Ref.
#: CMO-F-032
Rev. #: 1
Rev. Date: 10 November 2020
WEEKLY SAFETY STATISTICS REPORT
PROJECT : REPORT No. :
LOCATION : PERIOD COVERED :
OWNER: : STARTED DATE :
Project Manager : EXPECTED END DATE :
NO. DESCRIPTION PREVIOUS
WEEK YEAR TO DATE JOB TO DATE
1 Actual No.of Employees on site
2 No. of Lost Time
3 No. of First Aid Cases
4 No. of COVID-19 Cases (Quarantined)
5 No. of COVID-19 Cases (Positive)
6 No. of Planned Inspection
7 Total No. of Employees Trained
8 Total No. of Training Hours
9 No. of Safety Meetings
10 No. of Fires
11 Total Fatal Accidents on Duty
12 Total Man-hours Worked
13 Total Man-hours lost due to LTAs
14 No. of Near Misses
15 Total Man-hours from last LTA
16 Overall frequency rate
17 Severity Rate
Prepared by : Noted by:
Safety Officer Resident Construction Manager
NOTE:
1. For workers/personnel being quarantined - equivalent lost time is 14-days x 8 hrs = 112 man-hrs.
2. For workers/personnel being positive patient - equivalent lost time is 30 days x 8 hrs = 240 man-hrs
3. Any LTA, must always be supported by (CMO-F-037) QESH-Incident Investigation Report.