Checklist of RBA Requirement (Criteria of Safety, Health, Environment)

Criteria Sub Criteria Item Scope No. Item Condition

Criteria
OK NO N/A
B1. B1.1 All required permits, licenses, and test reports for Crane, boiler, forklift, 1 List of equipment that needs permit (kind of equipment, permits
Occupational Safety health & safety is in place and a process is implemented to ensure permits industrial hygiene sampling, drinking expired date, year of next permits)
and licenses are up to date at all times (crane, boiler, forklift, industrial water sampling, ventilation flow tests
hygiene sampling, drinking water sampling, ventilation 2 Permits are update (not expired)

3 Permits displayed at equipment

B1.2 Potential for worker exposure to safety hazard Chemical 1 Chemical are adequately and effectively managed (listed,
(example chemical, electrical, other energy sources, fire, vehicles, and fall registered/assessed, categorized, handled, stored, transported)
hazards) are controlled thorugh proper design, engineering, and administrative
controls and safe work procedures
2 Chemical controlled (access to hazardous substance locked, PIC
displayed, control of exposure, segregation, secondary containment, ventilation, fire
protection, appropriate storage cabinets)

Fall 1 Stairways and elevated work areas are provided by guardrails

and handrails
2 Aisles, stairways and work area are free of tripping hazards
(stored materials, electrical cords, etc.)
3 Workers are provided with appropriate fall protection for work in
elevated work area (roof work, etc.).
Electrical and other 1 Pre-cautions and controls of electrical hazards (such as locked
energy sources cabinets, closed panels, unobstructed access)
2 Energized parts protected by barriers and covers

3 Electrical installation and wiring are regularly inspected and

maintained
Vehicle 1 Powered industrial vehicles and pedestrian walkways are clearly
delineated and physically separated
2 Daily checksheet or prior to each use for powered industrial
vehicles
Fire 1 Flammable and combustible materials are properly stored

2 Hot work permit system in place for welding, cutting, and

brazing
Confined space 1 Confined space hazards are evaluated

LOTO 1 Lockout/tag out program in place for work in equipment where

stored energy (electrical, pneumatic, mechanical)
B1.3 Appropriate PPE is consistently and correctly used PPE requirement 1 PPE selection appropriate for hazard (Job specific PPE matrix)
where required to control safety hazards and worker exposure
2 Communicated to employees by posted signs and worn by all
affected people
PPE availability 1 PPE list (type & quantity), checklist (include monitoring,
cleaning, and inventory), PIC are displayed
2 PPE appropriately stored and accessible

PPE evaluation 1 PPE adequacy evaluation records

B1.4 Reasonable steps are in place to remove pregnant Pregnant employee, 1 Risk assessment available at the time of:
women/nursing mothers from working conditions with high hazards, minimize nursing mother - before pregnancy is reported
any workplace health and safety risks to pregnant women and nursing and - after pregnancy is reported
provide reasonable accomodations for nursing mothers - after mother returns to work

2 General and specific of Risk Assessment of:

- lifting and carrying heavy loads
- standing or sitting for long time
- exposure to infectious diseases
- exposure to lead
- exposure to toxic chemicals
- work-related stress
- workstations and posture
- exposure to radioactive material
- threat of violence in workplace
- long working hours
- extreme heat

B2. Emergency B2.1 All required permits, licenses, and test reports for fire Fire safety response 1 List of equipment that needs permit (kind of equipment, permits
Preparedness safety response equipment (including fire suppression equipment) and equipment (including fire expired date, year of next permits)
emergency preparedness are in place and a process is implemented to ensure suppression equipment)
permits and licenses are up to 2 Permits are update (not expired)

3 Permits displayed at equipment

B2.2 Adequate and effective fire detection, alarm and Fire alarm, Fire 1 Installed and access are free of obstruction
suppression systems are in place Extinguisher, Hydrant, Sprinkler (if
required)
2 Maintenance records (checklist include inspection tags,
records)
3 Inspection records from third party

B2.3 All potential emergencies that could affect the site are Signage 1 Adequate and effective signage is observed with emergency
identified and assessed, and effective emergency preparedness and response number(s), emergency team and emergency flow, evacuation, and response plan
programs

Criteria Sub Criteria Item Scope No. Item Condition

Criteria
OK NO
(plans/procedures) are established 2 Evacuation route layout displayed which clearly identify exit
routes and assembly points in correct orientation
Assembly point 1 Safe location, accountable during an emergency

Emergency response kits 1 Easily located and accessible near assembly point

Risk assessment 1 Risk assessment process available in place, considering harm of

life, environment, property
2 Risk assessment current (updated when there's significant
change or at least every 3 years)
BCP 1 Business continuity and resumption procedures available,
current and adequate
B2.4 Effective emergency exit access, exits, and exit Clear and unobstructed 1 Adequate number of exit routes from every area
discharge are adequate in number and location, readily accessible, and exits
properly maintained
2 Exit routes are separated by an appropriate distance

3 Exit routes are clear from obstructions, free from material

storage, barrier not used for any purpose except for exits
4 Exit discharge to open space,
Not discharge to an enclosed/gated/locked area
5 All exit route doors which occupancy > 50 employee or
hazardous area, must be swing-out
6 All exit route doors should open without using a key, badge,
code, special knowledge, or effort
Exit signs 1 Provided to mark exits on every floor

2 Illuminated and/or lighted in event of power failure

 Exit signs

3 Additional exit and/or directional signs are provided at main

passageways/aisles, long corridors and others location where the way to the nearest exit is
not clear

Emergency lighting 1 Provided and installed, illuminated in event of power failure

2 Provide and functional in stairs, aisles, corridors, ramps, and

passageways leading to exits
3 Provide battery or backup generator may power emergency
lighting
Separation 1 Fire door in good condition, self-closing or automatic closing
(upon fire alarm or detection of smoke), maintenance records

General 1 Maintenance records for all above items

2 No good situations for exit route doors (inside of :

- multiple steps required to open doors
- anything requiring a tight grasp
- rolling doors that open vertically

3 All exit discharge doors (directly to outside) must:

- single motion exit or
- listed panic hardware installed which is pushed open in single motion

B2.5 Adequate and effective fire and other identified Emergency response plan 1 Emergency response plan drill program (fire, other emergencies)
emergency situations and evacuation drills are conducted with all employees, and implementation - annual evacuation drill
and records are maintained - all workers
- every area
- all work shifts
- one drill conducted at night

2 ERP drill evaluation reports, CAPs

B2.6 Designated emergency response personnel are Emergency response 1 Formed and available during all working shifts
provided adequate and effective PPE and training on annual basis team (ERT)
2 ERT members have required qualifications, get annual training

3 Training material and training records reviewed and up to date

(such as first aid training, fire fighting training, etc.)
PPE for emergency 1 PPE for emergency response is vvailable, adequate, good and
response working condition
2 Storage of emergency response PPE clearly marked, visible and
easily accessible
3 Badges, different colores clothes/hat, and office/cubicle
signage may identify ERT personnel
B3. B3.1 All required permits, programs, licenses, and testing Occupational injury and 1 On-site medical treatment facility is available for review
Occupational Injury reports for occupational injury and ilnness are in illness permits and licenses
and Illness
2 List of medical professional certificates (permits expired date,
year of next permits)
3 Permits are update (not expired)

4 Permits displayed at public view (common area/break/canteen

locations)
5 Records (injury logs, respiratory protection, hearing
conservation programs, notice of availability of medical records)

Criteria Sub Criteria Item Scope No. Item Condition

Criteria
OK NO
B3.2 Investigations to determine root cause(s) and Accident report and 1 Accident report and investigation, near misses report (past 3
implement corrective / preventive actions for work- related injuries / illness in investigation years)
the past three years are performed and documented, communicated to affected
employees, and tracked to closure 2 Trend analysis of occupational injury and ilness data (annually,
past 3 years)
3 Accident report to government

B3.3 An effective first aid process and adequate number of 1 First aid responders are easily identificable by badges, colored
first responders are available to provide initial medical treatment for injured or attire, office/work area signage
ill workers is in place
2 Assigns a team of trained / certified first aid responders (refer
to regulation)
B3.4 Adequate first response equipment and first aid kits to First aid kits 1 First aid kits available in designated locations
provide medical treatment for injured or ill workers are available to employees
in designated areas. The kits have adequate supplies and are inspected on a
montly basis 2 First aid kits are unlocked or if locked, first responder can
access the key at all times
3 First aid kits have inventory list

4 Monthly inspections for first aid kits

First response equipment 1 First response equipment available in designated locations

Example of first response equipment : fire blanket, eye wash,
emergency shower, etc…

2 Monthly inspections for first response equipment

B4. Industrial B4.1 All required permits, licenses and testing reports for 1 Industrial hygiene permits, testing reports, monitoring logs are
Hygene potential industrial hygiene exposures are in place and a process is available
implemented to ensure permits and licenses are up to date at all times
2 Displayed are in place

B4.2 Appropriate controls according to the hierarchy of Exposure to chemical, 1 Workplace free from obvious door, visible fume, dust, other
controls for worker exposures to chemical, biological and physical agents are biological, and physical agents condition leading to potential unhealthy feelings
implemented. Potential hazards are eliminated or controlled through proper
2 Medical surveillance records are available related to specific job
design, engineering and administrative controls
activities

3 Safety assessment for chemical completed when new chemical,

change of process, etc.

4 Adequate and effective risk assessment with associated

industrial hygiene sampling and testing is in place to identify and access potential hazards
of chemical, biological, or physical agents.

5 Adequate controls to reduce or eliminate worker exposure to

chemical, biological, and physical agents are in place and effective including:
- proper design (elimination and/or substitution)
- engineering controls (exhaust ventilation, enclosures)
- administrative controls (limiting worker exposure time, job rotation)

B5. Physically B5.1 Worker exposure to the hazards of physically Physical demanding work 1 Adequate and effective risk assessment is in place to identify
Demanding Work demanding work is identified, assessed, communicated and controlled (heavy repetitive lifting, prolonged and access potential hazards of physical demanding work
effectively standing, etc.)
B5. Physically B5.1 Worker exposure to the hazards of physically Physical demanding work
Demanding Work demanding work is identified, assessed, communicated and controlled (heavy repetitive lifting, prolonged
effectively standing, etc.)

2 Adequate and effective documented program to controls

identified potential hazards of physical demanding work is place and follows hierarchy of
controls:
- proper design
- engineering controls (palletizers, lift tables, adjustable work platforms, etc)
- administrative controls (limiting worker exposure time, job

3 Review and trend analysis of past 3 years of injuries related to

physical demands of job duties
B6. Machine B6.1 All required permits, licenses and testing reports for Machinery 1 List of machinery that needs permit (kind of machine, permits
Safeguarding machinery are in place and a process is implemented to ensure permits and expired date, year of next permits)
licenses are always up to date
2 Permits are update (not expired)

3 Permits displayed at machine

B6.2 An adequate and effective machine-safeguarding Emergency stops 1 All machines have adequate emergency stops
program is implemented, and workers operate machinery safely
Safeguards 1 All machines have adequate safeguards

Operation 1 All workers operate machine safely

Machine Safety 1 Safety assessment to identify machine safeguarding needs

Assessment (pre-purchase/pre-installation hazard review of all machinery)

Machine Risk assessment 1 Adequate and effective risk assessment is in place to identify
and access potential hazards of machine process

Control program 1 Regular inspection and preventive maintenance of machine are

available (include its safeguards, emergency stops) (3 years)

Criteria Sub Criteria Item Scope No. Item Condition

Criteria
OK NO
Work instructions 1 Work instruction are available in language understood by the
worker at machine (or in nearest area)

Criteria Sub Criteria Item Scope No. Item Condition

Criteria
OK NO
B7. Food, B7.1 All required health and safety licenses, permits, Valid hygiene permit 1 All required food and sanitation permits and license are in
Sanitation and registrations and certificates related to food, sanitation and housing are in place, available for review
Housing place and an adequate and effective process is established to ensure permits
and licenses are up to date at all times 2 Food and sanitation testing reports are in place, available for
review
3 Canteen/kitchen workers have valid health certificates

4 Food and sanitation testing reports , example:

- drinking water
- food worker health tests
- food sample testing

B7.2 Dormitories, bathrooms, employee spaces are clean,

safe and well-maintained and meet international housing standards

B7.3 Canteens (cafetarias) are clean, well maintained, and Environment 1 Canteen, kitchen and food preparation areas are clean and well
well managed maintained
2 Exits must be adequate for numbers of workers served

3 Provided with adequate hand washing facilities

4 Adequate pest control

Food workers 1 Wear masks, hairnets and gloves to prevent food contamination

Food storage 1 Food storage and preparation areas are clean

2 Food is stored properly (not on the floor, refrigerated if

necessary)
3 Raw and cooked food stored separately, food kept covered

4 Food is used or disposed of before the marked expired date

Procedure & records 1 Safe food handling procedures and hygiene standards (in
refrigerator, storage, preparation area) in placed and followed include reporting

2 Adequate and effective cleaning and sanitation program and

document is in place
3 Adequate and effective pest control program and control log is
in place
4 Adequate and effective preventive maintenance program and
logs is in place
B8. Health and B8.1 Workers are provided with appropriate clearly posted Communication 1 Health and safety communication clearly posted or placed in a
Safety workplace health and safety information and training in the language of the location identifiable and accessible by workers
Communication worker or in a language the worker can understand for all identified workplace
hazards that workers are exposed to. Workers shall be encouraged to raise 2 Appropriate signs, placards and labels identifying hazards
safety concerns (chemical, physical, biological, vehicular, etc.)
3 Potential workplace hazards that workers are exposed to clearly
posted or placed in location identifiable and accessible by workers

4 Hazard communication flow is available and understood by

employee
5 Internal and external assembly points are communicated to all
employees and visitors
Safety concern 1 Adequate and effective program to receive, review, and respons
notification to employee's safety concerns reported
Language 1 All communications and training must be in a language
understood by worker
Training 1 Adequate and effective training program is in place.
Training program has minimum requirements (mechanical, electrical, chemical, fire, and
physical hazards) and training identified in training needs assessment, but must include:
- correct use of approriate PPE
- types of potential emergencies that may occur at work location and what to do during an
emergency, including internal and external assembly points
- machine safety and the use of safeguards and emergency stops
- Reporting injuries and illnesses
- Hazardous situation and confined space work procedures prior to entry of confined
spaces
- Lock out-tag out procedures

2 Training is provided to all workers prior to the beginning of work

and regularly, then as per training program
 3 Required training and license refer to regulation implemented,
such as first responders, chemical, electric, radiation, crane, forklift, etc

Records 1 Training records, education materials, evaluation

2 Hazard communication records, safety concern records