For Submission – please keep all pages in this package
together for ease of review.
Small Employer Certificate of Recognition (SECOR)
2015 Audit Instrument
RELEASE DATE » JANUARY 2015
Page | 1
Small Employer Audit Instrument
This audit instrument is designed to measure whether or not the small employer has implemented the basics of a health and safety
management system. The instrument is to be used, by the owner or the key employee to submit a SECOR Assessment for review by
Enform. SECOR Assessments require submission of notes and adequate documentation to allow Enform to verify the status of the small
employer’s health and safety system and score the questions in the audit instrument. A minimum overall score of 80% is required to pass the
audit, and each individual element must score at least 50%.
Anyone conducting a SECOR Assessment must have completed Enform’s Safety Program Development course prior to completing the
assessment.
In addition, if you have already taken the Safety Program Development course you may also consider taking the online SECOR Refresher
course as it will guide you in preparation for the changes in this new SECOR protocol. This course will also count towards your assessor
renewal, resetting your status for another three years. Please contact Enform for further information on SECOR training requirements.
Instructions for completing a SECOR Assessment
1. Read each question and instructions, and respond to the question in the “Notes” field provided. The assessor must explain the
process or describe what is in place in the “Notes” section. Questions will require both a written explanation and attached
documentation.
2. Where attached documents/record samples are required by the guidelines, attach copies of the requested documentation.
Records submitted must be sufficient to verify health and safety activities over the previous 12-month period. DO NOT
ATTACH ORIGINAL DOCUMENTATION.
3. Ensure that documentation is submitted in a logical and orderly manner, and avoid submitting more documentation than
required by the question guidelines. Enform may reject submissions that are difficult to assess. In the Notes field, please
reference where the document can be found in your binder (i.e. page number or tab).
4. While completing the audit document, you will likely identify deficiencies in your health and safety system. For each deficiency
identified, consider what steps you could take to improve this area of your system, and enter an appropriate action item in the
attached Action Plan.
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Tips for completing the SECOR Assessment
Page | 3

Questions can only be marked as “not applicable” (n/a) if the guidelines allow it, and the Assessor’s answer to the question must
fully justify why the question should be “n/a.”

Ensure the SECOR Summary Sheet is completed filled out, and signed off as required.

Assessors will not award a score for each question, or fill out the Summary Score Sheet at the end of the audit. Scoring will be
determined by an Enform reviewer.

SECOR Assessors internal to the operation are not required to conduct worker interviews, but must fill out the Employee Breakdown
and Sampling Details table.

Unless this is your first SECOR Assessment, a completed action plan based on the results of your previous year’s audit must be
included in the SECOR submission.
The list below contains examples of documentation that can be attached to the SECOR submission to verify the questions listed
Question
Documentation
Documents to submit
A1
Health & Safety Policy
Directive Document
A2
Documented Employee Awareness - *please submit for
all employees
Health and Safety Roles and Responsibilities
Document samples for all current employees
Document samples for all current employees
A5
Communication of Responsibilities - *please submit for
all employees
Legislation list and awareness
B1
Position inventory table
Directive document
B2
List of tasks
Directive document
B3
List of hazards
Directive document
B4
Policy / Procedure to evaluate risk
Directive document
B5
Hazard assessments
B6
Prioritization
Formal Hazard assessment for all positions in
inventory
Directive document
B7
Process for review of hazard assessments
Directive document
B8
Inspection policy
Directive document
A3
A4
Page | 4
Directive document
Directive document
Page | 5
Question
Documentation
Documents to submit
B9
Inspection forms
B10
Training records - *please submit for all employees
B11
Hazard reporting policy
Quarterly sampling of all inspections in policy. Unless
otherwise specified in the policy. (yearly inspection
only one required)
Document samples for ALL employees that perform
inspections
Directive document
B12
Hazard report forms
C1a
Formal Hazard assessments engineering controls
Quarterly sampling unless otherwise specified by
notes.
Directive document
C1b
Formal Hazard assessments administrative controls
Directive document
C1c
Formal Hazard assessments - PPE
Directive document
C2
PPE policy
Directive document
C3
Document samples for all current employees
C4
Training records PPE
*please submit for all employees
Discipline policy
C5
Safe work procedures
Directive documents for all critical tasks
C6
Preventative maintenance policy / procedure
Directive document
C7
Preventative maintenance documents
D1
Orientation Policy
Quarterly sampling of maintenance records, CVIP’s,
service records from professional mechanics, pre-trip
inspections (one week per quarter)
Directive document
D2
Orientation records- *please submit for all employees
Directive document
Document samples for ALL NEW employees, visitors or
contractors
Question
Documentation
Documents to submit
D3
Training records (i.e. H2S, 1st aid..)
D4
E1
Training records (i.e. on-the-job) - *please submit for all
employees
Right to refuse documents- *please submit for all
employees
Emergency Response Plan
Document sample of training listed in formal hazard
assessments
Document sample for all current employees
E2
Emergency Response Procedures
Directive document
E3
E4
Emergency Response Procedures Communication
Documentation - *please submit for all employees
Emergency response plan training
Document sample for all employees and any
responsibilities mentioned in the policy
Any responsibilities mentioned in the policy
E5a
Emergency response plan evaluation process / forms
Blank form
E5b
Emergency response drill records
F1
Incident reporting policy
Document sample of all completed drills throughout
the year. (must match the policy)
Directive Document
F2
Completed incident reports
All completed incident reports
F3
Investigation policy
Directive document
F4a
Investigation forms
Blank form
F4b
Completed investigations forms
F5
Investigation training records
F6
Near miss reports
All completed investigation forms. (near miss
investigations are accepted)
Documented training for all employees completing
inspections
All completed near miss reports
D5
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Document sample for all current employees
Directive document
Question
Page | 7
Documentation
Documents to submit
F7
Statistical reports
Quarterly completed statistics
G1
Safety meeting policy
Directive document
G2
Safety meeting records
G3a
Site specific orientation documents
G3b
Safe work plans documentation
G3c
Safe work plans communications
G4
Action plan developed
Quarterly sampling of all types of safety meetings
mentioned in the policy. Unless otherwise explained
in the policy
Quarterly sampling of all prime contractor site forms
unless otherwise specified by notes
Quarterly sampling of all prime contractor site forms
unless otherwise specified by notes
Quarterly sampling of all prime contractor site forms
unless otherwise specified by notes
Completed action plan
G5
Action plan implemented
Details on where you have implement your action
plan
Complete the Summary Sheet:
Enform
SECOR SUMMARY SHEET
Employer Legal Name (as registered with WCB):
Employer Trade Name (if applicable):
Address:
WCB Account(s) in scope:
Industry Code(s) in scope:
Facilities/Work Sites in scope:
Contact Person:
Phone Number:
Fax Number:
Email:
Contact person’s original
SECOR Training date:
Contact person’s last refresher
date:
Assessor Name:
Assessor most recent training
/refresher date:
Assessor Phone Number:
Assessor Email:
Audit/Assessment Start Date:
Audit Purpose (certification or maintenance):
Course taken as refresher
session:
Code of Ethics
signed?
Audit/Assessment End Date:
Number of employees:
Name of the OHS Consultant used to help build the OHS management system (if applicable):
Employer Sign off:
Assessor Sign off:
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Complete the Submission Checklist:
SUBMISSION CHECKLIST
Registration
employer has required training prior to audit registration/submission (i.e. Safety Program Development or related refresher training which is
required 3 years from initial training date)
Payment of applicable fees at time of submission (see www.enform.ca to determine costs
Report Components and Submission
Cover Letter to Enform (describe purpose of submission i.e. maintenance of SECOR)
Documentation is attached for all provinces seeking SECOR (see below Document Sampling area)
Company Profile
Company Organizational Chart
Provided detailed answer to each question and include reference in your note to where the document is located in your submitted binder.
Small Employer Health and Safety Action Plan
Complete the Employee Breakdown and Sampling Details table
Sign the Code of Ethics
Submit package by mail: Enform, Attn: SA&C Department, 5055 – 11 Street NE, Calgary, AB, T2E 8N4
Multi-Province Document Sampling
For employers seeking SECOR certification in multi-provinces, confirmation that documentation to support safety program activities in all
applicable provinces is required.
AB
BC
SK
MB
NWT
Other N/A
List of relevant Legislation
Meeting Minutes
CVIP’s
Inspections
Hazard Reports
ERP Drills
Safe Work Permits
Prime Contractor Info forms
Incident/near miss
Field Level Hazard assessments
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Employee Breakdown and Sampling Details table
Complete the following:
Employee Breakdown and Sampling Details
Total
Number
Levels
Departments/Shifts
List departments, and (if
applicable) shifts below
Total Employees
Dept./shift
totals
FullTime
PartTime
Managers
Supervisors
Workers
Total
Employees
Contractors
Visitors
List of Employees
Employee Name
Page | 10
Length of Time with
Company
Position
Casual
Question Scoring
Scoring is assessed and calculated by the Enform Audit Reviewer. Scoring for each question is based on the instructions in the
question and % of positive indicators based on documentation samples required to be submitted that meet the criteria in the
question.
Example One:
 Question A1 is 0-7 points - the question and guideline asks the assessor to answer the question and submit a policy that
includes the criteria in the question and guideline
 The reviewer will assess the submitted policy to determine if it meets the criteria in the question and guideline. 1 point for the
signed/dated policy and 2 points for each of the other bullets are possible points available for a total of 7 points for this
question. If one or more of the criteria in the question/guideline are missing from the content of the policy then points would
be deducted accordingly
Example Two:
 Question E5a is 0,2 points – this is an all or nothing question. This means the employer would need to answer the audit
question and submit a document that meets all the criteria in the question to receive full points. If the document exists but
does not meet one of the criteria then a 0 would be awarded. There are only a few all or nothing questions.
Example Three:
 Question D3 is 0-8 points - the question and guideline asks the assessor to answer the question and submit employee
training records (i.e. H2S, first aid, forklift, PPE, job specific)
 The reviewer will assess the submitted training records and compare against other submitted documents to ensure
employees have received appropriate training. The reviewer would then calculate a % of those results to reach the score.
(i.e. 4 types of training certificates required and 4 training records were submitted = 100% or 8 out of 8 points awarded. If
during the review of the audit it is found that an employee who should have training did not have training submitted, points
would be deducted (i.e. 3 of 4 types of training certificates = 75% or 6 out of 8 points awarded for this question.
Important - The assessor’s notes are also reviewed to determine if the assessor’s answer to the question would support or explain
what has been submitted. This will help support the score that the reviewer will be awarding.
The scoring in the Enform SECOR Audit Protocol was developed by performing a gap analysis on the governing body audit
standards to ensure it met all provincial SECOR standards.
Page | 11
Read, complete and sign the Code of Ethics:
Enform SECOR Assessor Code of Ethics
Professionalism and Integrity
SECOR Assessors are expected to hold themselves to the highest standards of honesty and professionalism in conducting audits. The behavior of
a SECOR Assessor should not call into question their good faith and integrity.
Assessor Conduct
In conducting SECOR audits, Enform SECOR Assessors are expected:








To maintain confidentiality
o Assessors should ensure that information provided in confidence in the audit interview process is respected as such and to protect
the anonymity of interviewees in audit reporting.
To be diligent.
o Assessors must act in good faith, with due care and competence, without misrepresenting material facts or allowing their
independent judgment to be compromised.
To be objective
o Assessors must be objective in the assessment of their workplace health and safety management systems and base their
evaluations on objective and measurable data, and not subjective opinions or assumptions.
To be accurate.
o Assessors must strive for accuracy and consistency in compiling documentation, and in the delivery of interview and observation
results in their audit report documents.
To be complete
o Assessors must ensure their evaluations are complete, and avoid any omissions relevant to the scope of the audit.
To be relevant
o Assessors must ensure their action items and suggestions for improvement in the SECOR audit report are relevant and are
intended to improve the health and safety management system.
To be clear.
o Assessors must ensure their notes and documentation are clear, concise, reflect their findings, and written in plain language.
To be timely.
o Assessors must comply with the required timelines for audit completion, submission, and correction.
Compliance
Enform SECOR Assessors must follow all of the audit quality assurance standards as established by Enform and its provincial partners, and any
applicable legislated requirements while conducting and completing the audit.
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Enform SECOR Assessor Code of Ethics
STATEMENT OF AGREEMENT
I, _________________________ (SECOR Assessor) agree to comply with the Small Employer Certificate of Recognition audit protocol currently
sanctioned by Enform without additions or deletions thereto, and to conduct myself at all times in a professional manner and in accordance with the
Enform SECOR Assessor Code of Ethics. As the SECOR assessor, I also agree to use only current Enform audit materials and to comply with
all of the Enform audit standards, policies and procedures.
I further acknowledge that Enform has the authority to suspend my ability as SECOR assessor to conduct further audits pending a full review by
Enform.
By signing this letter, I acknowledge that this document accurately defines the relationship between myself as a SECOR assessor and Enform.
SECOR Assessor Signature
Date
(
Legally Registered Company Name
Page | 13
)
Phone Number
Element A. Management Involvement and Commitment
Number
A1
Page | 14
Question
SECOR Assessor Instructions
Is there a written health
and safety policy that
includes;
• key safety responsibilities
for each level (i.e.
manager, supervisor,
workers, contractors and
visitors).
• a reference to the
company's goals, aims,
responsibilities and
commitment to health and
safety.
• requirement to comply
with applicable
government regulations
and the companies health
and safety standards.
• signature of the current
owner, including date.
Answer the audit question in the
Notes and Attach a copy of the
health and safety policy that shows
that the requirements of the question
are included.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
The signature must be of the current
owner.
/0-7
Number
A2
Question
SECOR Assessor Instructions
Are employees made
aware of the content within
the health and safety
policy?
Answer the audit question in the
Notes and Attach copies of
documentation (for example:
orientations, safety meeting minutes,
employee sign off on policy) showing
evidence all employees who have
been made aware of the content of
the health and safety policy.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
*please submit for all employees
A3
Have health and safety
roles and responsibilities
been written for
manager(s), supervisor(s),
and worker(s)?
This question is not applicable (n/a)
if the operation does not have any
employees.
Owner/Operators are exempt from
this question.
(Owner/Operators are companies
with only one person covered under
their Workers Compensation Board
account)
Answer the audit question in the
Notes and Attach a copy of
responsibilities for manager(s),
supervisor(s), and worker(s) from
the manual. This document should
be separate from the health and
safety policy.
Depending on size or nature of the
organization, one or more of these
categories may not be applicable
(n/a). This should be explained in
the notes section.
Page | 15
/0-10
/0-4
/0-4
/0-4
/12
Number
A4
Question
SECOR Assessor Instructions
Are employees at all levels
aware of their health and
safety roles and
responsibilities?
Answer the audit question in the
Notes and Attach documentation (for
example: safety meeting minutes,
orientations, etc.) which confirms
that these duties have been
communicated to all employees
(example: Managers, supervisors
and workers). The documentation
should explain how employees have
been made aware of their health and
safety roles and responsibilities.
Attach employee records for all
employees to support the question.
Notes
(All questions require a full answer by the
employer assessor)
/0-5
/0-5
/0-5
- *please submit for all employees
A5
Are key employees familiar
with legislation that is
applicable to the scope of
their work?
Enform
Reviewer
Assessed
Score
/15
Answer the audit question in the
Notes and Attach a list of relevant
sections, or parts of the occupational
health and safety legislation that
apply to your workplace, and work
activities. Explain how it is
accessible to employees.
This may include federal, provincial
and/or municipal legislation if it is
applicable to your operation.
This may also include references to
other safety related legislation, in
addition to the health and safety
legislation, such as: motor vehicle or
explosives legislation.
/0-4
Do not send in the actual legislation
book.
Total Points Possible: 48
Page | 16
Minus N/A = _____
___ / ___
Element B. Hazard Identification and Risk Assessment
Number
B1
B2
Question
SECOR Assessor Instructions
Have all company positions or
disciplines been inventoried
for formal hazard assessment
purposes?
Answer the audit question in the
Notes and Attach an inventory or
list of all positions/disciplines in the
company.
Do all positions/disciplines
have tasks identified within the
formal hazard assessments?
For example:
A list of all positions within the
company: administration staff, field
technician, truck driver, etc.
Answer the audit question in the
Notes and Attach a list of tasks for
each position/discipline in the
company as identified in B1.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-5
For example:
Position: truck driver
Tasks include: operate vehicle,
secure load, basic maintenance,
loading and unloading equipment,
etc.
/0-5
Page | 17
Number
B3
Question
Have both health and safety
hazards for each task been
identified in question B2,
including (as appropriate)
hazards presented by:
• operations,
• equipment,
• vehicles,
• materials or products, and
• working conditions
/environment?
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach a list of health
and safety hazards for each task
identified.
For example:
Task: operate vehicle
Hazards: awkward sitting position,
fatigued, animals on the road, other
drivers, inclement weather, etc.
/0-7
B4
Is there a system to evaluate
risk for the identified hazards
to determine an order of
importance to apply controls?
Answer the audit question in the
Notes and Attach a policy or
procedure that show how the
employer used a system to
evaluate the hazards and rank
them from the highest to the
lowest.
For example:
- Potential consequences of
exposure to the hazard (severity).
- Likelihood of an incident occurring
(probability).
- Degree of exposure to the hazard
(frequency).
This evaluation may be qualitative
(high, medium, low; A, B, C) or
quantitative (3, 2, 1).
Page | 18
/0,5
Number
B5
Question
Have both health and safety
hazards for each task been
assessed using any
combination of severity,
probability, frequency or
similar measurement to
determine risk?
SECOR Assessor Instructions
Have all health and safety
hazards been prioritized
according to risk to determine
the order of importance when
implementing controls?
/0-15
Answer the audit question in the
Notes and Attach samples of
completed formal hazard
assessments in which hazards
have been evaluated to determine
risk using the system described in
B4.
For example:
Improper lifting: severity 3 x
frequency 4 x probability 1 =
priority 12
Page | 19
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach samples of
completed formal hazard
assessments in which hazards
have been evaluated to determine
risk using the system described in
B4.
For example:
- Potential consequences of
exposure to the hazard (severity).
- Likelihood of an incident occurring
(probability).
- Degree of exposure to the hazard
(frequency).
This evaluation may be qualitative
(high, medium, low; A, B, C) or
quantitative (3, 2, 1).
B6
Notes
(All questions require a full answer by the
employer assessor)
/0-15
Number
B7
Question
SECOR Assessor Instructions
Is there a system or
documented process to create
or review/revise formal hazard
assessments:
• when new operations,
equipment, materials or
products are introduced,
• when operations or
equipment are modified, and
• on an ongoing scheduled
basis?
Answer the audit question in the
Notes and Attach a reference from
the safety manual which confirms
that formal hazard assessments
will be reviewed for accuracy
whenever the operation changes.
Is there an inspection policy
which outlines:
• Types of inspections
• Frequency of each type
• Who is responsible for
conducting each type of
inspection
• A checklist to follow, and
• A means of tracking
corrective actions
Enform
Reviewer
Assessed
Score
These documents should
demonstrate ongoing review of
formal hazard assessments. This
may include meeting minutes,
supervisor’s log book, assessment
documents, etc. These documents
should describe how and when
these reviews occur.
Changes to operation may include:
new equipment purchased, new
services offered, facility renovated,
etc.
B8
Notes
(All questions require a full answer by the
employer assessor)
/0,2
Answer the audit question in the
Notes and Attach the inspection
policy that confirms that these
topics have been covered.
/0-6
Page | 20
Number
B9
B10
Question
Have inspections been
completed and any
deficiencies corrected as
outlined by the company's
written policy?
Have employees conducting
inspections received training
that is appropriate to what is
being inspected?
SECOR Assessor Instructions
Answer the audit question in the
Notes and Attach an example of
each type of inspection from each
quarter of the previous year where
applicable.
Corrective measures need to be
implemented in a timely manner
pertaining to the deficiencies
identified.
***If an inspection is only
conducted once a year, such as
sprinkler systems or CVIP, then
only one sample is required.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-5
Answer the audit question in the
Notes and Attach training records
to confirm that employees
conducting inspections are trained
to an appropriate level.
This may include documented onthe-job training, orientation, safety
meetings that provided instruction
on inspections, or third party
training.
- *please submit for all employees
B11
Is there a system that allows
employees a means of
reporting existing or new
hazards which includes;
• What is reportable
• How to report it
• Who is responsible for
investigating and correcting
reported concerns
Page | 21
/0-10
Answer the audit question in the
Notes and Attach a Hazard
Reporting Policy that confirms that
the topics in the question are
covered.
/0-4
Number
B12
Question
Is a hazard reporting process
in use and do the reports
include;
• A description of the hazard
and its location
• An assessment of the risk it
represents
• Control measures needed
• Interim actions taken
• follow-up or sign-off
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach examples of
completed hazard reports that
address the requirements outlined
in the question.
/0-10
Total Points Possible: 89
Page | 22
Minus N/A = _____
___ / ___
Element C. Hazard Control
Number
C1.a
C1.b
Question
SECOR Assessor Instructions
Are hazards controlled with the
use of engineering controls
whenever feasible or required
based on risk or legislation?
Answer the audit question in the
Notes and Attach formal hazard
assessments from element B
confirming that engineered
control measures have been
identified for the hazards
outlined in the Formal Hazard
Assessments.
For hazards not eliminated by
engineering controls, have
administrative controls been
identified where applicable and
required based on risk or
legislation?
Completed formal hazard
assessments that represent:
• the highest risk activities
• those subject to legislative
controls
• those with industry standard
engineering controls.
Consider these as opportunities
for applying engineering
controls.
Answer the audit question in the
Notes and Attach formal hazard
assessments from element B
confirming that administrative
control measures have been
identified for the hazards
outlined in the Formal Hazard
Assessments.
Consider the following as
opportunities for administrative
controls:
• any that could be effectively
addressed with an
administrative control
• any that require an
Page | 23
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-9
/0-7
Number
Question
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
administrative control by
legislation
C1.c
Are health and safety hazards
controlled by using industry
standard personal protective
equipment (PPE) where
engineering and administrative
controls do not sufficiently
control the hazard?
Answer the audit question in the
Notes and Attach formal hazard
assessments from element B
confirming that PPE control
measures have been identified
for the hazards outlined in the
Formal Hazard Assessments.
Consider the following as
opportunities for PPE controls:
• those that could be effectively
controlled with industry standard
PPE
• those that require PPE by
legislation
Enter the percentage of these
that that have PPE controls
documented.
/0-5
Page | 24
Number
C2
C3
Question
SECOR Assessor Instructions
Is there a Personal Protective
Equipment (PPE) Policy
developed that is appropriate to
the nature of the tasks
performed by the company,
which includes;
• A list of PPE used by the
company
• Description of how staff will be
trained in the use, care and
maintenance of relevant PPE
• Description of how staff will be
trained in the fitting of relevant
PPE
• Under what circumstances is
the PPE required
• Codes of Practice for
legislated activities where
appropriate. (Confined Space
Entry, Working at Heights)
Does the company provide
training on PPE that includes
the care, use, maintenance,
and limitations of any required
PPE?
Answer the audit question in the
Notes and Attach PPE policy
that contains the requirements
outlined in the question.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-6
Answer the audit question in the
Notes and Attach training
records to show that employees
are trained in the content of the
PPE Policy as well as the use,
care and maintenance of
Personal Protective Equipment.
The training records should
include an area for sign off by
the employee and the
supervisor.
/0-5
Page | 25
Number
C4
Question
SECOR Assessor Instructions
Is there a disciplinary system
for enforcing Health and Safety
policies, rules and procedures?
Answer the audit question in the
Notes and Attach a Discipline
Policy that contains :
• the steps taken when
violations are identified
• how violations will be corrected
• a form for recording these
infractions and the subsequent
actions taken
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-4
C5
C6
Page | 26
Have work safe procedures,
rules and/or Code of Practice
been developed where
specifically required, inclusive
of legislation?
Is there a preventive
maintenance program for
equipment and machinery?
Answer the audit question in the
Notes and Attach copies of all
safe work procedures for
hazardous tasks performed by
employees. (e.g., Code of
Practice for confined space
entry or respiratory equipment,
working alone, etc.).
Answer the audit question in the
Notes and Attach a Preventative
Maintenance Policy or
procedures that outlines;
• Equipment to be serviced
• Frequency of services
• Reference to manufacturers’
requirements where applicable
• Reference to legislated
standards where applicable
/0-5
/0-5
Number
C7
Question
SECOR Assessor Instructions
Is the preventive maintenance
program being implemented as
outlined?
Answer the audit question in the
Notes and Attach completed
documentation, Commercial
Vehicle Inspections,
maintenance logs, service
records/invoices, pre-trip/preuse inspections etc. that
confirms the system is being
used.
Total Points Possible: 54
Page | 27
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-8
Minus N/A = _____
___ / ___
Element D. Training
Number
D1
Question
Is there an Orientation Policy
which includes;
• Who is responsible for
conducting them
• Requirement to be completed
on the first day
• Health and Safety Policies
and responsibilities
• Hazard Reporting procedures
• Emergency Response
Procedures
• Incident, Injury, Illness, and
Near Miss reporting
• Sign off requirement by new
hire
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach an Orientation
Policy that contains the
requirements outlined in the
question.
/0-8
D2
Are new employees (including
any rehired or transferred
employees), contractors and
visitors provided with an
orientation that covered the
critical topics identified in the
Policy on or before the first day
of work?
Answer the audit question in the
Notes and Attach completed
orientation records that show
orientations are completed the first
day of employment. Attached
documents must cover topics listed
in the orientation policy and
signature of orientated employee.
- *please submit for all employees
This question is not applicable (n/a)
if the operation does not have any
employees or if no new employees
or contractors have been hired or
had visitors in the past 12 months.
Page | 28
/0-7
Number
D3
Question
Is training provided to
employees which includes;
• Specific industry hazards
• Hazards and their control
methods (e.g. safe work
practices and procedures)
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach training records
to confirm that employees are
trained on specific industry hazards
and their control methods.
Examples of job specific training
include training of safe work
procedures, PPE, ergonomics, use
of equipment and employee
certificates (for example; H2S Alive,
First Aid, Forklift Operator, Crane
Operator Certificate, etc.).
/0-8
D4
Is on-the-job training provided?
Answer the audit question in the
Notes and Attach samples of
completed on-the-job training
records for the critical tasks
identified for the position.
On the job training identifies:
• Specific competencies required
for each position that covers job
specific hazards.
• The required training to ensure
competency.
• The trainer’s competency
requirements.
- *please submit for all employees
This question is not applicable (n/a)
if the operation does not have any
employees.
Owner/Operators are exempt from
this question.
(O/O are companies with only one
person covered under their
Page | 29
/0-10
Number
Question
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Workers Compensation Board
account)
D5
Are workers made aware of
their right to refuse unsafe
work?
Answer the audit question in the
Notes and Attach documentation
that supports the Right to Refuse
Unsafe work has been
communicated. (example;
Completed Orientations, Policy
Sign-off, Safety Meeting Minutes)
- *please submit for all employees
/0-6
Total Points Possible: 39
Page | 30
Minus N/A = _____
___ / ___
Element E. Emergency Response Procedures
Number
Question
SECOR Assessor Instructions
E1
Does the Emergency Response
Plan outline:
• communication procedures,
• emergency contacts,
• evacuation plans,
• rescue plans,
• responsibilities of employees /
workers
Answer the audit question in the
Notes and Attach the Emergency
Response Plan that contains the
requirements outlined in the
question.
E2
Does the Emergency Response
Plan sufficiently identify the
potential emergency procedures
applicable to the company’s
operations and legislative
requirements; at minimum;
• Fatality
• Injury (First Aid)
• Fire and explosion
• Natural Disasters
• Spills (Chemical and
Biological)
Answer the audit question in the
Notes and Attach procedures
developed for emergency
scenarios that are appropriate to
the company’s activities and
include the emergencies outlined
in the question.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-6
/0-5
Page | 31
Number
E3
Question
Does the employer
communicate to employees the
company's emergency response
procedures?
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach documentation
(For example; Orientations,
Safety Meeting Minutes,
Employee sign off on drills, etc.)
that verifies that this information
has been communicated.
- *please submit for all employees
E4
Has training been provided to
employees given specific
responsibilities in the
Emergency Response Plan?
Owner/Operators are exempt
from this question.
(O/O are companies with only one
person covered under their
Workers Compensation Board
account)
Answer the audit question in the
Notes and Attach documentation
that confirms that appropriate
training has been conducted to all
employees as pertains to their
duties within the Emergency
Response plan.
For example;
Some staff may be trained only in
evacuations but others may have
confined space rescue training.
(First Aid, signed off emergency
drills, etc.)
Page | 32
/0-5
/0-6
Number
E5a
E5b
Question
SECOR Assessor Instructions
Enform
Reviewer
Assessed
Score
Is there a process/form to
evaluate the Emergency
Response Plan for
effectiveness, including:
• The emergency scenario being
tested
• Signatures of attendees
• Date and location of drill
• identifying deficiencies and a
means of correcting the
deficiencies
Answer the audit question in the
Notes and Attach Emergency
Response Plan process or form.
The process or forms are to
include the following;
• The emergency scenario being
tested
• Signatures of attendees
• Date and location of drill
• a means to identify deficiencies
and correct them
/0,2
Is the process and schedule for
testing the ERP being met
annually?
Answer the audit question in the
Notes and Attach completed
records of emergency response
drill(s) / table top drills completed
within the last 12 months.
/0-8
Total Points Possible: 32
Page | 33
Notes
(All questions require a full answer by the
employer assessor)
Minus N/A = _____
___ / ___
Element F. Incident/Accident Reporting and Investigation
Number
F1
F2
Question
SECOR Assessor
Instructions
Is there an Incident Reporting
Policy which includes the
reporting of injuries, illness,
incidents and near-misses and
what to report to applicable
governing bodies?
Answer the audit question in
the Notes and Attach the
Incident Reporting policy that
includes the requirements in
the question.
Are incidents being reported as
required by the policy?
Answer the audit question in
the Notes and Attach all
completed injuries, illness, and
incidents reports within the
past year including date, time,
location and nature of event.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
/0-5
/0-10
F3
Page | 34
Is there an Investigation Policy
which includes;
• requirement that injuries,
illnesses, incidents and nearmisses will be investigated
• responsibilities of key people
• how to investigate an incident
• how to preserve and collect
evidence
• involvement of workers
knowledgeable of the type of
work involved
Answer the audit question in
the Notes and Attach the
Incident Investigation Policy
that contains the requirements
of the question.
/0-5
Number
F4a
F4b
F5
Question
SECOR Assessor
Instructions
Do investigation forms include
the following;
• names of everyone involved
• location, date, time of incident
• names of victims and injury /
illness description
• description of damages
• description of incident
• description of events prior to
incident
• preliminary determination of
root cause
• identification and
implementation of corrective
actions
Answer the audit question in
the Notes and attach samples
of investigation forms that
include all the identified
criteria.
Are investigations being
completed?
Answer the audit question in
the Notes and Attach samples
of completed investigations for
the last 12 months confirming
that the investigation
documentation includes all the
identified criteria.
Has investigation training been
provided to individuals assigned
the task of investigation?
Enform
Reviewer
Assessed
Score
/0,2
/0-8
Answer the audit question in
the Notes and Attach training
records to confirm that
employees conducting
investigations are trained to an
appropriate level.
This may include documented
on-the-job training, orientation,
safety meetings that provided
instruction on investigation, or
third party training.
Page | 35
Notes
(All questions require a full answer by the
employer assessor)
/0-10
Number
F6
Question
Are near-miss incidents being
reported as per policy?
SECOR Assessor
Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in
the Notes and Attach samples
of near-miss incident reports.
/0-7
F7
Page | 36
Are statistics relating to health
and safety collected?
Answer the audit question in
the Notes and Attach report
showing workplace safety
statistics for the last 12 month.
(at least quarterly
documentation) These could
include near misses, incidents,
first aid treatment, lost time
injuries etc.
A summary describing any
trends identified by the
company
Total Points Possible: 53
/0,6
Minus N/A = _____
___ / ___
Element G. Communication
Number
G1
G2
Question
Is there a Safety Meeting
Policy which includes;
• Types of meetings required
• Frequency of each meeting
type
Are regular two-way
communications held with
employees at all levels to
discuss current safety issues?
a. Explain how management
communicates their
commitment towards
improving workplace safety
culture.
b. Explain how employees are
advised of health and safety
issues.
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach a Safety
Meeting policy which includes
the requirements of the
question.
Owner/Operators may apply N/A
to this question
Answer the audit question in the
Notes and Attach samples of
how health and safety issues
are communicated, and attach
quarterly samples of relevant
documentation (e.g. newsletter,
records of safety meetings,
records of toolbox meetings,
bulletins, hazard identification
and assessment records,
suggestion boxes, etc.).
/0-3
Owner/Operators may apply N/A
to this question
c. Explain how employees are
encouraged to offer feedback
on health and
safety issues, and confirm
employee awareness of the
system.
d. Explain how follow‐up is
done, and confirm that
employees are aware of it.
/0-12
Page | 37
Number
G3a
G3b
Question
Are site-specific orientations
provided prior to starting work
on a new site?
Have plans been developed in
consultation with the prime
contractor /contractor for
ensuring workplace health and
safety, including:
- identification of site specific
hazards and controls
- ongoing site specific hazard
assessments
- communication of changes to
work site conditions
- review of ERP plans
- process of dealing with
noncompliance
- on-site supervision of
contract employees
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach samples of
completed documents (For
example; Prime Contractor
Orientations or Field Level Risk
Assessments, or Company Field
Level Assessments with Prime
sign-off, etc.) which confirm the
communication of hazards and
controls between the employees
and the prime contractor
This question is not applicable
(n/a) if the operation does not
work as a contractor or a sub‐
contractor.
Answer the audit question in the
Notes and Attach documentation
(For example; Safe Work
Permits, Hot Work Permits,
critical task procedure, or prejob meetings that include
hazards and control measures.)
which confirms that a plan was
developed with the Prime
Contractor that includes the
requirements in the question.
/0-10
This question is not applicable
(n/a) if the operation does not
work as a
contractor or a sub‐contractor.
/0,2
Page | 38
Number
G3c
Question
SECOR Assessor Instructions
Are these completed plan(s)
(developed in consultation with
the prime contractor for
ensuring workplace health and
safety) effectively
communicated to affected
employees?
Answer the audit question in the
Notes and Attach documentation
(For example; Safe Work
Permits, Hot Work Permits,
critical task procedure, or prejob meetings that include
hazards and control measures.)
which confirms that a plan was
developed with the Prime
Contractor. and communicated
with employees.
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
This question is not applicable
(n/a) if the operation does not
work as a
contractor or a sub‐contractor.
/0-8
G4
Has an action plan been
developed to address all the
deficiencies found in the
previous year's audit?
including;
• person responsible
• target completion dates
• actual completion dates (if
applicable)
Answer the audit question in the
Notes and Attach the previous
year’s action plan that was
developed from the previous
audit deficiencies if there were
any.
For each item on the action
plan, the person responsible
should be identified. Target
completion dates and (if
applicable) actual completion
dates should be noted for each
action item.
n/a if no deficiencies were
identified during QA evaluation
of the previous year.
/0-8
Page | 39
Number
G5
Question
Has the action plan from the
previous audit been
implemented?
SECOR Assessor Instructions
Notes
(All questions require a full answer by the
employer assessor)
Enform
Reviewer
Assessed
Score
Answer the audit question in the
Notes and Attach last year's
completed action plan to show
that you have corrected the
deficiencies.
For example;
Completed Action plan showing
corrective action taken on last
year’s audit deficiencies.
n/a if no deficiencies were
identified during QA evaluation
of the previous year.
Total Points Possible: 53
Page | 40
/0-10
Minus N/A = _____
___ / ___
SMALL EMPLOYER ACTION PLAN
IDENTIFIED
DEFICIENCY
ACTION PROPOSED
PERSON (S)
RESPONSIBLE
TARGET
DATE
ACTION TAKEN
DATE
COMPLETED
Use the above template to develop an action plan from the audit results. Deficiencies identified by the assessor, external auditor
and/or the Certifying Partner reviewer should be itemized in this plan, and completed before your next audit.
DATE:
Page | 41
SIGNATURE:
SUMMARY SCORE SHEET
*For use only by Enform reviewers *
Employer Name:_________________________________________________________
Element
Total
Points
Possible
A.
Management Involvement and Commitment
48
B.
Hazard Identification and Risk Control
89
C.
Hazard Control
54
D.
Training
39
E.
Emergency Response Procedures
32
F.
Incident/Accident Reporting and Investigation
53
G.
Communications
53
Total Audit Points
368
Page | 42
Audit Dates:_____________________
Points
N/A
Total
Points
Total Points
Scored
Percentage