RECORDS OF GRIEVANCES – To be filled by the PIU (Monthly)

PIU:

Name of Hospital and District: Round:

Reporting Period (Week/Month/Year):

Name of Respondent: Date:

Response Method to ensure issues

Action taken to resolve the issue
and Details of the issue is resolved
o Confirm if any dust was
noted to escape the site
boundaries
o Confirm if high levels of
noise was noted to escape
the site boundaries
Confirm if muddy water was
escaping site boundaries or
muddy tracks were seen on
adjacent roads.
Were there any issues with
erosion and sediment
control measures installed
on site/s?
Were there any issues with
the designated areas for
concrete works, stockpiles,
construction material
storage, and equipment
yards?
Were there any
construction wastewater on
nearby roads/drains?
Were there any notice of
chemical spills (including
cement slurry)?
 Were there any issues with
management of stockpiles
(construction materials,
excavated soils, spoils,
etc.).?
Were there any issues with
the management of solid
and liquid wastes on-site?
Are the safety measures
adopted on-site adequate?
e.g., barricades, signages,
and on-site boards.
Any notice of workers not
wearing PPEs or engaging
in dangerous practices
while at work?
Confirm if there are any
activities being undertaken
out of working hours/during
busy hours that disturb the
activities of the hospital
Are the safety measures
taken to ensure public
health and safety
adequate?
Were there any complaints
related to public safety from
the patients and other users
of the hospital?
Were there any complaints
related to labourers and/or
labour camps from the
patients, other users of the
hospital and neighbors?

Any other complaints?

Records of other grievances

1. Provide information on number, nature, and resolution of complaints received during reporting period.
2. Details of any meeting conducted during the period should be recorded. Provide meeting minutes and photographs.

Respondents Response Action taken to resolve the Method to ensure issues is

and Details of the issue issue resolved
Contractor

Patients and other hospital users

Neighborhood

Others