSHA standards, if any.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors adopt and begin implementing equivalent hazard control programs in the work they			No Action Taken	No Action Taken
are contracted to perform.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Tracking of Hazard Correction - Required Actions			Participant Status	Administrator Status
1. Continue implementing and improving the documented system established in Stage I to record			No Action Taken	No Action Taken
hazards identified.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Record priority, responsibility for correction, timeframes for correction, and follow-up to ensure total			No Action Taken	No Action Taken
hazard abatement.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontractors have begun implementing a hazard correction tracking system for hazards identified in			No Action Taken	No Action Taken
the baseline hazards analyses, trend analysis, and self inspection.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Preventive Maintenance of Equipment - Required Actions			Participant Status	Administrator Status
1. Company reviews the equipment inventory developed in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company establishes and begins following a preventive maintenance schedule to monitor and maintain			No Action Taken	No Action Taken
equipment so it can be replaced or repaired on a schedule according to manufacturers’ recommendations.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontractors adopt equivalent preventive maintenance systems and begin implementation by			No Action Taken	No Action Taken
inventorying equipment and material needing preventive maintenance.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Occupational Health Care Program - Required Actions			Participant Status	Administrator Status
1. Licensed health care professionals. Company provides workers access to licensed health care			No Action Taken	No Action Taken
professionals who can provide onsite or offsite services.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Health services, as needed. Company arranges for health services, such as pre-placement physicals,			No Action Taken	No Action Taken
audiograms, and lung function tests for workers, as needed, based on the outcomes of the baseline
safety and health analysis.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontractors determine how to provide equivalent access to licensed health care, physician care, and			No Action Taken	No Action Taken
emergency services for their workers working on site.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Subcontractors and company (per agreements) begin providing occupational health care for			No Action Taken	No Action Taken
subcontractor workers.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Information will be communicated to workers in writing and will be a part of the worker site			No Action Taken	No Action Taken
orientation program.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Emergency Preparedness and Response - Required Actions			Participant Status	Administrator Status
1. Company and subcontractors continue communicating the emergency procedures .			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company and subcontractors improve emergency procedures and services, including provisions for			No Action Taken	No Action Taken
emergency medical care, emergency transportation, emergency clinics, or hospital emergency rooms.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company and subcontractors establish an Emergency Response team including: persons trained in first aid			No Action Taken	No Action Taken
and CPR available on all shifts (or an alternative that is at least as effective). Increase the number of
trained individuals from Stage I.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Company and subcontractors conduct at least one evacuation drill, assess how well the procedures			No Action Taken	No Action Taken
worked, and improve the emergency procedures, as needed.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage II -- Safety and Health Training
1. Safety and Health Training - Required Actions			Participant Status	Administrator Status
1. Company and subcontractors continue to provide training to managers, supervisors, non-supervisory			No Action Taken	No Action Taken
workers, and subcontractors following the general guidelines established in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. As needed, company and subcontractors continue to provide current or new managers, supervisors,			No Action Taken	No Action Taken
non-supervisory workers, subcontractors, and designated safety and health staff all the required training
established in Stage I.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. In addition to required training established in Stage I, at a minimum, company and subcontractors provide the
following types of training to designated safety and health staff and others with assigned safety and health
responsibilities to help them develop the knowledge and skills necessary to perform their assigned tasks.
This includes the following:
a. How to develop a disciplinary plan			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. How to develop a system and written procedures to annually evaluate the total site’s safety			No Action Taken	No Action Taken
and health management system			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. How to conduct hazard analyses of significant changes			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
d. How to conduct pre-use analyses			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
e. How to conduct IH sampling, if applicable			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
f. How to conduct an annual evaluation of the site’s safety and health management system			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. In addition to required training established in Stage I, at a minimum, subcontractors provide their workers			No Action Taken	No Action Taken
with training on how to recognize hazardous conditions, signs and symptoms of workplace-related illnesses,
protective measures, and safe work procedures for the work they are contracted to perform.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage II -- Documentation
1. Minimum Required Documentation			Participant Status	Administrator Status
1. All documentation required in Stage I			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Job Hazard Analysis forms and records			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Routine self-inspection forms and records			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Worker Hazard reporting forms			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Minutes, charters, mission statements of safety and health teams			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Subcontractor program documentation – updated to include additional policies established in this stage			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Trend analysis procedure and reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Written IH Program - and any sampling results since the baseline			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Documentation showing implementation of hazard controls and their effectiveness			No Action Taken	No Action Taken
(i.e.- ventilation studies, PPE purchases, machine guarding purchases)			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
10. Written Preventive Maintenance schedule and system			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
11. Emergency Procedures – updated since Stage I			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
12. Training matrix and records			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
13. Revised S&H Goals and Objectives			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
14. Annual self evaluation procedure			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
15. Policy on subcontractor removal			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
16. Subcontractor documentation
§ Safety and Health Program			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
§ Inspection reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
§ Correction tracking reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
§ Accident reports			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:

Sheet 5: 4 - Stage III Status

OSHA Challenge - Construction Track
Stage III Tracking Form


Participant Name	Administrator Name	Report Period
[Enter Participant Name]	[Enter Administrator Name]	Time Period	[Enter Time Period]
[Enter Participant Name]	[Enter Administrator Name]	Year	[Enter Year]

Stage III -- Management Leadership and worker Involvement
1. Management Commitment - Required Actions			Participant Status	Administrator Status
1. Safety and Health Mission and Policy Statements. Continue to communicate the			No Action Taken	No Action Taken
company’s Safety and Health Vision and Policy Statements and take necessary steps to ensure all
workers understand the statements. Ensure that appropriate information about the company’s
Safety and Health Vision and Policy Statements becomes a routine part of the training for new workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Leadership by example. Management continues setting an example through behaviors that			No Action Taken	No Action Taken
demonstrate total commitment to safety and health (see examples in Stage I). Ensure total involvement of
all executives, managers, and supervisors in the safety and health related activities and programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Adequate resources and safety and health integration. Managers continue committing and			No Action Taken	No Action Taken
ensuring the utilization of adequate resources to support safety and health activities and programs.
Ensure that safety and health is routinely integrated into all planning processes at the site, for both
company and subcontractors.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Safety and health goals and objectives. Company and subcontractors review, revise, and			No Action Taken	No Action Taken
continue communicating, as appropriate to this Stage, the previous year’s safety and health goals and
objectives, as well as the policies and procedures to meet them. Ensure that safety and health goals
and objectives are routinely considered in planning for and implementing the various activities
and programs.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Clear lines of communication with workers and worker access. Continue to take			No Action Taken	No Action Taken
necessary action to clarify lines of communication with all workers and subcontractors and ensure
reasonable access to senior management with regard to safety and health issues. Take proactive steps
to encourage open dialogue between management staff and workers.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Clear responsibilities, authority, and accountability for safety and health. Company			No Action Taken	No Action Taken
and subcontractors continue clarifying safety and health expectations for each worker working on the
project/site. Ensure that all workers understand and accept their safety and health roles and
responsibilities. Continue supporting the authority of designated staff members who are accountable
for achieving safety and health goals and objectives. In addition:
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
a. Ensure that safety and health performance elements have been incorporated into the written			No Action Taken	No Action Taken
job descriptions and performance plans of all workers, including managers, supervisors,
and non-supervisory workers, as well as subcontractors.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Incorporate safety and health responsibilities into the job descriptions and performance plans			No Action Taken	No Action Taken
of all non-supervisory workers and ensure that every individual’s safety and health
performance is monitored and evaluated and that everyone receives feedback on
their safety and health performance.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Develop and implement a system of rewards and recognition for exemplary safety			No Action Taken	No Action Taken
and health performance.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Disciplinary plan. Improve and continue implementing the disciplinary plan, developed in Stage I			No Action Taken	No Action Taken
ensuring equitable enforcement as required. Enforce the plan to ensure higher levels of compliance to
achieve the desired outcomes.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Annual self-evaluation of safety and health management system. Company and subcontractors			No Action Taken	No Action Taken
implement systems and written procedures to annually evaluate the entire site’s safety and health mgt.
systems. The evaluations may be conducted by company and/or subcontractor workers with managers,
qualified corporate staff, or trained outsiders. The evaluations must: identify in a written narrative report
the strengths and weaknesses of the safety and health management system; contain specific
recommendations, timelines, and assignment of responsibilities for improvements; and document actions
taken to satisfy the recommendations. The company must conduct at least one annual self-evaluation of
its safety and health management system in this stage. The company must conduct additional
self-evaluations each year they remain in OSHA Challenge. If applicable, a self-evaluation
must be performed immediately prior to construction completion.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Worker Involvement - Required Actions			Participant Status	Administrator Status
1. Follow-up Safety and Health Perception Survey. Company conducts a follow-up Safety and Health			No Action Taken	No Action Taken
Perception Survey to identify further improvements.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Safety and Health Perception Survey Change Plan. Company continues implementing the Safety and			No Action Taken	No Action Taken
Health Perception Survey Change Plan developed in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Worker notification. Company continues notifying new managers, supervisors, and non-supervisory			No Action Taken	No Action Taken
workers of their rights under the OSH Act and of the site’s participation in OSHA Challenge. All changes
will be incorporated into the company’s orientation training for new workers and subcontractors.
Take proactive steps to encourage all workers to freely excerise their rights, especially that of freely
reporting hazards in the workplace. At least annually, reinforce policies regarding rights and
responsibilities for all company and subcontractor workers working on the site or project.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Worker involvement. Take proactive steps to ensure full implementation of the site’s worker
involvement plan developed in Stage I and refined in Stage II. Additionally for Stage III the company will:
a. Ensure that all the safety health teams needed to achieve the required outcomes for			No Action Taken	No Action Taken
Stage III are established and that there is broad and active worker participation in these teams.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Ensure that audits, accident/incident investigations, self-inspections, and job hazard analyses are			No Action Taken	No Action Taken
routinely conducted by regular teams that have broad and active worker representation.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Take proactive steps for subcontractor worker participation. Encourage more active			No Action Taken	No Action Taken
and open worker participation by all subcontractor workers and continue to develop programs to
include more participation for subcontractor workers where appropriate.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Contract Worker Coverage - Required Actions			Participant Status	Administrator Status
1. Adherence to rules. Ensure subcontractors and multi-tier subcontractors are aware of company			No Action Taken	No Action Taken
safety and health rules and continue to enforce for safety and health violations.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Subcontractor selection and oversight. Continue to improve and implement subcontractor oversight			No Action Taken	No Action Taken
program. Take proactive steps to ensure that subcontractors receive safety and health protection equal to
that received by company workers; that they adhere to the company’s safety and health rules and are
removed promptly for safety and health violations; that company management considers contractors’ safety
and health management systems and performance in selecting subcontractors and overseeing their work.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Subcontractor hazard correction. Ensure that the subcontractors have the ability to identify, correct,			No Action Taken	No Action Taken
and track uncontrolled hazards in work areas for which they are responsible.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Removal Policy. Ensure subcontractors and multi-tier subcontractors are aware of the penalty policies			No Action Taken	No Action Taken
and possible their possible removal for serious safety and health violations that go uncorrected.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Safety and health management systems for subcontractors. Continue working with subcontractors and			No Action Taken	No Action Taken
encourage and support the development and operation of their own effective safety and health
management systems.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage III -- Worksite Analysis
Worksite Analysis - Required Actions			Participant Status	Administrator Status
1. Baseline survey. Company and subcontractors repeat the baseline survey only if necessitated by			No Action Taken	No Action Taken
significant changes (e.g., changes in processes, equipment, hazard controls, etc.).			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard analyses of routine jobs, tasks, and processes. Company and subcontractors continue			No Action Taken	No Action Taken
conducting hazard analyses, following guidelines specified in Stage II, to identify, analyze, and control
hazards at the site. Specifically, for this Stage:
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
a. Identify hazards of routine jobs, tasks, and processes and recommend adequate hazard controls			No Action Taken	No Action Taken
by conducting task-based or system/process hazard analyses when the routine jobs, tasks,
and processes have written procedures; have been recommended by other studies and
analyses for more in-depth analysis; or are determined by the Challenge participant to warrant
hazard analysis. Follow the guidelines established in Stage II.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard analysis of significant changes. Company and subcontractors continue to identify and			No Action Taken	No Action Taken
document safety and health hazards of significant changes, including but not limited to non-routine tasks
(e.g., performed less than once a year) and new processes, materials, equipment, and facilities to identify
uncontrolled hazards prior to the activity or use and recommend adequate hazard controls.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Pre-use analysis
a. Company and subcontractors when considering new equipment, chemicals, facilities, or significantly			No Action Taken	No Action Taken
different operations or procedures, continue to conduct a pre-use analysis (defined in Stage II)
to review the potential safety and health impact on the workers at a level of detail appropriate
considering the perceived risk and the number of people who may be affected.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Company develops and begins implementing a plan for how to integrate this practice into the			No Action Taken	No Action Taken
procurement/design phase to maximize the opportunity for proactive hazard controls and requires
that subcontractors adopt and implement the company or an equivalent plan.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Company and subcontractors take proactive steps to ensure that pre-use analysis continues to be			No Action Taken	No Action Taken
integrated into the procurement/design phase.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Industrial hygiene program. Company and subcontractors continue implementing the IH programs to			No Action Taken	No Action Taken
identify, analyze, and control health hazards to prevent occupational disease.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Routine self-inspections
a. Company and subcontractors continue implementing the documented system for routinely			No Action Taken	No Action Taken
scheduled self-inspections of the workplace developed in Stage II.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Company and subcontractors continue conducting self-inspections by designated safety and			No Action Taken	No Action Taken
health staff, with the participation of other non-supervisory workers.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
c. Company and subcontractors take proactive steps to ensure that self-inspections are routinely			No Action Taken	No Action Taken
conducted and the entire worksite is covered at least weekly.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Hazard-reporting system. Company and subcontractors continue implementing the hazard-reporting system			No Action Taken	No Action Taken
and encourage more active reporting. Implement program improvements as needed.
Ensure regular feedback to all workers on the status of hazards reported (e.g., through
meetings, newsletters, e-mail messages, bulletin board postings, Intranet postings, etc.).
Take proactive steps to encourage all workers to freely make suggestions and report hazardous
conditions without fear of retaliation.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
8. Investigation of accidents and near-misses. Company and subcontractors continue investigating			No Action Taken	No Action Taken
accidents and near-misses, as needed, following the guidelines specified in Stages I and II.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
9. Trend analysis. Company takes proactive steps to implement systems for trend analysis of company			No Action Taken	No Action Taken
and subcontractor safety and health information and to ensure that the process takes place regularly (at least
annually) as scheduled for all types of safety and health information and is used in setting future goals to
address identified trends of accidents, injuries, and illnesses.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage III -- Hazard Prevention and Control
Hazard Prevention and Control - Required Actions			Participant Status	Administrator Status
1. Certified professional resources. Company and subcontractors continue to provide necessary resources			No Action Taken	No Action Taken
such as appropriate use certified safety professionals (CSP), Certified Industrial Hygienists (CIH), and other
professionals and experts as needed based on the risks at the site.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard elimination and control methods. Company and subcontractors continue to proactively identify			No Action Taken	No Action Taken
hazards through all means and select options or combinations of options to eliminate or control hazards
using the most appropriate methods or combination of methods, i.e., engineering controls (including
protective safety devices), administrative controls, work practices, and PPE.
Correct all hazards identified in this and previous stages, including long-term abatement projects,
before graduating from Stage III.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Hazard control programs. Company and subcontractors continue to maintain all hazard control programs			No Action Taken	No Action Taken
required by an OSHA standard, complying with all rules, requirements, and guidelines, including an
annual review and training if required. Take proactive steps to establish hazard control programs, if any,
required by new OSHA standards and to modify or update existing programs, as needed.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Hazard correction tracking. Company and subcontractors continue to implement and improve the			No Action Taken	No Action Taken
company’s documented hazard tracking system. Take proactive steps to improve the tracking system,
ensure that it is fully implemented, and communicate with all workers throughout the process on the status
of specific hazards identified until they are totally abated.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Preventive maintenance of equipment. Company and subcontractors continue to implement the			No Action Taken	No Action Taken
preventive maintenance schedule on equipment to prevent any hazardous conditions. Take proactive steps
to ensure that the company and subcontractors have an established, routinely-observed preventive
maintenance schedule and that preventive maintenance is automatically part of future systems.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
6. Occupational health care program. Company and subcontractors take proactive steps to continue
providing effective occupational health care programs, including:
a. Provisions for access to or availability of certified health care professionals, needed			No Action Taken	No Action Taken
health services, and emergency physician and medical care; improve the program based
on all available safety and health information.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
b. Expand use of licensed health care providers to include site visits to help identify causes			No Action Taken	No Action Taken
and symptoms of occupational injuries and illnesses. Ensure care provided is within the scope
schedule of licensure and standard operating procedures.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
7. Emergency preparedness and response. Company and subcontractors continue to improve, communicate,			No Action Taken	No Action Taken
and implement the written procedures for responding during all shifts to all types of emergencies.
Review the results of previous drills and conduct and evaluate, at a minimum, an annual drill. Ensure that
there is at least one fully operational emergency response team in every shift. Encourage use of AEDs, as
appropriate, and training on their use. Take proactive steps to ensure full implementation and
automatic tracking of the site’s emergency preparedness and response program and procedures. Establish
a HAZMAT Team if necessary and consult with local fire department to ensure adequate coverage for
fire, explosion, or chemical release.
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage III -- Safety and Health Training
Safety and Health Training - Required Actions			Participant Status	Administrator Status
1. Company and subcontractors continue to provide training to all workers following the general			No Action Taken	No Action Taken
guidelines specified in Stage I.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Company and subcontractors take proactive steps to improve and continue providing training on			No Action Taken	No Action Taken
specific topics, as needed.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Company and subcontractors provide training for workers on how to recognize and control hazardous			No Action Taken	No Action Taken
conditions and the signs and symptoms of workplace-related illnesses and injuries.			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
Stage III -- Documentation
Documentation			Participant Status	Administrator Status
1. All documentation from Stages I and II completed and updated			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
2. Hazard analysis form showing analysis of non-routine tasks or significant changes			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
3. Pre-use analysis forms and results			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
4. Annual self-evaluation of the company’s safety and health management program			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:
5. Follow up Safety and Health Perception Survey and results			No Action Taken	No Action Taken
Participant Goal:			Date Completed:
Participant Actions Taken:
Administrator Narrative:

File Type	application/vnd.ms-excel
Author	Harris, Richard - OSHA
Last Modified By	Owen, Todd - OSHA
File Modified	2014-09-30
File Created	2004-02-09