Contractor Competency assessment form (Star rating system) - Annexure "8"

Form No:SAFETY/FORMS/CSM/08 Revision No:05 Effective Date :1st Nov 2019

CSMS TOTAL SCORE
Organization name
Contractor Proprietor
Name
Organization Registered
Address
554 CSMS RATING : 2 Star
Interstate Syndicate Assessment team :
Mr. Bhim Sharma - Proprietor Team Leader : Abhishek Vishal DNV-GL
Vendor Representative:-
1. Mr. Rakesh Karua- Office staff
Bad Jamda, Near SBI Bank, Pin- 833221 West Singhbhum. Team Member : 2. Mr. Shantanu Pradhan- Office staff

TSL representatives (CA/ 9.30 AM.

CO /Mentor / Local safety Mr. Rakesh Kumar P.No- 500601 Date of Assessment 29.09.2020
professional)

Vendor Code I 124 Comments by Assessor : 1st assessment for 1000 marks.

Work Order No.1: 3000131904 Valid

till 03.03.2021 with Rs. 95 lacs for Department : Mining CO Name & Personal No.: Mr. Rakesh Kumar P.No- 500601
one year.

Work Order No.2: Department : CO Name:

Active work order
numbers with Department
Work Order No.3: Department : CO Name:

Work Order No.4: Department : CO Name:

Audit Location: FAMD

Risk Parameter: (Risk of ✓ High Risk :

job where contractors to Low Risk :

be engaged)
Both :

Type of Contract

Manpower contract ✓
Supervision contract ✓
Set apart contract
Transient contract

Other Services

Tick the type of work the company is capable of undertaking :

Civil, Structural & Building

Lifting equipment Maintenance and Services Utility Services
Maintenance

Electrical Maintenance and

Cleaning Services Mechanical Maintenance and services
Services

Instrumentation Calibration Transportation and Material

Catering Services
and Testing Handling

Waste materials / slag /

Manpower supply Mining related activity
reclaiming & disposal

Lifting, Loading, Unloading,

Road maintenance Rail maintenance
feeding & packaging

Any Others, please specify Placing of screen.

1.What is total manpower strength of your organisation working in Tata Steel? 07 nos of employee

1.1. Number of Supervisors and their qualifications (Attach list): 01 nos of site sup

1.2. Number of certified and skilled employees (Please attach list of employee with skill level): 06 nos of skilled

1.3. Number of unskilled employees: 01 nos unskilled

No specific safety sup for this

1.4. Number of Site Safety Supervisors and their qualifications (Attach list):
location

2.Total Value of Contract in currency as applicable with Tata Steel: Example in Rupees: (less than 5 Lacs / 5
Rs. 95 lacs for one year.
to 25 lac/ 25 lac to 1 crore, and above 1 crore If more than 1 crore, mention exact value ).

3. Name of the departments/locations where you are currently engaged in Tata Steel: Mining- FAMD

4. Organisational Structure of your organisation: (e.g. MD, GM, Managers etc.) Mr. Bhim Sharma- Proprietor.

Evaluation Criterion for Star Rating and Safety Performance Evaluation

0 = Process not yet started/ No System.

1 = Poor- Weak Safety system and process, weak or no system of Lead Indicator identification, reporting and compliance monitoring; little awareness; minimal or no ownership and
commitment. (Survival)
2 = Reasonable- Some system & process exist; inconsistent system of Lead Indicator identification, reporting and compliance monitoring; awareness may be present, but
implementation of this aspect is haphazard or not evident at all. (Reactive stage)

3 = Good- Safety Management system & process exist and documented; improving trend of system of Lead Indicator identification, reporting and compliance monitoring; system is
implemented at the minimum levels; ownership and commitment visible at some extent. (Dependent stage)

4 = Very Good- H&S Management System is addressed systematically, documented and updated regularly, reaching the respective targets regularly; good system of Lead Indicator
identification, reporting and compliance monitoring; integration with other activities is at high levels; felt and visible ownership and commitment. (Independent stage)

5 = Excellent- Can be recognised as a leader in this particular aspect of the H&S Management System; everyone is involved and high levels of integration and ownership &
commitment are demonstrated.; continuous improvement is evident. (Interdependent stage)

Assessment Frequency: Once in two years(within 24months) for the 4 & 5-Star rated vendors and once in a year(within 12 months) for 3 -Star rated Vendors from the date of the previous assessment .
Assessment reports must be logged in ‘ENSAFE-IT SYSTEM’ by the CA/ CO within 4 days after receiving report from central safety team. [Refer to DOC. NO.: SAFETY/PROC/CSM/ 01, SAFETY/PROC/CSM/ 02]
NOTE: [(5 Star- 850-1000), (4 Star-750-849), (3 Star-650-749), (2 Star- 550-649), (1 Star- 450- 549), (No Star- Less than 450)]
All the requirements will be evaluated in a scale of 0 to 5 which will be weighted for Star rating score calculation.

Attributes SN Criteria Requirements
1.1 Safety & Health Management
System (Policy & Principles,
Safety Manuals, Safety
Organization) (Safety manuals –
(Look for HIRA or JHA
document, Legal compliance
system, Emergency Planning
system, Safety dash board,
Safety audit & review system,
Operational control, Asset
Management).
1.2 Documented procedure on 0. 0% :No system exists.
selection, deployment of skilled
and Certified employees. Job
description, Roles
Responsibilities to be available
mentioning safety as one of the
mandatory requirement (Which
institute ,Type of skill training
like Mechanical, Electrical etc..)
Evaluation status Multiplying Actual
Guideline for audit Expected Aspects Remarks
( on the 0 to 5 ) factor score
0. 0% :No system exists. # No system exists- no policy , no organization Other and customer requirement has not been included in the documented policy Ref no.
structure. ISS/SHM/#001 Dated 01.01.2019 rev 03.
10 0
1. 20% : Documented Safety and Health #Documented Safety and Health management JHA is in place but seasonal hazard is not coverd in the same. Also ergonomical health hazard
management system exists and system exists and organizational structure exists- not included. Also Hierarchy control measures needs to be reviewed since administrative
organizational structure exists. safety manual (policy, procedure, control is applicable but in the JHA it has been mentioned as nil.
objectives,OCP,hazard & risk assessment- EPRP system is there. But natural calamities has not been included in the same as one of the
GRA/HIRA, JHA, SWP,SOP, emergency emergency situation.
preparedness & response plan), organization Roles and responsibility is there but it needs to be reviewed for document controller specially
1 10 10
structure (roles and responsibility , competence for conducting Line walk, share all audit findings with safety sup and ground level employee.
management)
2. 40% : Regular Audits done through # Regular Audits done through Internal & Regular audits has been done as per the field audit format on weekly basis. As per the record-
Internal & External agencies. External agencies- audit done at planned Only rating 2 has been seen. No rating 3 observation has been there as per the record. But
interval either internal or external in reference UA/UC has not been mentioned against the observation noted during the site audit. Moreover
to requirements / criteria (CSMS,OHSAS OR severity index is not familiar and even it has not been reviewed as per the set objectives and
other safety management system) 10 0 target.
Annual assessment procedure is there in the procedure manual with frequency even
conducted for fy 19-20 but name , date and assessor has not been mentioned. Moreover no
action plan for then same
3. 60%: Evidence exists for Corrective and #Evidence exists for Corrective and Preventive CAPA is in place for rating 2 only- since severity is coming to be 2 as per the report.
Preventive action taken along with action taken along with improvement regularly-
improvement regularly. based on audit presence of corrective and
preventive action along with root cause
10 0
analysis.
4. 80%: Continuous improvement in the # Continuous improvement in the system based Annual assessment has been done for FY 20-21 But continual improvement in the system has
system based on feedback of Audits. on feedback of Audits - improvement in not been seen based on the audit findings - Since action plan has not been taken for the raised
objective (leading & lagging indicator), & observation during the same.
evidence of continual improvement trend. 10 0
5. 100% participation of all employees # participation of all employees along with all
along with all of above. of above - evidence of participation in tool box
talk, safety meeting, safety campaign, safety
quiz, safety competition etc. 10 0
# No system exists - No procedure for selection selection procedure has been there in the manual .
and deployment of skilled and Certified 10 0
employees
&
 1.2 Documented procedure on
selection, deployment of skilled
and Certified employees. Job
description, Roles & 1. 20% : Benefit of Safety Certification given # Benefit of Safety Certification given at the No specific safety sup is theer for the same location specific but sometimes mr. Purshottam
Responsibilities to be available at the time of employment time of employment - whether safety Kewat is looking after the safety activity who is diploma in industrial safety and engg. Even Mr.
mentioning safety as one of the supervisor, project manager have undergone Ashwani Kumar is site incharge who is 2nd class manager approved from DGMS .
mandatory requirement (Which any formal certified safety courses (OHSAS, 1 10 10
institute ,Type of skill training NEBOSH,RLI/CLI courses, diploma in industrial
like Mechanical, Electrical etc..) safety, Tata Steel courses)

2. 40% : Existing Personnel encouraged # Existing Personnel encouraged undertaking No sponsored safety training courses has been done for the location .
undertaking safety courses. safety courses - company initiated , sponsored
safety training. 10 0

3. 60% : Safety a mandatory requirement # Safety a mandatory requirement for engaging Safety a mandatory requirement has been seen in the selection procedure.
for engaging all employees. all employees - safety aspect in job description,
appointment/employment contract.
10 0

4. 80% : Documented Safety certification # Documented Safety certification requirement Mr. Ashwani Kumar is site incharge who is 2nd class manager approved from DGMS .
requirement beyond a certain level in the beyond a certain level in the hierarchy - safety
hierarchy. certification course by safety supervisor project
manager & above.
10 0

5. 100% : Positions beyond a certain level # Positions beyond a certain level can be
can be occupied by personnel having occupied by personnel having exemplary safety
exemplary safety records and having safety records and having safety certification - 10 0
certification. evidence of safety competence of top
management , excellent safety record.
1.3 Documents showing safety 0. 0% : No system exists. # No JHA in place 10 0
planning process for safe
execution of jobs- JHA 1. 20% : Job hazard Analysis exists for 25 % # 20% Job takes into account of JHA, but no
document, Audit plans, of the jobs. No evidence of preventive and corrective and preventive measures in place 10 0
planning for tools & corrective measures at site.
equipments,Job execution plan, 2. 40% : Job hazard Analysis exists for 50 % # 40% Job takes into account of JHA, but no JHA is in place but seasonal hazard is not coverd in the same. Also ergonomical health hazard
work permit system, Method of the jobs. No evidence of preventive and corrective and preventive measures in place not included. Also Hierarchy control measures needs to be reviewed since administrative
1.Planning
statement corrective measures at site control is applicable but in the JHA it has been mentioned as nil.
of Safety
System & 2 10 20
Process

3. 60% : Job hazard Analysis exists for 50 % # 60% Job takes into account of JHA, with
of the jobs. The jobs are well planned and preventive measures planned w.r.to potential
evidence exists of Safety features at site to hazard identified
counter the Hazards identified.

10 0

1.4 System and processes for
training on Safety standard,
Behavioural based, Job specific,
skill development, emergency
preparedness for employees
and supervisors.
1.5 System for two way
communication (Top – Bottom
– Top) between contractor
leadership and their workforce
(Proprietor engagement in line
walk, Safety meeting etc.).
4. 80% : Job hazard Analysis exists for 75 % # 80% Job takes into account of JHA, with
of the jobs. The jobs are well planned and preventive measures planned w.r.to potential
evidence exists of Safety features at site to hazard identified
counter the Hazards identified.
10 0
5. 100% : Job hazard Analysis exists for 100 # 100% Job takes into account of JHA, with
% of the jobs. The jobs are well planned and preventive measures planned w.r.to potential
evidence exists of Safety features at site hazard identified 10 0
counter the Hazards identified
0. 0% :No system or process exists. # No system or process exists - 10 0
1. 20 %: Documented system and process # Documented system and process exists along Documenetd system is in place for training.
exists along with training organizational with training organizational structure and
10 0
structure and infrastructure. infrastructure - Organization has defined
personnel for training , training infrastructure
2. 40 %: Along with above a training records # Along with above, training records maintained Training plan for FY 20-21 is not in place but for FY 19-20 , the same has been prepared. Some
maintained on all SOPs. on all SOPs - Training on SOP given with of the training record has been maintained for SOP's, BBS, EPRP Etc. But as per the Job - Some
evidence/record. 2 10 20 training is missing like MSDS, Work permit etc.
3. 60%: Along with above SOPs getting # Along with above SOPs getting revised based One SOP's has been revised based on employee's feedback for reverse driving . Ref No. SOP no-
revised based on feedback continuously on feedback continuously - revision on SOP ISS/CSM/06 Rev 02 16.11.2019.
based on feedback (training effectiveness) But it has not been done as such for this particular location.
10 0
4. 80%: Along with above pictorial SOPs # Along with above pictorial SOPs displayed at
displayed at site in regional languages for site in regional languages for better
better understanding of all employees. understanding of all employees - pictorial
display of SOP (in regional language) 10 0
5. 100%: Along with the above employees # Along with the above employees display an
display an exemplary understanding of all exemplary understanding of all SOPs at site - 10 0
SOPs at site. interview / discuss during site visit.
0. 0% : No system or process exists. # No system of communication 10 0
1. 20 %: Documented system and process # Documented system is in place for internal documenetd system is in place for two way in terms of Line walk & mass meeting.
exists for communication between all levels communication. MoM available as
10 0
of Contractor leadership and their record/display in office
workforce. Visual displays MoM of
meetings
2. 40 %: and action
Along withtaken
the reports.
above evidence
# Documented system is in place. Evidence of Leasdership and team visit has been seen during the line walk- Some sample has been verified.
exists of leadership team visits and Leadership team visit, discussion and action
discussions and action. exist
10 0
 walk, Safety meeting etc.).

3. 60%: Along with the above evidence # Along with above top management
exists of leadership team and the involvement in implementation action exist
proprietor visits and discussions and action (evidence is must)
3 10
Top management has been seen during the same. But duirng the line walk , Mass meeting and
safety committee meeting - One way has been reflected as per the produced record during the
document verification.(Dated July - Aug 2020 record).
30 Point has been taken care from the top to bottom but not from bottom to top.
Moreover in the agenda of the mass meeting - Reward parameter has not been included.

4. 80%: Along with above record of # Along with evidence exist w.r.to feedback and Point has not been taken care from the bottom end w.r.t feedback from the employee end. It
improvements undertaken as a result of communication on action needs to be taken care.
such communication and feedback
10 0

5. 100%: Along with the above recognition # Along with above reward/recognition Reward system is in place along with the defined mechanism of selection. Last has been given
and reward for participants for such mechanism exists for participation/ suggestion to Mr. Rakesh Chetomba for best suggestion but date has not been mentioned in the pictorial
communication exists on action (evidence/record) proof. Also in the agenda of the mass meeting - Reward parameter has not been included.

10 0

2.1 Capability of Workforce, (Skilled # Deployment of certified supervisors ,site a) Deployment of below 70% certified
,Certified Competent safety supervisors and specific job required employees at site , Score- 0 marks
Supervisor, Site Safety employees from JNTVTI or other TSL b)Deployment of 70 to 99% certified
Supervisors and manpower etc.) approved institutions. employees at site , Score- 10 marks
Total work persons at site-7. Competency certified-5 (71%).
Verify through site visit and c) Deployment of 100% certified employees at 1 10 10
The site safety supervisor Mr. Purusottam Kewat is competency certified,
Interview. site , score- 20 marks

Hazard identification and Risk assessment a) Inadequate hazard identification and poor
:Inclusion of site specific , job specific and implementation of safety measures mentioned
adequate six directional hazard in Work in work permit ,score – 0 marks
permit .Job Hazard Analysis by contractor b) Site specific & job specific hazards and safety JHA document existing and incorporated in SOP. But communication to the shopfloor worker
1 10 10
supervisors .Learnings from JHA measures mentioned adequately in work needs to be improved. Awareness level found low.
incorporating in ‘SOP’ permit and implemented ,score – 10 marks

# Compliance to deployment of applicable a)Below 70 % compliance to safety standards

safety standards at site as mentioned in and ‘SOP’ ,score - 0 marks
“SOP” and permit system b) 70 % to 99 % compliance to safety standards
and ‘SOP’ ,score - 10 marks
c) 100% compliance to safety standards and 1 10 10 70-90% compliance observed. Needs improvement.
‘SOP’ ,score - 20 marks
 2.2 Conducting Tool box, mass # Conducting Tool Box meetings daily at all a) Inadequate records on Tool Box meetings and
meeting regularly and sites of location by site supervisors , site poor coverage of supervisors in Tool Box
leadership engagement safety supervisors .Participation of meetings ,score – 0 marks
(Contractor proprietor line Proprietor / Locational in charge in Line b)) Maintaining adequate records of Tool Box
walk). (Verify through Records, walks and Monthly mass meetings and meetings and all supervisors participating in Tool Box meeting being done and records are evident at site. Participation of supervisors
1 10 10
Interview & site visit) maintaining records Tool Box meetings ,score – 10 marks evident.

Coverage of 100% employees of all the sites a) Below 80% , score - 0 marks
of Location in Tool Box Meetings b)80 % to 100% coverage of all supervisors and
employees in Tool Box Meetings ,score - 10 1 10 10 Coverage of employees 90%
marks
# Compliance on points captured during a) Compliance below 80 % , score – 0 marks
proprietor line walks ,Tool Box meetings b) Compliance from 80 to 94 % , score – 10
and Mass meetings marks
c) Compliance from 95 to 100 % , score – 30 0 10 0 Compliance of actionable points is below 80%. Needs improvement.
marks

2.3 Providing & ensuring usage of
standard (IS/EN) and right PPEs
while performing the job.
Ensure timely replacements.
(Verify through site visit and
Interview).
Hazard mapping with respect to location
specific and usage of applicable and
standard PPEs by contractor employees at
working site
a) Hazard mapping not available and
compliance of required PPE below 80% ,score –
0 marks
b) Availability of Hazard mapping and 80 % to
99% employees using required and standard
1 10 10 Hazard mapping is 80%. Seasonal, area specific hazards to be incorporated for hazard mapping.
PPE ,score – 10 marks
c) Availability of Hazard mapping and 100%
employees using required and standard PPE
,score – 20 marks

Physical condition of PPE using by a) Some of employees using non defective PPE ,
employees at working site score - 0 marks
b) 100% employees using non defective PPE
2 10 20 All employees area using non-defective PPE.
,score - 20 marks

Regular audits on usage of PPE by a) Poor compliance on Audits on PPE usage and
supervisors and review of PPE quality and review , score – 0 marks
2.Impleme improvements by vendor b) Regular audits by supervisors with specified
ntation frequency and review by vendor on monthly 0 10 0 PPE audit being done on adhoc basis. Needs improvement.
Safety basis , score – 10 marks
system
and
Process 2.4 Providing & ensuring safe usage Availability and usage of applicable and a) List of Standard, applicable Tools & Tackles
of standard, certified and right standard tools & tackles by contractor at not available and sub standard Tools & Tackles
tools & tackles, equipment's working site being used at site ,
and calibrated safety gadgets score – 0 marks
(e.g. Gas detectors) while b) List of 80 % to 99% Standard, applicable Tools
performing the job. (Verify & Tackles available and being used at site ,score
1 10 10 80% tools and tackles are of standard make. (Taparia). Rest needs to be replaced.
through Records and Site visit) – 10 marks
c) List of 100% Standard, applicable Tools &
Tackles available and being used at site ,score –
20 marks
 performing the job. (Verify
through Records and Site visit)

Physical condition & legal compliance of a) Legal compliance not followed and poor Defect free tolls & tackles are being used.
applicable tools-tackles & equipment at condition of Tools & Tackles , score – 0 marks
working site ( As applicable) b) 100% Legal compliance being followed and
all the Tools & Tackles are defective free ,score -
2 10 20
20 marks

Tools & Tackles based audit by a) Poor compliance of audits and review ,
contractor's supervisors (site verification) score – 0 marks
b) Regular audits by supervisors with specified
frequency and review by vendor on monthly 0 10 0 Tools & Tackles audit being done on adhoc basis. Needs improvement.
basis , score – 10 marks

2.5 Ensuring a good housekeeping
free from any slip / trip / fall
hazards at working sites. (Verify
through site visit)
Working sites house keeping maintained in a) Poor house keeping at site ,score – 0 marks
systematic approach .Material storage area, b) 100% compliance to excellent House keeping
stores area and rest sheds orderliness at site ,score – 20 marks
2 10 20 House keeping at site observed good.
maintained. Free from Slip / Trip / Fall
hazards.

Implementation of 1S ,2S at site. a) Concept of 1S & 2S not followed , score – 0

marks
b) Deployment of 1S & 2S at site ,score - 20
2 10 20 Concept of 1s & 2s found being implemented.
marks

#and approach for 5S concept at working a) Poor compliance of audits and review ,
sites . Check list developed on 5s and being score – 0 marks
followed regularly b)Regular audits by supervisors with specified
frequency and review by vendor on monthly 0 10 0 5S concept need improvement.
basis , score – 10 marks

2.6 Self-Safety Initiative / Project by # System of safety improvement projects
contractor for Safety exist and known to 100% supervisors.
Improvement Involvement of top management in self
initiated safety projects (record of no. of
suggestion received, no. of suggestion
implementation, resource provision)
a) System not exist and poor engagement of top
leadership ,score – 0 marks
b)System exist ,involvement of top leadership in
implementation of safety improvement projects
.Process of suggestion management exist to
0 10 0 Safety related projects (SIPs) not done. Though amenities related facilities provided at site.
capture from employees ,score – 20 marks

# Safety improvement projects a) Below 4 safety improvement projects in a

implemented at working sites year , score – 0 marks
b) Minimum 4 safety improvements at site in
0 10 0 No such projects evident.
a year ,score - 20 marks

Safety projects to improve system related a) Below 2 system related safety improvement
gaps in a year , score – 0 marks
b)Minimum 2 system related safety 0 10 0 No safety system improvement projects found.
improvements in a year ,score - 10 marks

3.1 Contractor safety audit by the 0.
contractors' supervisor and site
safety supervisors in the field. 1.
(Verify records)
0% -System does not exists # No safety audit done
8 0
20%-Regular self-audits not done. # Safety audit done on adhoc basis (no audit Regular audit done .
8 0
plan, no checklist)
3.1 Contractor safety audit by the
contractors' supervisor and site
safety supervisors in the field.
(Verify records)
2. 40% -Audit done occasionally but no # Safety audit done with no record Safety audit is also seen on some sample basis in which rating 2 has been seen. No severity 3
2 8 16
record found has been seen as per the produced record.
3. 60% -Regular audit done but record # Safety audit done as per plan, but no record Regular audits has been done as per the field audit format on weekly basis. As per the record-
not in place. Only rating 2 has been seen. No rating 3 observation has been there as per the record. But
8 0 UA/UC has not been mentioned against the observation noted during the site audit. Moreover
severity index is not familiar and even it has not been reviewed as per the set objectives and
target.

4. 80%-Regular audit done, record is in # Safety audit done as per plan, report available CAPA is there for rating 2 only. No severity 3 has been noted.
place with follow up action. with CAPA
8 0

5. 100%-The same points are not # Safety audit findings are not repetitive
8 0
recurred in the next audit (effectiveness of audit)
3.2 Corrective and preventive 0. 0%: No system exists. # No CAPA 6 0
action on self-audit report 1. 20%: System for identification of # CAPA covers unsafe practices of severity 4&5 No severity 4 and 5 is there and thus no CAPA.
6 0
specifically on 4 & 5 severity unsafe practices of severity 4 & 5 exists.
potential. (Verify records & site 2. 40%: Structured review mechanism # Review of CAPA of unsafe practices of severity No 4 & 5 Has been seen for severitry as per the produced record. But rating 2 has been seen for
visit) for unsafe practices of severity 4 & 5. 4&5 which CAPA been prepared. But UA/UC has not been mentioned against the observation noted
2 6 12
during the site audit. Moreover severity index is not familiar and even it has not been reviewed
as per the set objectives and target.
3. 60%: Systematic process of # Systematic process of correction of all unsafe NO CAPA has been seen . Since no rating is there for 3, 4 & 5 as per the available record.
correction of all unsafe practices of severity practices of severity 3, 4 & 5 exists.
3, 4 & 5 exists. 6 0

4. 80%-There is no unsafe practice of # No unsafe practice of severity 4 & 5 observed No unsafe practices has been seen for rating 4 & 5 as per the record. Also no CAPA record.
severity 4 & 5 observed during filed visit. by auditor during filed visit at the time of 6 0
assessment.
5. 100%-Procedure violations of # Procedure violations of severity 3 does not
6 0
severity 3 does not exists exists
3.3 Compliance to Generic and 0- 0%- Basic deviation of PPE observed # Basic deviation of PPE observed
6 0
Specific Safety clauses as per
contract. (Verify through site 1- 20%-Generic safety clauses have been # Generic safety clauses have been followed Safety clause has been followed .
visit and Interview based on followed
some Work order). 6 0

2- 40%-Specific safety clauses with
reference to hierarchy of hazard control is
followed
3- 60%-Safety violation with respect to
workforce capability does not exists
4- 80%-Infrastructure resources tools &
tackles are provided with right quality
# Specific safety clauses with reference to Specific safety clauses with reference to hierarchy of hazard control is followed
hierarchy of hazard control is followed 6 0
# Safety violation with respect to workforce No safety violation has been seen as per the record of field audit and also the same has bene
6 0
capability does not exists confirmed from the concerned line manager.
# Infrastructure resources tools & tackles are Infrastructure resources tools & tackles are provided with right quality as per the concerned
provided with right quality CO. . Tools list and cehcklist has also been maintained properly.
4 6 24

5- 100%-Process of doing job has been # Process of doing job has been standardized
standardized and followed and learning and and followed and learning and integration 6 0
integration approach is visible approach is visible
4.1 Reporting, investigation and 0- No system of reporting incident and # No system of reporting incident and health
8 0
learning of all incident / health issues issues
accident, Health issue. 1- Adhoc and weak system available # Adhoc and weak system available 8 0
2- A documented procedure for # A documented procedure for reporting of Documeneted procedure of accident/ Incident has been verfiied during the assessment.
reporting of incidences exists and followed incidences exists and followed and investigation
8 0
and investigation carried out carried out
 4.1 Reporting, investigation and
learning of all incident /
accident, Health issue.
3- Reporting and investigations done
systematically and root causes are
identified
4- Recommendations are implemented
and learning shared
5- Learning from other incidents shared # Learning from other incidents shared and
and implemented
4.2 Near miss and Unsafe act / 0- No system of reporting incident and
condition reporting, health issues
investigation and corrective 1- Adhoc and weak system available
action.
2- A documented procedure for
reporting of Near miss exists and followed
and investigation carried out
3- Reporting and investigations done
systematically and root causes are
identified
4- Recommendations are implemented
and learning shared
5- Learning from other near miss shared
and implemented
4.3 Skill retention, amenities, 0- No system. No amenities and high
employees liability etc. (Verify skilled employees turnover
through records and Interview)
4.Perform 1- Amenities provided and it is of
ance
minimum requirement
Measure: 2- Employees are motivated and remain
Lead
with the organization
indicator 3- Employees grievances are recorded
and individual consideration is given
4- No grievances from employee and
amenities are provided considering hygiene
and workplace environment
5- A feedback system exists for
capturing employees engagement and
retention
4.4 Campaign e.g. (Safety quiz, 0- No system for safety campaign
Safety skid etc.) to develop 1- It is done haphazardly
Safety Culture. (Verify through 2- Done systematically and involvement
records and Interview) of employees are there
3- A monthly or annual plan is available
and campaigns are conducted as per theme
4- Ownership of campaign are fixed and # Responsibility of campaign are defined and
topic based are conducted topic based campaign are conducted
5- Campaigns are linked to past
incidents and based on learning
4.5 Reward, Recognition and 0- No system
Consequence Management 1- Ad hoc system available
System of Contractor. (Verify 2- There is criteria and documented
through records) procedure for both
3- System is followed and applied to
identify good and bad performer
# Reporting and investigations done No such cases of accident/ Incident has been seen as per the safety dash board record But
systematically and root causes are identified 3 8 24 system has also been developed for root cause analysis.
# Recommendations are implemented and Some of the stripes has been shared among the employee in terms of RED/ORANGE/GREEN but
learning shared 8 0 LTI is not welll familiar. Last stripe has been discussed on orange stripe no. 19 /FY-21 in TBT
dated 12.06.2020.
implemented 8 0
# No system of reporting near miss & unsafe
8 0
act/ condition
# Adhoc and weak system available Weak system of near miss capturing has been seen. Only 03 in nos has been captured till date
1 8 8
as per the dash board record.
# A documented procedure for reporting of Documeneted procedure is there for the same.
Near miss exists and followed and investigation 8 0
carried out
# Reporting and investigations done Even last has been captured on 08.06.2020 but CAPA is not fully taken. Only correction has
systematically and root causes are identified been highlighted . Preventive measures is not fully taken.
8 0
# Recommendations are implemented and
8 0
learning shared
# Learning from other near miss shared and
8 0
implemented
# No system of skill retention
# No amenities provided 8 0
# High employee turnover
# Amenities provided is of minimum Amenities are provided which is of minimum requirement.
8 0
requirement
# Employees are motivated to remain in the Employees are motivated to remain in the organization as per the inetraction.
8 0
organization
# Employee grievance are recorded and Employees grievnaces capturing system is in place . Some cases has been recorded for FY 19-20
8 0
considered for action with complinaces.
# No grievance from employees on amenities Yes Grievances has been captured from the employee end with their closure.
provided, hygiene and workplace environment 4 8 32
# Feedback system exists to capture employee But feedback system has not been developed from the employee end related to retention
suggestion, engagement and retention 8 0 system.
# No safety campaign 8 0
# Adhoc safety campaign 8 0 System is in place for campaign.
# Safety campaign done systematically (record Safety campaign record has been verified.
8 0
is must)
# Plan for campaign available with theme Plan of the campaign has been seen for the FY 20-21 with theme but till June 2020 only. It is
3 8 24 not available for the entire year.
Responsibility of the campaign has been mentioned in the plan. Last hass been done on
8 0 Housekeeping & slip trip & Fall on 15th March 2020 . But it is not as per the set plan or theme.
Mmoreover only picture is there - No content of the same has been seen.
# Campaigns are linked to past incidents and No such campaign has been organized that has been linked to past accident/ incident.
8 0
based on learning (record/evidence)
# No system 8 0
# Ahhoc system 8 0 Reward system is in place.
# Defined criteria & documented procedure Criteria has been defiend in the procedure manual .
8 0
# Mechanism of bad & good performer exist Mechanism has been seen for bad & good performer
(shall be transparent and shall be known to 3 8 24
employees)
 4.5 Reward, Recognition and
Consequence Management
System of Contractor. (Verify
through records)

4- PDCA is followed and learning and # PDCA is followed and learning and integration Reward system is in place along with the defined mechanism of selection. Last has been given
integration approach visible and reduction approach visible and reduction in unsafe acts to Mr. Rakesh Chetomba for best suggestion but date has not been mentioned in the pictorial
in unsafe acts and practices and practices 8 0 proof. Also in the agenda of the mass meeting - Reward parameter has not been included.
PDCA Not followed properly.

5- There is positive impact among # Positive impact amongst employees and they
contract employees and they are highly are motivated 8 0
motivated
Nil as per ENSAFE
0-60 # No LTI/Serious injury/ permanent disablement
Zero Lost time /serious injury incident
5.1 60 60
or permanent disability
# 1 or more LTI/Serious injury/ permanent
>/=1-0
disablement incident
5.Perform
ance 0-40 Score # No first aid incident Nil as per ENSAFE
measure: 5.2 Zero First aid case 40 40
1 or more-0 score
Lag # 1 or more first aid incident
indicators 0-10 score # No property damage case Nil as per ENSAFE
Non-Injury Incidents (e.g.
applicable 5.3 10 10
Property Damage) 1or more-0 score
for the # 1 or more property damage case
Location Safety violation of fatal # No fatal potential violation of severity 4 & 5 Nil as per ENSAFE
itself 0 - 20
potential of severity 4&5 violation.
(Previous 5.4 20 20
(reference contractor safety # Fatal potential violation of severity 4 & 5
Financial >=1 - 0 violation are more than or equal to 1.
audit system)
year and
Safety noncompliance cost 0-20 score # No cost recovery violation evident Nil as per ENSAFE
Current
5.5 recovery / Penalty imposed / 20 20
Financial 1-0 score
Job stopped. # 1 or more cost recovery violation evident
year as on
assessmen # No fatality, zero score will be awarded, i.e. no Nil as per ENSAFE
0 : 0 score
t date) deduction of marks.
Fatality : 1 # If vendor is responsible -100 score will be
5.6 Fatality of contractor employee a) Responsible awarded.i.e 100 marks will be deducted from 0 0
b) Not Responsible total score
# If vendor not responsible, marks will not be
deducted.

TOTAL SCORE 554

1
Yes
Self assessment done by vendor :Yes / No

2 Verified by CO / Mentor : :Yes / No Yes

Yes
Report (1 &2) seen by Third
party agency during assessment :Yes / No
Annexure #1
CSM Star rating assessment key findings and feedback form
(A) Key Audit findings:
1.
2.
3.
4.
5.
(B) Feedback by CO (TSL employee) and Vendor :
a) Are the auditors following Scope of assessment?
Ans: Yes / No
b) Behavior of Auditor?
Ans: Good / Satisfactory
c)Field visit conducted by the Auditor?
Ans: Yes / no
d)Have you understood Auditor’s inputs?
Ans: Yes / No
e) Any suggestion on assessment process of auditors?
Ans:
Acceptance taken in Teams chat box from vendor

(C) Contract Owner (TSL employee - Name, P. No. & signature):Mr. Rakesh Kumar P.No- 500601
Email id Mobile number:

(D) Vendor code: I124 Organization and Rep. name: Interstate Syndicate & Mr. Bhim Sharma- Proprietor

Email id Mobile number:

( E ) Name of theAssessor and signature: Mr. Abhishek Vishal- DNV.GL
Assessor Name and signature: abhishek

4.Audit Date - 29.09.2020…Time- 09.30AM Location - FAMD