Challenge Participant Tracking - Construction

Challenge Participant Tracking-Construction Track.xlsx

Voluntary Protection Program Information

Challenge Participant Tracking - Construction

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

4. Meaningful worker involvement. Develop a plan, including an implementation schedule, for

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

(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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(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

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

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

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

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

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

(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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. Document attendance.

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

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. OSHA Challenge

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

e. Specific responsibilities for each type of emergency

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

f. Emergency evacuation procedures

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. Methods for changing workplace safety and health attitudes and practices

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

c. Requirements for OSHA Challenge Stage I

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. OSHA Challenge

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

c. Hazards in the workplace

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

e. Specific responsibilities for each type of emergency

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

f. Emergency evacuation procedures

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

2. The most recent annual safety and health goals and objectives

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

3. Accountability plan

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

5. Disciplinary Plan

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

6. Contract selection requirements

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

• Insurance claim forms

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

• Accident reports

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

8. Baseline hazard analysis results, including IH reports

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

9. Written hazard control programs

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

10. Accident investigation forms and reports

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

11. Written contractor policies for this stage

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

12. Safety and Health Perception Survey form

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

14. Trend analysis results

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

15. Accident Investigation procedure

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

16. Hazard correction action plan

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

17. Hazard correction tracking system

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

18. Preventive maintenance inventory

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

19. Written emergency procedures

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

20. Training records

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]

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

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

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

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

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

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

clarifying safety and health expectations for company and subcontractor workers on the site.

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

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

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

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

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

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

or establish an equivalent process.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

7. Disciplinary plan. Develop and begin implementing a disciplinary plan (policy, procedures,

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

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

the Safety and Health Perceptions Survey conducted in Stage I.

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

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

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

needs at this Stage of OSHA Challenge.

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

near-miss investigations, self-inspections, and job hazard analyses.

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

participate in activities per contract and/or agreement, or establish equivalent plans.

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

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

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

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

processes for the timely identification, correction, and tracking of uncontrolled hazards in their work

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

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

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

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

change or when errors are found that invalidate the most recent hazard analysis.

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

or establish equivalent plans. Subcontractors begin performing effective hazard analysis of routine work.

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

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

significant changes in the work they are contracted to perform, including but not limited to non-routine tasks.

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

or procedures, conduct a pre-use analysis to review the potential safety and health impacts on workers.

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

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. Establish and implement sampling frequencies – a schedule for sampling identified hazards

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

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

are contracted to perform or establish an equivalent program.

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

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

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

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

establish an equivalent program.

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

begun performing routine inspections of work areas and the activities they are contracted to perform.

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

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

the hazards they report.

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

or establish an equivalent system.

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

the activities hey are contracted to perform.

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

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

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

on request (although actual investigation records need not be provided).

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

(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

initial trend analysis.

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

establish an equivalent system.

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

health care professionals, and other experts as needed, based on the risks at the site.

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

health care professionals as needed.

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

or 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. Company identifies options and selects the most appropriate option or combination of options for

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

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

above in the work it has been contracted to perform.

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

improve, as needed.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

2. Company continues training all workers on these programs, as needed.

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

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

are contracted to perform.

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

hazards identified.

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

hazard abatement.

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

the baseline hazards analyses, trend analysis, and self inspection.

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

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

equipment so it can be replaced or repaired on a schedule according to manufacturers’ recommendations.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

3. Subcontractors adopt equivalent preventive maintenance systems and begin implementation by

No Action Taken

inventorying equipment and material needing preventive maintenance.

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

professionals who can provide onsite or offsite services.

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

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

emergency services for their workers working on site.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

4. Subcontractors and company (per agreements) begin providing occupational health care for

No Action Taken

subcontractor workers.

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

orientation program.

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

2. Company and subcontractors improve emergency procedures and services, including provisions for

No Action Taken

emergency medical care, emergency transportation, emergency clinics, or hospital emergency rooms.

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

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

worked, and improve the emergency procedures, as needed.

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

workers, and subcontractors following the general guidelines established in Stage I.

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

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

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

and health management system

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

c. How to conduct hazard analyses of significant changes

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

d. How to conduct pre-use analyses

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

e. How to conduct IH sampling, if applicable

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

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

2. Job Hazard Analysis forms and records

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

3. Routine self-inspection forms and records

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

4. Worker Hazard reporting forms

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

7. Trend analysis procedure and reports

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

9. Documentation showing implementation of hazard controls and their effectiveness

No Action Taken

(i.e.- ventilation studies, PPE purchases, machine guarding purchases)

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

10. Written Preventive Maintenance schedule and system

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

11. Emergency Procedures – updated since Stage I

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

12. Training matrix and records

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

13. Revised S&H Goals and Objectives

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

14. Annual self evaluation procedure

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

15. Policy on subcontractor removal

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

16. Subcontractor documentation

§ Safety and Health Program

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

§ Inspection reports

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

§ Correction tracking reports

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

§ Accident reports

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]

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

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

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

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

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

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

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

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

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

and health performance.

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

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

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

Perception Survey to identify further improvements.

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

Health Perception Survey Change Plan developed in Stage I.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

3. Worker notification. Company continues notifying new managers, supervisors, and non-supervisory

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

Stage III are established and that there is broad and active worker participation in these teams.

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

routinely conducted by regular teams that have broad and active worker representation.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

5. Take proactive steps for subcontractor worker participation. Encourage more active

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

safety and health rules and continue to enforce for safety and health violations.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

2. Subcontractor selection and oversight. Continue to improve and implement subcontractor oversight

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

and track uncontrolled hazards in work areas for which they are responsible.

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

and possible their possible removal for serious safety and health violations that go uncorrected.

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

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

significant changes (e.g., changes in processes, equipment, hazard controls, etc.).

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

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

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

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

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

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

integrated into the procurement/design phase.

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

identify, analyze, and control health hazards to prevent occupational disease.

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

scheduled self-inspections of the workplace developed in Stage II.

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

b. Company and subcontractors continue conducting self-inspections by designated safety and

No Action Taken

health staff, with the participation of other non-supervisory workers.

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

conducted and the entire worksite is covered at least weekly.

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

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

accidents and near-misses, as needed, following the guidelines specified in Stages I and II.

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

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

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

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

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

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

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

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

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

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

guidelines specified in Stage I.

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

specific topics, as needed.

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

conditions and the signs and symptoms of workplace-related illnesses and injuries.

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

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

3. Pre-use analysis forms and results

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

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

5. Follow up Safety and Health Perception Survey and results

No Action Taken

Participant Goal:

Date Completed:

Participant Actions Taken:

Administrator Narrative:

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