Survey : Questions

	The following 10 questions deal with Workplace Safety in your organization. The results will be published at heattreat.net once survey deadline has passed. 3 of the questions ask you about your OSHA Incident, Frequency and Lost Day Rates. You can calculate those numbers at the following link: http://data.bls.gov/iirc/calculate.do Survey Deadline: July 15, 2011

1.

Estimate the percentage of workers given training or guidance by each risk category in your company.

	0 - 10%	11 - 20%	21 - 30%	31 - 40%	41 - 50%	51 - 60%	61 - 70%	71 - 80%	81 - 90%	91 - 100%
Slip/Trip
Chemical Exposure
Noise
Power Industrial Truck
Lifting/Carrying (Ergonomics)
Lockout/Tagout

2.

How often does your Safety Committee Meet?

Once a Week

Once a Month

Once a Quarter

Once Every Six Months

We don't have a Safety Committee

3.	What is your Workers' Compensation Experience Modification Factor Rate as shown on your annual statement for the last 2 or 3 years: 2010 2009 2008
	350 characters left.

4.	What was your OSHA Incidence Rate (IR) for the last 2 or 3 years. 2010 2009 2008
	350 characters left.

5.	What was your OSHA Frequency Rate (DART) for the last 2 or 3 years. 2010 2009 2008
	350 characters left.

6.	What was your OSHA Lost Work Day Injury Frequency Rate (LWR) for last 2 or 3 years? 2010 2009 2008
	350 characters left.

7.

Do supervisors frequently spend time discussing safety with the workforce?

Very Frequently

Somewhat Frequently

Not Very Often

Never

8.

Do you feel management demonstrates their commitment to safety everyday in your company?

Strongly Agree

Agree

Somewhat Agree

Disagree

9.

Are each of your employees provided a safety manual for their reference and do they sign off agreeing they have read it and fully understand it?

Employees are issued a safety manual and sign off on it

Employees are issued a safety manual and do NOT sign off on it

We have a centralized area with all of our safety information for employees' reference

We have no written communication on safety issues

10.

When did your company perform your last Workplace Safety Self Audit?

This year

Over 1-year ago

Over 2-years ago

3+ years ago