Sheet 1: TITLE

	
	
	
	
	
	
	

		
Leading Indicator Tool - Culture Assessment
		


		


	
	

		
Company Wide Data
		
	

		


		
	

		

 
		
		


		
ABC Contracting Group
		


		
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236 BUILDING CONSTRUCTION
		
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Completed by:
		


	
	

		


		


		
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ESIS Health, Safety & Environmental Services
		


	
	

		


		


		
	

		


		
Date Completed:
		
	

		


		


		
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Overview
		
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Management Commitment
		
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Fall Management
		
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Subcontractor Selection/Management
		


	
	

		


		


		
Automobile Safety
		


	
	

		


		
Quality Assurance/Quality Control
		


		
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Substance Abuse
		
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Summary Table and Chart
		
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PLEASE READ CAREFULLY; This sample form is being provided to you as a tool that you may wish to use in providing a safety and risk management program. You are responsible for providing safety and risk management services. We at Chubb are providing this tool to you in support of our underwriting objectives and we hereby disclaim any obligation to oversee or monitor the adherence to required or otherwise reasonable safety and risk control practices. We further disclaim liability for claims or suits relating to the alleged or actual failure to conduct reasonable safety control practices, or relating to the use of or failure to use this document. Please note that neither this tool or any of its components contain every possible operation, inspection requirement or other detail that may be relevant to your project or that may be required by federal or state law, or by local building codes, statutes, or other requirements. This tool is intended only as a guideline, and not as a substitute for consultation with your insurance broker, or for engineering, legal or other professional advice. 
		
	

		
Chubb is the marketing name used to refer to subsidiaries of Chubb Limited, providing insurance and related services. For a list of these subsidiaries, please visit our website, www.chubb.com. Insurance is provided by ACE American Insurance Company and its U.S. based Chubb underwriting company affiliates. All products may not be available in all states. This communication contains product summaries only. Coverage is subject to the language of the policies as actually issued. Surplus lines insurance is sold only through licensed surplus lines producers. Loss control evaluations, reports, recommendations and services are made solely to assist the insurer in underwriting and loss control and are not to be construed as an added benefit for the insured, property owner or any other party (this may not apply if loss control services are purchased separately and specifically pursuant to a service agreement). Evaluation for any hazard or condition does not imply that it is covered under any policy. Chubb is the world’s largest publicly traded property and casualty insurance group. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. Chubb Limited, the parent company of Chubb, is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Copyright ©2016
		


		


	

 




Sheet 2: Overview

	
	
	
	
	

		
Leading Indicator Tool - Culture Assessment
		
	

		
Company Wide Data
		
	

		


		


	
	

		

 
		
		


		
ABC Contracting Group
		


	
	

		


		
	

		


		


		
	

		


		
	

		


		
Chubb believes construction organizations that strive to be the best they can be are the ones that will continue to be the most successful. This holds true for safety and health, production, and operational perspectives.
		
	

		


		
	

		


		


		
	

		


		
Adopting a pro-active safety culture that exceeds the norm may meet with some resistance.  However, organizations that understand its value will benefit in several ways:
• Morally, through employee gratification resulting in a more productive work force, and
• Economically, reducing accident frequency and severity and ultimately lowing insurance costs.
		
	

		


		


		
	

		


		
Chubb experience has shown that organizations focusing safety and health efforts in selected areas including management commitment, fall management, subcontractor selection/management, quality assurance, and substance abuse have the greatest opportunity to maximize success in construction safety and health.  Chubb has identified key elements in each of these areas that we believe correlate to superior construction safety and health results.
		
	

		


		
	

		


		
	

		


		
	

		


		


		
	

		


		


		
	

		


		
	

		


		


		


	
	

		
	

		


		
	

		


		
	

		
See Disclaimer on Title Page.
		
	

		


		


		
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Sheet 3: MC

	
	
	
	
	
	
	
	
	

		

 
		
		


		
ABC Contracting Group
		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		
236 BUILDING CONSTRUCTION
		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


	
	

		


		
Leading Indicator Tool - Culture Assessment
		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		
Management Commitment
		


		
Scoring 
		


		


		


		


		


	
	

		


		


		
60 and Below - Needing Attention
		


		


		


		


		


	
	

		


		
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60 to 69 - Safety Culture In Progress
		


		


		


		


		


	
	

		


		


		
70 to 79 - Effective Safety Culture
		


		


		


		


		


	
	

		
Component
		


		
Score
		


		
80 to 89 - Good Safety Culture
		


		


		


		


		


	
	

		
1. There is 100% management commitment and involvement in fostering a company/project-wide safety culture.
		


		


		


		
90 to 100 - Excellent Safety Culture
		


		


		


		


		


	
	

		
2. Senior management including the company president is engaged in development, implementation, and enforcement of company programs and philosophy.  This includes regular job site safety audits to monitor the progress of the safety culture and programs at jobsites.  Audits are documented and reviewed w/project management staff.
		


		


		


		


		


		


		


		


	
	

		
3. An accountability program measuring the safety performance of each project and the project management team is in place.  Projects safety record influences each project management team member's annual bonus and salary incentive.  
		


		


		


		


		


		


		


		


	
	

		
4. Job specific safety program is developed, implemented, and enforced on each project.
		


		


		


		


		


		


		


		


	
	

		
5. Pre-Job planning addresses safety, performed by project management team. The plan is in writing and reviewed with all employees on site.
		


		


		


		


		


		


		


		


	
	

		
6. Job Safety Task Analysis (JSTA) performed prior to the start of each activity.  JSTA addresses scope of work, equipment used, identification of exposures, and identification of controls implemented and enforced.  JSTA is in writing and reviewed with each employee engaged in the activity.
		


		


		


		


		


		


		


		


	
	

		
7. Subcontractors contractually obligated to submit JSTA’s prior to the start of their operation, and not permitted to begin operations without JSTA.  
		


		


		


		


		


		


		


		


	
	

		
8. Subcontractors are pre-qualified using established selection criteria.  Requirements include a review of the contractor's safety record including OSHA recordable and incident rate, OSHA citations, and EMR.
		


		


		


		


		


		


		


		


	
	

		
9. Employee orientation for each project is attended by all workers (including subcontractor).  Orientations are documented and kept on file.
		


		


		


		


		


		


		


		


	
	

		
10. All accidents are investigated and reviewed by project management staff as to root cause. 
		


		


		


		


		


		


		


		


	
	

		
11. Upper management regularly reviews the accident record of each project and meets with field management to discuss project safety performance.
		


		


		


		


		


		


		


		


	
	

		
12. Drug and alcohol testing program is in place and performed for all workers on each project. 
		


		


		


		


		


		


		


		


	
	

		
13. Safety infraction policy is in place on each project.  Violation of safety requirements result in penalty to worker resulting in fine and or removal from the project.
		


		


		


		


		


		


		


		


	
	

		
14. A QA/QC program monitoring construction work is in effect, performed and documented by an third party or a specialized in-house unit.
		


		


		


		


		


		


		


		


	
	

		
15. Crane operators are certified by CCO or local city/state certification governing organization.
		


		


		


		


		


		


		


		


	
	

		
16. Crane picks are engineered determining weight of loads, crane selection, and ground conditions.  Engineering includes verification that picks are within the safe working capacity of the crane.  
		


		


		


		


		


		


		


		


	
	

		
17. Fleet management program is in effect for all drivers.  MVR checks are performed and fleet management training conducted and attended by all drivers.  Information is documented and filed for review.
		


		


		


		


		


		


		


		


	
	

		
18. 100% fall management program is in effect company-wide at heights of 6 feet and higher, including steel erection operations.
		


		


		


		


		


		


		


		


	
	

		
19. Contractual risk transfer language meeting insurance company requirements is in place.
		


		


		


		


		


		


		


		


	
	

		
20. A Return to Work program is in effect. 
		


		


		


		


		


		


		


		


	
	

		
21. Temporary light duty positions/assignments are pre-determined.
		


		


		


		


		


		


		


		


	
	

		
22. Annual safety objectives and goals established and discussed by senior management.
		


		


		


		


		


		


		


		


	
	

		
23 Senior Management monitors and evaluates the performance and achievement of these goals throughout the year.
		


		


		


		


		


		


		


		


	
	

		
24. Roles and responsibilities of all management and labor personal addressing safety clearly defined, outlined, and communicated.
		


		


		


		


		


		


		


		


	
	

		
25. Feedback either positive or negative solicited by senior management from field management and labor regarding current safety programs, policies, and safety culture.  This information is utilized to enhance overall safety.
		


		


		


		


		


		


		


		


	
	

		
26. Labor/Management Safety Committee established that meets on a regular basis throughout the year to review and discuss safety related issues.
		


		


		


		


		


		


		


		


	
	

		
27. Stretch and Flex or other overexhursion control program put in place.
		


		


		


		


		


		


		


		


	
	

		
28. Accidents/Claims allocated back to the project where the accident/claim originated.
		


		


		


		


		


		


		


		


	
	

		
29. Superintendents/Project Managers required to meet with upper management to review and explain each loss time accident including measures to be taken to prevent a re-occurrence. 
		


		


		


		


		


		


		


		


	
	

		
30. Crisis Management Plan established addressing appropriate procedures and protocols to be followed when dealing with the news media in a crisis situation at the project site.
		


		


		


		


		


		


		


		


	
	

		
31. Projects are staffed with full time safety personnel.
		


		


		


		


		


		


		


		


	
	

		
32. All management personal including project executive, estimators, project managers, superintendents, field engineers and foreman are required to have at least OSHA 30 hr training certification.
		


		


		


		


		


		


		


		


	
	

		
33. Contractor provides annual training to field managers.
		


		


		


		


		


		


		


		


	
	

		
34. Mandatory safety meeting held are weekly on each project, covering training on project hazards (e.g. scaffolding, PPE, fall, excavation) and topics pertaining to ongoing and/or upcoming activities.  Meetings are documented, signed, and kept on file.
		


		


		


		


		


		


		


		


	
	

		
35. Contractor assigns competent person trained in the appropriate area per OSHA.
		


		


		


		


		


		


		


		


	
	

		
36. Local medical facilities are identified for each project, and arrangements made with facility to handle first aid and non life threatening injury.
		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


	
	

		
Overall Score for Management Commitment
		


		
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