Voluntary Protection Program, Special Government Employee

Voluntary Protection Program Information

Challenge Participant Tracking-Construction Track.xlsx

Voluntary Protection Program, Special Government Employee

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]






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.








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.




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.




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.




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.




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.








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








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.




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.








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.








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.








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.




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.




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.








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.




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.




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.




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).




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.




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.




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.








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.




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.








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.




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.




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.




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.




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.




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.




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.








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.




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.




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.




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.




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.




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.








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.




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.




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




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)




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]






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.




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.




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.




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.








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.








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.




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.




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.








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.).




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.




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.




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.




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.




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.




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.








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.




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.




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.




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:




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