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Please note that this is an example questionaire at this time.
You will be able to register in the next few days. - HAS Consultants

Health & Safety (Excluding Ireland)

Questionnaire

Company Details 
 
 Name of person filling in this form :  
 Name of Firm :  
 Address (1st Line) :  
 Address (2nd Line) :  
 City/Town :  
 County :  
 Postcode :  
 Email :  
 Website Address  
 Position in Firm :  
 Phone Number :  
 Number Of Employees :  
 Main type of Work :  

Section A

Safety Advice

Q1
Give the name of the person acting as the competent health and safety adviser in your firm. This can be the owner or any designated member of staff. The falls under Regulation 7 of the Management of Health and Safety Welfare Regulations 1999.


Q2
Please provide details of their health and safety qualifications. if any


Q3
Is this person


Q4
If you are the competent health and safety advisor in the organisation, please describe how you get health and safety information.


Q5
Describe your procedures for reporting and investigating accidents.





Accidents

Q6
Who is responsible for reporting accidents, dangerous incidents and so on to the HSE or appropriate enforcing authority?


Q7
Please provide figures for any accidents in the last 3 years.

 Year ending  Fatal Major Injuries or Over three Days Non Reportable

Q8
Please give full details of any enforcement notices or prosecutions the HSE or local authority has served on your firm in the last three years.


Q9
Describe what action your firm has taken as a result of any enforcement notices or prosecutions against it.


Subcontractors' and subconsultants' safety

Q10
If your firm employs subcontractors or subconsultants, please describe what procedures you use to identify their health and safety competence.


Q11
Who is reponsible for making sure that the subcontractor meets health and safety requirements?


Site Safety

Q12
Set out the procedures your firm has in place if serious or imminent danger arises on-site or in the workplace.


Training

Q13
Say who is responsible for indentifying and putting into practice training needs in your firm.


Q14
Describe the health and safety training you have provided to your managers and employees over the last year.



Q15
Please give details of any assessments that your firm may have had current accreditation for health and safety, including Construction Skills Certificate Scheme (CSCS) or equivalent.


Q16
Please give full details of the number of employees who hold the valid skill registration cards or equivelant.
 Name  Type Of Card  Card No
     
     
     
     
     
     
     

Q17
What arrangements does your firm have for protecting the safety of employees and others, from the work you undertake? This may include safe working procedures for working at height, safety instructions for using dangerous equipment, what to do if employees discover asbestos or suspected asbestos at work, and what personal protective equipment they have, such as safety boots, helmets and masks.


Section A - Part 2

Health and Safety Policy

Q18
Please upload a copy of your firm's health and safety policy statement (Statement only, not the entire policy). An owner, director or a senior partner should sign it.


Q19
Describe how you tell your employees about your policy.


Managing health and safety

Q20
Please say who is responsible for health and safety in your firm.


Q21
Please describe how you monitor health and safety in the workplace.


Q22
Who carries out site monitoring and inspections?


Risk assessment for a firm with five or more employees

Q23
What arrangements does your firm have for carrying out risk assessments, carrying out actions and telling staff about control measures for the following?

Q23a
General risk assessments


Q23b
Dangerous substances assessments


Q23c
Noise and vibration assessments (If this applies)


Q23d
Manual handling


Q24
Say who carries out these assessments and what training, if any, they have received specifically for risk assessment.


Q25
If you use general assessments, please describe what you do to make them specific to a job or site.


Q26
Please attach at least two examples or risk assessments that are relevant to the type of work you are undertaking. 




Section B part 1
Associations or Memberships

Q27
Is your firm a member of any trade association (for example, CITB, NBC, and so on?)
Y/N

                    
 Association Name  Member Number  Do they health and safety?
     
     
     
     
     
     
     
     


Q28
Is your firm a member of a health and safety organisation such as RoSPA or the British Safety Council?
Y/N

If 'Yes', please give details.


Section B part 2

Health and safety policy

Q29
You must include a copy of your firm's health and safety policy with your application. Please explain your arrangements or procedurres for carrying out the policy that is, risk assessment, COSHH, manual-handling proceedures, safety procedures, safety manuals and so on. Please upload your full Health and Safety policy.


Health and safety management

Q30
Describe how your firm carries out formal reviews of health and safety performance.



Health surveillance

Q31
Describe (if this applies) your firm's arrangements for providing satisfactory health surveillance for your employees.


So that the assessor can carry out their assessment, you must provide the following information, with the application.

Risk Assessment

You must upload examples of risk assessments carried out by or for your firm within the last three years. This should include COSHH, manual-handling, noise, working at height, working in confined spaces, fire risk assessment, working with machines, electrical equipment and so on. One example should show non-routine emergency actions and the implications for others such as contractors, visitors, clients and so on. The examples you provide must be specific to a job that your firm has carried out. We cannot accept general assessments unlesss there is clear evidence of how they have been made specific to a job.


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