SCS Meeting Feedback

Safety Culture Shift (SCS)

Committee Feedback Form (QF-077-00-174)

Unit / Section

Meeting #

Date

Department

Attendance Details

Total Strength

Actual Attendees

Staff & Mgmt Attendance (Gap)

Meeting Discussions

Topic of Safety Talk & Improvements

Discussion on Safety Incidents

Discussion on Behavior Based Safety (BBS) Audit Observations

Audit Details: Employee Name

Audit Details: Area of Improvement

Discussion on PSM Element

Recommendations / Suggestions

New Recommendations/Suggestions (1, 2, 3...)

Recommendations in progress (from previous)

Recommendations completed/closed

Incident Reporting (40% Ratio Requirement)

No. of Employees

No. of Incidents reported to HSE

Type of Incident (First aid, Near miss etc)

Responsible Unit

Detail of Incident

Verification

Is Deputy Manager participated in the Meeting?