Health & Safety Regulatory Compliance Evaluation
Company Information
Company Name: [Your Company Name]
Location: [Your Company Address]
Date of Evaluation: [Date]
Evaluator's Name: [Your Name]
Section 1: General Information
Type of Business: [Business Type]
Number of Employees: [Number of Employees]
Hours of Operation: [Operating Hours]
Type of Hazards Present:
Chemical
Biological
Physical
Ergonomic
Psychosocial
Section 2: Regulatory Compliance
a. Occupational Safety and Health Administration (OSHA) Compliance:
Are OSHA standards being followed? | | |
Are SDS available for hazardous chemicals? | | |
Are employees trained on OSHA regulations? | | |
b. Environmental Protection Agency (EPA) Compliance:
Any hazardous waste management procedures in place? | | |
Is there compliance with air and water quality regulations? | | |
c. Department of Transportation (DOT) Compliance:
Are vehicles and drivers compliant with DOT regulations? | | |
Is there a vehicle maintenance program in place? | | |
Section 3: Safety Procedures and Policies
a. Emergency Response Plan:
Is there an emergency response plan in place? | | |
Are employees trained on emergency procedures? | | |
b. Personal Protective Equipment (PPE):
Is PPE provided and used appropriately? | | |
Are there regular PPE assessments? | | |
c. Safety Training:
Are employees trained on safety procedures? | | |
Is safety training conducted? | | |
Section 4: Safety Inspections and Audits
a. Frequency of Safety Inspections:
How often are safety inspections conducted? | | |
Are inspection reports documented? | | |
b. Corrective Actions:
Are safety issues addressed? | | |
Is there a process for implementing corrective actions? | | |
Section 5: Incident Reporting and Investigation
a. Incident Reporting Procedure:
How are incidents reported? | | |
Is there a system for investigating incidents? | | |
b. Incident Analysis:
Are incidents analyzed to prevent recurrence? | | |
Is incident analysis used to implement corrective actions? | | |
Section 6: Health and Wellness Programs
a. Health and Wellness Initiatives:
Do programs promote employee health and wellness? | | |
How are these programs evaluated for effectiveness? | | |
b. Employee Assistance Programs (EAP):
Is there an EAP in place for employees? | | |
Are EAP services communicated to employees? | | |
Section 7: Documentation and Recordkeeping
a. Recordkeeping Procedures:
Are health and safety records maintained? | | |
Are records readily available for review? | | |
b. Document Retention Policy:
Is there a health and safety documents preservation policy? | | |
Are records stored securely? | | |
Section 8: Recommendations and Action Plan
a. Recommendations for Improvement:
Conduct a comprehensive review of all current safety procedures and policies to ensure they are up to date and in compliance with relevant regulations.
Implement regular safety training sessions for all employees to ensure they are aware of and understand the importance of safety procedures.
Improve documentation and record-keeping procedures to ensure all health and safety records are properly maintained and readily available for review.
b. Action Plan:
Conduct a review of current safety procedures and policies by [DATE].
Schedule and conduct safety training sessions for all employees by [DATE].
Revise documentation and record-keeping procedures by [DATE].
Section 9: Evaluator's Signature

Date: [Date Signed]
Compliance Templates @ Template.net