HSEMS AUDIT CHECKLIST

LOCATION : AUDITEES 1 2 3
AUDITORS 1 2 3

DATE OF AUDIT ……………………………………………………..

OBSERVATIONS COMMENT REMARKS
1 HSE Policy Answer Evidence (If avilable mark with √)
a Available ? Y/ N
Displayed ? Y/ N
English Y/ N
Sinhala Y/ N
b Make understood ? Y/ N
c Method Meeting Printed Display Leaflets Other
d Degree of understading among employees Excellent Better Average Poor Very Poor
e Number of People interviewed

2 Hazard Identification Risk Assessment(HIRA) and Determining Controls (ISO 45001:2018)

a Are procedure established ? Y/ N

b communicated ? Y/ N
c Possible Hazards Identified? Y/ N
d Prioritization of Risks of hazards? Y/ N
Are implemented control measures to reduce risk of hazards?
e Y/ N

f Is available Risk Assessment register? Y/ N

g Are Controls Up to Date? Y/ N
3 Environmental Impact (EIA) & significant aspect Identification (ISO 14001:2015)
a Are procedure established ? Y/ N
b Communicated ? Y/ N
c Environmental Aspects of Activities Identified? Y/ N
Normal,abnormal & emergency situations considered in
d aspect identification? Y/ N

e Are Significant Environment Aspects Identified? Y/ N

f Prioritization of Aspects as per significancy? Y/ N
g Application of Controlling the environmnetal aspects? Y/ N
h Is updated environmental aspect register available? Y/ N
Are implemented control measures to minimize the
i significancy of impacts? Y/ N

4 Legal and Other Requirements

All Related Acts, Ordinances, Regulations, Standards and Y/ N

Principles of Guidence for HSEMS are identified and Collected?

Legal register is available? Y/ N

List of Relevent Approvals are maintained? Y/ N
Obtained all applicable legal aprovals,Permits,Lisences and
renewed up todate? Y/ N

Monthly Progress Report- Available Y/ N

Progress Review Minnutes- Available? Y/ N
Objectives, Targets and Programme
Established HSE Objectives Y/ N
Answer Evidence/Mehod (If avilable mark with √)
a Degree of understanding the concept Excellent Better Average Poor Very Poor
OBSERVATIONS COMMENT REMARKS
b Are areas identified ? Y/ N

c Are SMART objective(s) established for Health,Safety and Y/ N

Environment management?
d Are there Programmes to achieve HSE Objectives ? Y/ N
Are Performance indicators established to monitor the
e achievements of Objectives? Y/ N

f Are there privious records of acieved objectives Y/ N

i Progress monitored ? Y/ N
j Improvement Excellent Better Average Poor Very Poor
k Improvement as a measure
5 Resources, Roles, Responsibility, Accountability and
Authority Answer Evidance/Method (If avilable mark with √)
Orgainizational Chart and of HSE Implementation
a Available ? Y/N
b Accurate ? Y/N
Responsibilities, authorities
c defined ? Y/N
d Communicated ? Y/N

6 Competence, Training and Awareness on HSE Answer Evidance (If avilable mark with √)
a Are Training Needs Associated with HSE Identified Y/ N
b Effectiveness of HSE Training Evaluated? Y/ N
c Training Plans/Progammes- Identified Y/ N
d
Are competency of employees has been checked for the Y/ N
employees who involving in Hazardous machine operation?

HSE Communication (Internal/External),participation and

7 consultation
a Are required information communicated to employees ? Y/N
b Are methods available ? Y/N
c Effectiveness Excellent Better Average Poor Very Poor
d awareness among employees ? Excellent Better Average Poor Very Poor
e Are there communication gaps available ? Y/N
f Correspondence- 1.maintained? 2.Traceable ? Y/ N
g Traceble Y/ N
h Attendance of awareness Programmes- Available? Y/N
i Relevent Instructions Are Distributed? Y/N
j
Participation and consultation of workers is taking account in Y/N
to identification of hazards,controll measures etc.

k Feedback from External Parties? Y/N

l Meeting minutes on Communication- Available? Y/N

8 Documentation
a Is available HSE Manual,HSE Procedure manual,other
documents required for HSEMS.? Y/N
b
Is available the intergrated QMS Procedures for Document
control,Record control,Internal audits,Nonconformity
management and other related procedures.
Y/N
OBSERVATIONS COMMENT REMARKS
9 Control of Documents Evidance /Method (If avilable mark with √)
a Is the procedure available HSEMS? Y/ N
b Identified documents (title/code) ? Y/ N
c Approved documents prior to Issue ? Y/ N
d Revision status - clearly shown in all documents ? Y/ N
e legible and readily identifiable ? Y/ N
f responsibilities for receiving, issue, control of documents
Y/ N
g established ? Y/ N
h communicated ? Y/ N
i relevant version - available at point of use ? Y/ N
j A list of documents in use - maintained ? Y/ N
k Controlled HSE Manaual - available with Divisional Head ? Y/ N
l Mechanism to control documents with external origin Y/ N
m Does the control exist to prevent the unintended use of
obsolete documents and to apply suitable identification to
them if such document is retained Y/ N

10 HSE Operational Controls Answer Evidance (If avilable mark with √)

Are operational control procedures established to cover
a situations where their absence could lead to deviations from Y/ N
the HSE Policy and objectives.?
b
Controls Related to Purchased Goods, Equpment and Services? Y/ N

c Controls Related to Contractors and Other Visitors to the Work

Place- Available? Y/ N

e
Are instructions given to emplyees on good HSE practices and
implement the oprational guidance of OCPs. Y/ N

11 Emergency Preparedness and Response Answer Evidance (If avilable mark with √)
a Potential Emergency situations and Accidents-Identified? Y/ N
b Responds to Emergency Situations-Available? Y/ N
c Emergency Response Plan (ERP) available?
Accurate? Y/ N
d Training on ERP- Provided? Y/ N
e ERP- Updated?
Potential On-site and Off-site Impacts of the Emergencies-
f Identified? Y/ N

Materials and Equipments necessary for Responding to

g Foreseeable Y/ N
Emergencies- Maintained?
h Awareness and training programmes- Available? Y/ N
i Reports on Mock up test? Y/ N
j Commuinicated? Y/ N
12 Monitoring and Measurement Answer Evidance (If avilable mark with √)
a Are Performance Indicators Established? Y/ N
b Performance agaist established indicators- Monotored? Y/ N
c Corrective and Preventive Actions-Carried out? Y/ N
d Inspection Schedules and checklists- Available? Y/ N
e Measurement Schedules and records - Available Y/ N

f Calibration Scheme and Calibration Records on HSE Monitoring Y/ N

- Available?
g Completed Checklists and Inspection Reports- Available? Y/ N
OBSERVATIONS COMMENT REMARKS

13 Evaluation and Complience Answer Evidance (If avilable mark with √)

Are Legal Approvals and their complience periodicaly
a evaluated ? Y/ N

Licenses and Permits required and compliences of the

b conditions to be maintained are evaluated? Y/ N

Evaluated the legal documents required by the other parties ?

c Periodic Evaluation Results- Available? Y/ N

14 Nonconformity, Corrective Action and Preventive Action

4.5.3.1 Incident Investigation Answer Evidance (If avilable mark with √)
a Are advese event investigation Report available? Y/ N
b On-site Adverse Events-Investigated? Y/ N
c Off-site Business Related Adverse Events- Investigated? Y/ N
d Identified Y/ N
Corrective Actions? Y/ N
Preventive Actions? Y/ N
Cotinual Improvements? Y/ N
e Trend Analysis Report on Adverse Events? Y/ N
4.5.3.2 Nonconformity, Corrective Action and Preventive Action
a Nonconformities identified? Y/ N
Investigated? Y/ N
b Determined Possible Causes of Nonconformities? Y/ N
c Corrctive Actions? Y/ N
d Preventive Actions? Y/ N

15 Control of HSEMS Records Answer Evidence/Mehod (If avilable mark with √)

a Is there a procedure available Y/ N
b Identified (title/Code) ? Y/ N
c legible ? Y/ N
d Easily retrievable ? / Time taken Y/ N
e Codes given ? Y/ N
f Indices maintained ? Y/ N
g stored ? Y/ N
h protected (protection against insects; water damages; Y/ N
electronic data losses )
i (files / hard covers / shelves / back-up) Y/ N
j retaintion period - defined ? Y/ N
k Maintained in accordance with procedure ? Y/ N
l Disposal of Records? Y/ N

16 Internal Audits
a Are internal audit records available? Y/ N
b Are evidenace for Corrective actions available ? Y/ N
Y/ N

17 Management Review
a Records of Management review meeting conducted? Y/N/NA
b attendance Y/N/NA
c Inputs ? Y/N/NA
d Outputs? Y/N/NA
OBSERVATIONS COMMENT REMARKS
e Management Review meeting munits available? Y/N/NA

Issue :1(2010.02.01) Revision : 1(2012.02.01) Amendment : 0