Build a Safety Manual (Templates)

These updated templates can help you build an effective Health & Safety Managment System (HSMS) for your workplace.

**Customize any samples that you choose to use to suit your workplace(s).**

See NSNY's Safety Manual Review Form to ensure you have all the required components in place.

To review the COR and SECOR questions related to each individual section see the COR Harmonized Audit Tool

Section 1: Safety and Health Policy

Assignment of Responsibility and Accountability for Health and Safety

Company Safety Policy

Example of an Organizational Chart

Section 2: Hazard Assessment, Analysis, and Control

Critical Task List

Field Level Hazard Assessment

Formal Hazard Assessment

Formal Hazard Assessment Template from handbook

Combined Hazard Assessment & Tailgate form

Hazard Assessment Policy

Hazard-Assessment-Procedures

Pre-Project Hazard Assessment

Task List Example by Area

WSCB Hazard Assesment and Control Handbook

Sample Formal Hazard Assesment for Office Work

Sample Formal Hazard Assesment for Vaccumm Truck & Swamper

Section 3: Safe Work Practices

Safe Work Practice Policy

Safe Work Practice Annual Review Sheet

Defective Tools SWP

Fire Extinguisher Use SWP

Use of Cleaning Solvents SWP

Section 4: Safe Job Procedures

Safe Job Procedure Policy

Job Hazard Analysis (JHA) Column Style (Sample)

Job Hazard Analysis (JHA) Column Style (Template)

JHA Narrative Style (Sample)

JHA Narrative Style (Template)

Sample JHA Cutting sheet wood with a portable hand-held power saw

Safe Job Procedure Annual Review Sheet

Sample SJP - Backing-Up

Sample SJP - Set-up-traffic-signs

Sample SJP Basic-Office-Safety

Section 5: Workplace Safety Rules

Company Rules Sample

Enforcement Policy

Employee Warning Report

Section 6: Personal Protective Equipment

PPE Policy

PPE Maintenance Record

Info Sheet for Head Protection

Info Sheet for Foot Protection

Info Sheet for Eye and Face Protection

CCOHS Glove Selection Guide

WSCB Code of Practice: PPE Use in Building Constrcution

Section 7: Preventative Maintenance Program

Preventative Maintenance Policy

Inventory List

Maintenance Schedule

Records of Actions Taken form

Equipment & Vehicle Inspection Checklist

Vehicle Repair Log

PreStart Checklist

Aerial Lift Inspection

Scaffold Inspection Checklist

Mobile-crane-and-boom-truck-annual-inspections-guideline-

Section 8: Training and Communication

Training & Communication Policy

Employee Orientation form

Employee Orientation Questionnaire

On the Job Training Form

Safety Meeting Template

Toolbox Meeting Template

Personal record of Safety Meetings

Combined Tailgate & Hazard Assessment Template

CODE OF PRACTICE Young and New Workers

Section 9 - Inspections

Workplace Inspection Policy

Workplace Inspection Form

Office Inspection Form

Sample Inspection Checklist for Offices

Sample Inspection Checklist for Outdoor Areas

CCOHS Effective Workplace Inspections Guide

Section 10 - Incident Investigations and Reporting

Incident Investigation Policy

Incident Investigation Report

Near Miss Report Form

Investigation Procedure

Investigation checklist

Witness Statement Template

First Aid Log

Section 11 - Emergency Preparedness

Emergency Policy Sample

Fire Preventaion Policy

Emergency-Response-Plan-template

Emergency Response Plan template #2

Emergency Phone Number List

Emergency Evacuation Procedure

Emergency Evacuation Procedure Sample # 2

Emergency Prepardness Drills

Record of Emergency Drill

Fire Response Procedures

Section 12 - Statistics, Records, and Document Control

Record-Keeping Policy

Employee Training Records Form

Safety Activity Summary Form

Injury Summary Sheet

First Aid Plan

Nature of Injury Summary Sheet

Year End Injury Summary Sheet

Company Action Plan Template

Records and Stats policy (Large companies)

Module 13 - Legislation

Workplace Legislation

Medical Monitoring

Right to Refuse Unsafe Work

3 Worker Rights

Module 14 - Procurement and Contractor Management (NEW)

( scoring related to these questions in the 'V-2023' Audit Document' will not be counted in the final tally during the phase-in period )

Procurement & Contractor Management Policy Sample #1

Subcontractor Policy Sample #2

Service Provider Pre-Qualification Checklist

Contractor Safety Orientation

Pre- Construction Sub- Contractor Safety Checklist

Contractor Compliance Declaration

Section 15 - Territorial Supplement

15 A - Health and Safety Committee's (HSC) & Worker Health & Safety Rep (WHSR)

Refer to Sections 36-43 of the WHS Act to determine the requirements for your workplace

HSC Agenda

HSC Meeting Minutes

WHSR Policy

15 B - Return to Work (RTW)

Work related absences flow chart

15 C - Workplace Violence and Harassment Prevention (WVHP)

Workplace-violence-and-harassment-prevention-policy

Workplace Violence and Harassment Prevention Guide

Factors-influencing-workplace-violence-and-harassment

Respectful-workplace

Domestic-violence-in-the-workplace

Additional Forms and Policies

Drug and Alcohol Policy

Environment Policy

Ergonomics Policy

Working Alone Policy

Working in Extreme Temperatures Policy