Contractor Competency assessment form (Star rating system) - Annexure "8"

Form No:SAFETY/FORMS/CSM/08 Revision No:05 Effective Date :1st Nov 2019

CSMS TOTAL SCORE
Organization name
Contractor Proprietor
Name
Organization Registered
Address
674 CSMS RATING : 3 Star
Mallik engineers Assessment team :
Mr. Parmod Kumar Mallik- Proprietor Team Leader : Abhishek Vishal DNV-GL
Vendor Representative:-
1. Mr. Pramod Kumar Mallik- Proprietor.
Ghatotand, west Bokaro Division Pin- 825314 Team Member : 2. Mr. Arjun Karmali- safety sup.

TSL representatives (CA/ 9.30 AM.

CO /Mentor / Local safety Mr. Jeetendra Sharma P.No- 267887 Date of Assessment 23.09.2020
professional)
Comments by Assessor : Last assessment has been done on 02nd May 2019 .
Vendor Code MK64
Action plan with closure has been seen.
Work Order No.1: 4700083618 Valid
till 10.03.2023 with Rs. 2.73 Cr for Department : C & SM CO Name & Personal No.: Mr. Jeetendra Sharma P.No- 267887
three years

Work Order No.2: Department : CO Name:

Active work order
numbers with Department
Work Order No.3: Department : CO Name:

Work Order No.4: Department : CO Name:

Audit Location:

Risk Parameter: (Risk of  High Risk :

job where contractors to Low Risk :
be engaged)
Both :

Type of Contract

Manpower contract 
Supervision contract 
Set apart contract
Transient contract

Other Services

Tick the type of work the company is capable of undertaking :

Civil, Structural & Building

Lifting equipment Maintenance and Services Utility Services
Maintenance

Electrical Maintenance and

Cleaning Services Mechanical Maintenance and services
Services

Instrumentation Calibration Transportation and Material

Catering Services
and Testing Handling
Waste materials / slag /
Manpower supply Mining related activity
reclaiming & disposal

Lifting, Loading, Unloading,

Road maintenance Rail maintenance
feeding & packaging

Any Others, please specify ARC Job for Quarter Repairing and maintenance


1.What is total manpower strength of your organisation working in Tata Steel? 17- Total manpower

1.1. Number of Supervisors and their qualifications (Attach list): 1- site sup

1.2. Number of certified and skilled employees (Please attach list of employee with skill level): 8- skilled + semi skilled

1.3. Number of unskilled employees: 9- unskilled

1.4. Number of Site Safety Supervisors and their qualifications (Attach list): 1- safety sup

2.Total Value of Contract in currency as applicable with Tata Steel: Example in Rupees: (less than 5 Lacs / 5 to
Rs. 2.73 cr for three years
25 lac/ 25 lac to 1 crore, and above 1 crore If more than 1 crore, mention exact value ).

3. Name of the departments/locations where you are currently engaged in Tata Steel: TSL WB

Mr. Pramod Kumar Mallik-

4. Organisational Structure of your organisation: (e.g. MD, GM, Managers etc.)
Proprietor.

Evaluation Criterion for Star Rating and Safety Performance Evaluation

0 = Process not yet started/ No System.

0 = Process not yet started/ No System.
1 = Poor- Weak Safety system and process, weak or no system of Lead Indicator identification, reporting and compliance monitoring; little awareness; minimal or no ownership and
commitment. (Survival)
2 = Reasonable- Some system & process exist; inconsistent system of Lead Indicator identification, reporting and compliance monitoring; awareness may be present, but implementation
of this aspect is haphazard or not evident at all. (Reactive stage)

3 = Good- Safety Management system & process exist and documented; improving trend of system of Lead Indicator identification, reporting and compliance monitoring; system is
implemented at the minimum levels; ownership and commitment visible at some extent. (Dependent stage)

4 = Very Good- H&S Management System is addressed systematically, documented and updated regularly, reaching the respective targets regularly; good system of Lead Indicator
identification, reporting and compliance monitoring; integration with other activities is at high levels; felt and visible ownership and commitment. (Independent stage)

5 = Excellent- Can be recognised as a leader in this particular aspect of the H&S Management System; everyone is involved and high levels of integration and ownership & commitment
are demonstrated.; continuous improvement is evident. (Interdependent stage)

Assessment Frequency: Once in two years(within 24months) for the 4 & 5-Star rated vendors and once in a year(within 12 months) for 3 -Star rated Vendors from the date of the previous assessment .
Assessment reports must be logged in ‘ENSAFE-IT SYSTEM’ by the CA/ CO within 4 days after receiving report from central safety team. [Refer to DOC. NO.: SAFETY/PROC/CSM/ 01, SAFETY/PROC/CSM/ 02]
NOTE: [(5 Star- 850-1000), (4 Star-750-849), (3 Star-650-749), (2 Star- 550-649), (1 Star- 450- 549), (No Star- Less than 450)]
All the requirements will be evaluated in a scale of 0 to 5 which will be weighted for Star rating score calculation.
 Evaluation
Multiplying Actual
Attributes SN Criteria Requirements Guideline for audit Expected Aspects status Remarks
factor score
( on the 0 to 5 )
1.1 Safety & Health Management 0. 0% :No system exists. # No system exists- no policy , no organization
System (Policy & Principles, structure. Documented Policy is there but legal & Other requirement has not been mentioned in the
Safety Manuals, Safety 10 0
same. Organizational structure is also there.
Organization) (Safety manuals –
(Look for HIRA or JHA
document, Legal compliance 1. 20% : Documented Safety and Health #Documented Safety and Health management Organizational structure is there in the procedure manual having ref no. ME/OHSM/01/00
system, Emergency Planning management system exists and system exists and organizational structure Dated 12.02.2020.
system, Safety dash board, organizational structure exists. exists- safety manual (policy, procedure, Documented Policy is there but legal & Other requirement has not been mentioned in the
Safety audit & review system, objectives,OCP,hazard & risk assessment- same.
Operational control, Asset GRA/HIRA, JHA, SWP,SOP, emergency JHA is in place but seasonal and ergonomical hazard has not been identified in the same. MSDS
Management). preparedness & response plan), organization has also not been included in JHA as administrative control measure as per the scope of job.
10 0
structure (roles and responsibility , competence MSDS also not familiar.Hierarchy control measures is not familiar
management)

2. 40% : Regular Audits done through # Regular Audits done through Internal & Regular audits has been planned as per the site severity audit format internally in which
Internal & External agencies. External agencies- audit done at planned severity index target has been set as <=2.22 but in some cases 2.37 has been seen but for the
interval either internal or external in reference same, review mechanism has not been developed- Only CAPA has been taken.
to requirements / criteria (CSMS,OHSAS OR EPRP system is is in place but certified first aider is not in place.
other safety management system) 10 0

3. 60%: Evidence exists for Corrective and #Evidence exists for Corrective and Preventive CAPA has been prepared for rating 3 as per the severity report dated 22.08.2020 but it is not
Preventive action taken along with action taken along with improvement regularly- fully taken. Only correction has been taken - No corrective action has been taken against the
improvement regularly. based on audit presence of corrective and root cause.
preventive action along with root cause Tools list is there in which 30 m measuring tape is used which ahs not been highlighted in the
3 10 30
analysis. master sheet. Also no calibration / Test certficate of the same has been seen.

4. 80%: Continuous improvement in the # Continuous improvement in the system based Lead & Lag has been prepared in which repeatation of PPE's violation has been seen from
system based on feedback of Audits. on feedback of Audits - improvement in April20 to Aug 2020 but review mechanism has not been developed for the same.
objective (leading & lagging indicator), & No continual improvement trend has been made.
evidence of continual improvement trend. 10 0

5. 100% participation of all employees # participation of all employees along with all
along with all of above. of above - evidence of participation in tool box
talk, safety meeting, safety campaign, safety
quiz, safety competition etc. 10 0

1.2 Documented procedure on 0. 0% :No system exists. # No system exists - No procedure for selection
selection, deployment of skilled and deployment of skilled and Certified 10 0 Procedure is there for selection and deployment of skilled employee.
and Certified employees. Job employees
description, Roles & 1. 20% : Benefit of Safety Certification given # Benefit of Safety Certification given at the
Responsibilities to be available at the time of employment time of employment - whether safety
mentioning safety as one of supervisor, project manager have undergone
the mandatory requirement any formal certified safety courses (OHSAS, One safety sup is there who has gone training from TATA STEEL Vendor capability i.e V CAP In
10 0
(Which institute ,Type of skill NEBOSH,RLI/CLI courses, diploma in industrial which he has been certfied as safety sup.
training like Mechanical, safety, Tata Steel courses)
Electrical etc..)

2. 40% : Existing Personnel encouraged # Existing Personnel encouraged undertaking

undertaking safety courses. safety courses - company initiated , sponsored
No record produced for sponsored safety training. But as per the interaction V CAP has been
safety training. 10 0
provided by the company end.
 training like Mechanical,
Electrical etc..)

3. 60% : Safety a mandatory requirement # Safety a mandatory requirement for engaging

for engaging all employees.
all employees - safety aspect in job description,
appointment/employment contract.
Safety a mandatory requirement has been mentioned in the roles and responsibility and also in
3 10 30
the HSE Policy.

4. 80% : Documented Safety certification # Documented Safety certification requirement

requirement beyond a certain level in the beyond a certain level in the hierarchy - safety
hierarchy. certification course by safety supervisor project
manager & above.
10 0 No safety certfication is there beyond a certain level in the hierarchy.

5. 100% : Positions beyond a certain level # Positions beyond a certain level can be
can be occupied by personnel having occupied by personnel having exemplary safety
exemplary safety records and having safety records and having safety certification - 10 0
certification. evidence of safety competence of top
management , excellent safety record.
1.3 Documents showing safety 0. 0% : No system exists. # No JHA in place 10 0 JHA is in place.
planning process for safe
execution of jobs- JHA 1. 20% : Job hazard Analysis exists for 25 % # 20% Job takes into account of JHA, but no
document, Audit plans, of the jobs. No evidence of preventive and corrective and preventive measures in place 10 0
planning for tools & corrective measures at site.
equipments,Job execution plan, 2. 40% : Job hazard Analysis exists for 50 % # 40% Job takes into account of JHA, but no
work permit system, Method of the jobs. No evidence of preventive and corrective and preventive measures in place
statement corrective measures at site
10 0

1.Planning 3. 60% : Job hazard Analysis exists for 50 % # 60% Job takes into account of JHA, with
of Safety of the jobs. The jobs are well planned and preventive measures planned w.r.to potential
System & evidence exists of Safety features at site to hazard identified
Process counter the Hazards identified.
JHA is in place but seasonal and ergonomical hazard has not been identified in the same. MSDS
3 10 30 has also not been included in JHA as administrative control measure as per the scope of job.
MSDS also not familiar.Hierarchy control measures is not familiar

4. 80% : Job hazard Analysis exists for 75 % # 80% Job takes into account of JHA, with
of the jobs. The jobs are well planned and preventive measures planned w.r.to potential
evidence exists of Safety features at site to hazard identified
counter the Hazards identified.

10 0

5. 100% : Job hazard Analysis exists for 100 # 100% Job takes into account of JHA, with
% of the jobs. The jobs are well planned preventive measures planned w.r.to potential
and evidence exists of Safety features at hazard identified 10 0
site counter the Hazards identified

1.4 System and processes for
training on Safety standard,
Behavioural based, Job specific,
skill development, emergency
preparedness for employees
and supervisors.
0. 0% :No system or process exists.
1. 20 %: Documented system and process
exists along with training organizational
structure and infrastructure.
# No system or process exists - 10 0
# Documented system and process exists along
with training organizational structure and
infrastructure - Organization has defined 10 0 Documented system and process exists along with training organizational structure
personnel for training , training infrastructure
1.4 System and processes for
training on Safety standard,
Behavioural based, Job specific,
skill development, emergency
preparedness for employees
and supervisors.
1.5 System for two way
communication (Top – Bottom
– Top) between contractor
leadership and their workforce
(Proprietor engagement in line
walk, Safety meeting etc.).
2. 40 %: Along with above a training # Along with above, training records maintained
records maintained on all SOPs. on all SOPs - Training on SOP given with Training plan for FY 20-21 has been seen. But some of the training has not been included in
evidence/record. 10 0 terms of MSDS, material handling etc.
Some sample training record has been verified in terms of SOP's, EPRP, BBS, Work permit etc.
3. 60%: Along with above SOPs getting # Along with above SOPs getting revised based
revised based on feedback continuously on feedback continuously - revision on SOP
based on feedback (training effectiveness)
Training need identification is in place but it needs to be reviewed ased on the organizational
structure.
3 10 30
No SOP's has been revised based on the employee's feedback.
PRE/Post system is there for evaluation but re training criteri has not been defined .
4. 80%: Along with above pictorial SOPs # Along with above pictorial SOPs displayed at
displayed at site in regional languages for site in regional languages for better
better understanding of all employees. understanding of all employees - pictorial SOP's are there . Some pictorial SOP's are there at the site as per the inetraction which needs
display of SOP (in regional language) 10 0
to be verified during the site tour.
5. 100%: Along with the above employees # Along with the above employees display an
display an exemplary understanding of all exemplary understanding of all SOPs at site - 10 0
SOPs at site. interview / discuss during site visit.
0. 0% : No system or process exists. # No system of communication 10 0
1. 20 %: Documented system and process # Documented system is in place for internal
exists for communication between all levels communication. MoM available as
10 0 Documneetd system has been seen for internal communication.
of Contractor leadership and their record/display in office
workforce. Visual displays MoM of
meetings
2. 40 %: and action
Along withtaken
the reports.
above evidence
# Documented system is in place. Evidence of Two way communication record has been verified in terms of line walk, mass meeting and
exists of leadership team visits and Leadership team visit, discussion and action minutes of meeting. Some sample has been verified on randonm basis.
discussions and action. exist Minutes of meeting - Two way reflected.
10 0
Line walk- One way approach has been seen dated 08.08.2020
Mass meeting agenda has been seen with two way .
Team visit has been seen for the same.
3. 60%: Along with the above evidence # Along with above top management
exists of leadership team and the involvement in implementation action exist
proprietor visits and discussions and action (evidence is must)
Top management involvement has been there. But in some cases observation is there only
3 10 30 from top to bottom . It needs to be in such a fashion that top-bottom-top i.e bottom points
should also be there during the communication meeting.
4. 80%: Along with above record of # Along with evidence exist w.r.to feedback and
improvements undertaken as a result of communication on action
such communication and feedback
Some of the feedback has been taken along with the compliances.
Reward system is in place .. Last has been given to Mr. Kuleshwar Agaria on 26th Aug 2020
10 0
during the mass meeting. Only photographs is there which doesn't reveals the purpose. No
banner is in place.
 5. 100%: Along with the above recognition # Along with above reward/recognition
and reward for participants for such mechanism exists for participation/ suggestion
communication exists on action (evidence/record)

10 0

2.1 Capability of Workforce, (Skilled # Deployment of certified supervisors ,site a) Deployment of below 70% certified
,Certified Competent safety supervisors and specific job required employees at site , Score- 0 marks
Supervisor, Site Safety employees from JNTVTI or other TSL b)Deployment of 70 to 99% certified
Supervisors and manpower approved institutions. employees at site , Score- 10 marks Only 6 employees out of 9 are provided with Competency certificate which is 66% , Safety
etc.) Verify through site visit c) Deployment of 100% certified employees at 0 10 0 training pass is available with all the employees: Action to be taken: Competency training to be
and Interview. site , score- 20 marks provided to all the employees.

Hazard identification and Risk assessment a) Inadequate hazard identification and poor
:Inclusion of site specific , job specific and implementation of safety measures mentioned
adequate six directional hazard in Work in work permit ,score – 0 marks
Six directional Hazard were not identified properly as observed during audit. In report I have
permit .Job Hazard Analysis by contractor b) Site specific & job specific hazards and safety
0 10 0 collected the avidance. and SOP and JHA Was not proper information of the Line supevisor.
supervisors .Learnings from JHA measures mentioned adequately in work
Action should be tacken . All employee and supervisor are required to SOP training.
incorporating in ‘SOP’ permit and implemented ,score – 10 marks

# Compliance to deployment of applicable a)Below 70 % compliance to safety standards

safety standards at site as mentioned in and ‘SOP’ ,score - 0 marks
“SOP” and permit system b) 70 % to 99 % compliance to safety standards
and ‘SOP’ ,score - 10 marks
c) 100% compliance to safety standards and
‘SOP’ ,score - 20 marks
80% complaince of safety standard followed in the work site . Material storage area has
1 10 10 proper barricading. Fire extinguisher available and Regular work permit is being followed and
documented. Sop is being displayed and followed at work site.

2.2 Conducting Tool box, mass # Conducting Tool Box meetings daily at all a) Inadequate records on Tool Box meetings
meeting regularly and sites of location by site supervisors , site and poor coverage of supervisors in Tool Box
leadership engagement safety supervisors .Participation of meetings ,score – 0 marks
(Contractor proprietor line Proprietor / Locational in charge in Line b)) Maintaining adequate records of Tool Box
walk). (Verify through Records, walks and Monthly mass meetings and meetings and all supervisors participating in
Tool box register was maintained on daily basis, Line walk by Proprietor/ Locational in-charge
Interview & site visit) maintaining records Tool Box meetings ,score – 10 marks 1 10 10
was found maintained, involvement of top management seen in MASS meeting.

Coverage of 100% employees of all the sites a) Below 80% , score - 0 marks
of Location in Tool Box Meetings b)80 % to 100% coverage of all supervisors and
employees in Tool Box Meetings ,score - 10 1 10 10 All employees and supervisors attend the tool box meeting every day at work site.
marks
# Compliance on points captured during a) Compliance below 80 % , score – 0 marks
proprietor line walks ,Tool Box meetings b) Compliance from 80 to 94 % , score – 10
and Mass meetings marks Tool boxmeeting was captured in feed back form, 87 % of job completed(8 out of 7) of the
c) Compliance from 95 to 100 % , score – 30 1 10 10 Compliance done for points captured in Mass Meeting(13 out of 14) and 97% compliance for
marks points captured in Proprietor line walk.
 2.3 Providing & ensuring usage of
standard (IS/EN) and right PPEs
while performing the job.
Ensure timely replacements.
(Verify through site visit and
Interview).
2.Impleme
ntation
Safety
system
and
Process
2.4 Providing & ensuring safe usage Availability and usage of applicable and
of standard, certified and right standard tools & tackles by contractor at
tools & tackles, equipment's working site
and calibrated safety gadgets
(e.g. Gas detectors) while
performing the job. (Verify
through Records and Site visit)
2.5 Ensuring a good housekeeping
free from any slip / trip / fall
hazards at working sites. (Verify
through site visit)
Hazard mapping with respect to location a) Hazard mapping not available and
specific and usage of applicable and compliance of required PPE below 80% ,score –
standard PPEs by contractor employees at 0 marks
working site b) Availability of Hazard mapping and 80 % to
99% employees using required and standard
2 10 20 Hazard mapping of PPE was avilable at work site. all ppe used for work site as per standard.
PPE ,score – 10 marks
c) Availability of Hazard mapping and 100%
employees using required and standard PPE
,score – 20 marks
Physical condition of PPE using by a) Some of employees using non defective PPE ,
employees at working site score - 0 marks
b) 100% employees using non defective PPE work site employee PPE Physical condition was not ok Ex:- one contractor employee's Safety
0 10 0
,score - 20 marks shoes was in damaged condition at work site
Regular audits on usage of PPE by a) Poor compliance on Audits on PPE usage and
supervisors and review of PPE quality and review , score – 0 marks
improvements by vendor b) Regular audits by supervisors with specified
frequency and review by vendor on monthly Planned inspection of PPE's are in place and done on regular basis ppe review on the site
1 10 10
basis , score – 10 marks Example :- reflective jacket
a) List of Standard, applicable Tools & Tackles
not available and sub standard Tools & Tackles
being used at site ,
score – 0 marks
b) List of 80 % to 99% Standard, applicable
Tools & Tackles available and being used at site All tools and tackels set list available at work site. and all the tools and tackles used are found
2 10 20
,score – 10 marks as per standard.
c) List of 100% Standard, applicable Tools &
Tackles available and being used at site ,score –
20 marks
Physical condition & legal compliance of a) Legal compliance not followed and poor
applicable tools-tackles & equipment at condition of Tools & Tackles , score – 0 marks
working site ( As applicable) b) 100% Legal compliance being followed and
all the Tools & Tackles are defective free ,score - inspection and testing of tools and tackles are found evident. No tools and tackles are found
2 10 20
20 marks defective at the time of audit.
Tools & Tackles based audit by a) Poor compliance of audits and review ,
contractor's supervisors (site verification) score – 0 marks
b) Regular audits by supervisors with specified
Found OK. Safety review meeting is also done at work site. Quality has also been changed at
frequency and review by vendor on monthly 1 10 10
work site.Ex:- Rubber grip hammer
basis , score – 10 marks
Working sites house keeping maintained in a) Poor house keeping at site ,score – 0 marks
systematic approach .Material storage b) 100% compliance to excellent House keeping
area, stores area and rest sheds at site ,score – 20 marks
2 10 20 Rest and work place area was properly maintained, area was free from slip trip fall hazard.
orderliness maintained. Free from Slip /
Trip / Fall hazards.
Implementation of 1S ,2S at site. a) Concept of 1S & 2S not followed , score – 0
marks
Site was maintained properly, proper display was avialable at site, Initiative taken to improve
b) Deployment of 1S & 2S at site ,score - 20
2 10 20 housekeeping in near by area.Reward and recognition done to the employees engaged in
marks
Housekeeping activities.
 #and approach for 5S concept at working a) Poor compliance of audits and review ,
sites . Check list developed on 5s and being score – 0 marks
followed regularly b)Regular audits by supervisors with specified
frequency and review by vendor on monthly 0 10 0 5S audit monthly basis also done but work site is not implement. action should be tacken
basis , score – 10 marks

2.6 Self-Safety Initiative / Project by # System of safety improvement projects
contractor for Safety exist and known to 100% supervisors.
Improvement Involvement of top management in self
initiated safety projects (record of no. of
suggestion received, no. of suggestion
implementation, resource provision)
a) System not exist and poor engagement of
top leadership ,score – 0 marks
b)System exist ,involvement of top leadership in
implementation of safety improvement projects
.Process of suggestion management exist to Involvement of top management evident in SIP projects, Suggestion is evident, total of 20
2 10 20
capture from employees ,score – 20 marks suggestions are identified and implemeted at shop floor.

# Safety improvement projects a) Below 4 safety improvement projects in a

implemented at working sites year , score – 0 marks
b) Minimum 4 safety improvements at site in 4 SIP related to site safety done. Rubber grip hammer ,drill machine ,wood cutter machine,
2 10 20
a year ,score - 20 marks chopsaw machine,

Safety projects to improve system related a) Below 2 system related safety improvement
gaps in a year , score – 0 marks No system related safety improvement project found. Action to be taken: System Related
b)Minimum 2 system related safety 0 10 0
iprovement project to be done
improvements in a year ,score - 10 marks

3.1 Contractor safety audit by the 0. 0% -System does not exists # No safety audit done
8 0
contractors' supervisor and site
safety supervisors in the field. 1. 20%-Regular self-audits not done. # Safety audit done on adhoc basis (no audit
(Verify records) 8 0 Safety audit done as per the defined plan.
plan, no checklist)
2. 40% -Audit done occasionally but no # Safety audit done with no record
8 0 Safety audit done with some same record has been verified.
record found
3. 60% -Regular audit done but record # Safety audit done as per plan, but no record
not in place. Regular audits has been planned as per the site severity audit format internally in which
3 8 24 severity index target has been set as <=2.22 but in some cases 2.37 has been seen but for the
same, review mechanism has not been developed- Only CAPA has been taken.

4. 80%-Regular audit done, record is in # Safety audit done as per plan, report available
place with follow up action. with CAPA CAPA has been prepared for rating 3 as per the severity report dated 22.08.2020 but it is not
8 0 fully taken. Only correction has been taken - No corrective action has been taken against the
root cause.

5. 100%-The same points are not # Safety audit findings are not repetitive
8 0
recurred in the next audit (effectiveness of audit)
3.2 Corrective and preventive 0. 0%: No system exists. # No CAPA 6 0
action on self-audit report 1. 20%: System for identification of # CAPA covers unsafe practices of severity 4&5
6 0 No severity of 4 & 5 has been seen as per the produced record. So No CAPA.
specifically on 4 & 5 severity unsafe practices of severity 4 & 5 exists.
potential. (Verify records & site 2. 40%: Structured review mechanism # Review of CAPA of unsafe practices of severity
No unsafe practice of severity 4 & 5 as per the record of severity report. But CAPA is in place
visit) for unsafe practices of severity 4 & 5. 4&5 2 6 12
for rating 3.
3. 60%: Systematic process of # Systematic process of correction of all unsafe
correction of all unsafe practices of severity practices of severity 3, 4 & 5 exists. Regular audits has been planned as per the site severity audit format internally in which
3, 4 & 5 exists. 6 0 severity index target has been set as <=2.22 but in some cases 2.37 has been seen but for the
same, review mechanism has not been developed- Only CAPA has been taken.

4. 80%-There is no unsafe practice of # No unsafe practice of severity 4 & 5 observed

severity 4 & 5 observed during filed visit. by auditor during filed visit at the time of 6 0 No unsafe practices of 4 & 5 has been seen.
assessment.
5. 100%-Procedure violations of # Procedure violations of severity 3 does not
6 0
severity 3 does not exists exists
3.3 Compliance to Generic and 0- 0%- Basic deviation of PPE observed # Basic deviation of PPE observed
6 0
Specific Safety clauses as per
contract. (Verify through site
visit and Interview based on
some Work order).
 3.3 Compliance to Generic and
Specific Safety clauses as per
contract. (Verify through site 1- 20%-Generic safety clauses have # Generic safety clauses have been followed
visit and Interview based on been followed
some Work order). 6 0 Generic safety clauses have been followed

2- 40%-Specific safety clauses with # Specific safety clauses with reference to

reference to hierarchy of hazard control is
followed
3- 60%-Safety violation with respect to
workforce capability does not exists
4- 80%-Infrastructure resources tools &
tackles are provided with right quality
5- 100%-Process of doing job has been
standardized and followed and learning
and integration approach is visible
hierarchy of hazard control is followed
# Safety violation with respect to workforce
capability does not exists
3 6
# Infrastructure resources tools & tackles are
provided with right quality
# Process of doing job has been standardized
and followed and learning and integration
approach is visible
6 0 Specific safety clauses with reference to hierarchy of hazard control is followed
work order is in place. But generic and specific safety clause has not been captured. . it needs
to be captured based on the scope of Job.
18 Safety violation with respect to workforce capability does not exists as per CO and even the
same has been verfied with the site audit report observation.
Infrastructure resources tools & tackles are provided with right quality as per CO.
Tools list is there in which 30 m measuring tape is used which has not been highlighted in the
6 0
master sheet. Also no calibration / Test certficate of the same has been seen.
6 0

4.1 Reporting, investigation and 0- No system of reporting incident and
learning of all incident / health issues
accident, Health issue. 1- Adhoc and weak system available
2- A documented procedure for
reporting of incidences exists and followed
and investigation carried out
# No system of reporting incident and health
8 0 Repoting system is in place.
issues
# Adhoc and weak system available 8 0
# A documented procedure for reporting of
incidences exists and followed and investigation
8 0 Documented procedure has been there for reporting accident/ Incidents.
carried out

3- Reporting and investigations done # Reporting and investigations done No Health related issue has been taken place during the Last FY 20-21 to till date as stated by
systematically and root causes are systematically and root causes are identified the employee present during the document verification.Even the same has been verified
3 8 24
identified through the lead and lag indicator data. RED/ORANGE/GREEN stripe is well knwon to the safety
sup .But LTI concept is not much clear.
4- Recommendations are implemented # Recommendations are implemented and Last Stripe has been shared related to ORANGE 08.06.2020 During the TBT. TBT record along
and learning shared learning shared 8 0 with the stripe record has been verified. Learning is shared from the other incidents and
implemented .
5- Learning from other incidents shared # Learning from other incidents shared and
and implemented implemented 8 0

4.2 Near miss and Unsafe act / 0- No system of reporting incident and # No system of reporting near miss & unsafe
8 0
condition reporting, health issues act/ condition
investigation and corrective 1- Adhoc and weak system available # Adhoc and weak system available 8 0 System is there for capturing of near miss
action. 2- A documented procedure for # A documented procedure for reporting of
Documented procedure is there for the same. Reporting of near miss is being carried out .
reporting of Near miss exists and followed Near miss exists and followed and investigation
Total 05 in nos has been captured for the fy 20-21 till date. Weak system is there.
and investigation carried out carried out
8 0 Last has been done on 26.08.2020 as per the record for which CAPA has been taken but as per
the CAPA- Correction has been highlighted in the part of corrective measures. Moreover last
Near miss is not appropriately known to the one present during the assessment.

3- Reporting and investigations done # Reporting and investigations done

Last has been done on 26.08.2020 as per the record for which CAPA has been taken but as per
systematically and root causes are systematically and root causes are identified 3 8 24
the CAPA- Correction has been highlighted in the part of corrective measures.
identified
4- Recommendations are implemented # Recommendations are implemented and
8 0 Near miss has been discussed to site employee as per the record.
and learning shared learning shared
5- Learning from other near miss shared # Learning from other near miss shared and
8 0
and implemented implemented
4.3 Skill retention, amenities, 0- No system. No amenities and high # No system of skill retention
employees liability etc. (Verify skilled employees turnover # No amenities provided 8 0
4.Perform through records and Interview) # High employee turnover
ance 1- Amenities provided and it is of # Amenities provided is of minimum
8 0 Amenities are provided which is of minimum requirement.
Measure: minimum requirement requirement
Lead 2- Employees are motivated and remain # Employees are motivated to remain in the Employees are motivated to remain in the organization as per the interaction with the one who
2 8 16
indicator with the organization organization is present during the assessment.
3- Employees grievances are recorded # Employee grievance are recorded and Grievnaces capturing system is not in place.It has not been developed yet.
8 0
and individual consideration is given considered for action
4- No grievances from employee and # No grievance from employees on amenities No grievance from employees on amenities provided, hygiene and workplace environment
amenities are provided considering hygiene provided, hygiene and workplace environment 8 0
and workplace environment
5- A feedback system exists for # Feedback system exists to capture employee
capturing employees engagement and suggestion, engagement and retention 8 0
retention
 4.4 Campaign e.g. (Safety quiz,
Safety skid etc.) to develop
Safety Culture. (Verify through
records and Interview)
0- No system for safety campaign # No safety campaign 8 0
1- It is done haphazardly # Adhoc safety campaign 8 0 Safety campaign plan is in place.
2- Done systematically and involvement # Safety campaign done systematically (record
8 0 Campaign plan for fy 20-21 with responsibility has been planned.
of employees are there is must)
3- A monthly or annual plan is available # Plan for campaign available with theme
and campaigns are conducted as per theme 8 0 Campaign available with theme for the entire year of 2020.

4- Ownership of campaign are fixed and # Responsibility of campaign are defined and
Responsibility of the campaign has also been defined.Last has been carried out on 08.09.2020
topic based are conducted topic based campaign are conducted
4 8 32 related to housekeeping for which presence list has been seen from the bottom end. But
concept of 1s & 2s is not much clear to the one who is presenting the documents.

5- Campaigns are linked to past # Campaigns are linked to past incidents and
8 0 No such campaign has been organized that has been linked to past accident/ Incident.
incidents and based on learning based on learning (record/evidence)
4.5 Reward, Recognition and 0- No system # No system 8 0
Consequence Management 1- Ad hoc system available # Ahhoc system 8 0
System of Contractor. (Verify 2- There is criteria and documented # Defined criteria & documented procedure
8 0 defined criteria nad documented procedure is there for the reward system.
through records) procedure for both
3- System is followed and applied to # Mechanism of bad & good performer exist Reward system is in place .. Last has been given to Mr. Kuleshwar Agaria on 26th Aug 2020
identify good and bad performer (shall be transparent and shall be known to 3 8 24 during the mass meeting. Only photographs is there which doesn't reveals the purpose. No
employees) banner is in place.
4- PDCA is followed and learning and # PDCA is followed and learning and integration PDCA is not followed appropriately.
integration approach visible and reduction approach visible and reduction in unsafe acts Consequence maangement system is there but it has not been communicated appropriately
in unsafe acts and practices and practices 8 0 among the employee- verified with the interaction with the one present duirng the
assessment.
But no consequence has been applied to anyone till date.
5- There is positive impact among # Positive impact amongst employees and they
contract employees and they are highly are motivated 8 0
motivated
Nil as per ENSAFE
0-60 # No LTI/Serious injury/ permanent
Zero Lost time /serious injury disablement incident
5.1 60 60
or permanent disability
>/=1-0 # 1 or more LTI/Serious injury/ permanent
disablement incident
5.Perform
ance 0-40 Score # No first aid incident Nil as per ENSAFE
measure: 5.2 Zero First aid case 40 40
1 or more-0 score
Lag # 1 or more first aid incident
indicators 0-10 score # No property damage case Nil as per ENSAFE
Non-Injury Incidents (e.g.
applicable 5.3 10 10
Property Damage) 1or more-0 score
for the # 1 or more property damage case
Location Safety violation of fatal # No fatal potential violation of severity 4 & 5 Nil as per ENSAFE
itself 0 - 20
potential of severity 4&5 violation.
(Previous 5.4 20 20
(reference contractor safety # Fatal potential violation of severity 4 & 5
Financial >=1 - 0 violation are more than or equal to 1.
audit system)
year and
Safety noncompliance cost 0-20 score # No cost recovery violation evident Nil as per ENSAFE
Current
5.5 recovery / Penalty imposed / 20 20
Financial 1-0 score
Job stopped. # 1 or more cost recovery violation evident
year as on
assessmen # No fatality, zero score will be awarded, i.e. no Nil as per ENSAFE
0 : 0 score
t date) deduction of marks.
Fatality : 1 # If vendor is responsible -100 score will be
5.6 Fatality of contractor employee a) Responsible awarded.i.e 100 marks will be deducted from 0 0
b) Not Responsible total score
# If vendor not responsible, marks will not be
deducted.

TOTAL SCORE 674

1
Yes
Self assessment done by vendor :Yes / No

2 Verified by CO / Mentor : :Yes / No Yes

Yes
Report (1 &2) seen by Third
party agency during assessment :Yes / No
Annexure #1
CSM Star rating assessment key findings and feedback form
(A) Key Audit findings:
1.
2.
3.
4.
5.
(B) Feedback by CO (TSL employee) and Vendor :
a) Are the auditors following Scope of assessment?
Ans: Yes / No
b) Behavior of Auditor?
Ans: Good / Satisfactory
c)Field visit conducted by the Auditor?
Ans: Yes / no
d)Have you understood Auditor’s inputs?
Ans: Yes / No
e) Any suggestion on assessment process of auditors?
Ans:
Acceptance taken in Teams chat box from vendor

(C) Contract Owner (TSL employee - Name, P. No. & signature): Mr. Jeetendra Sharma P.No- 267887
Email id Mobile number:

(D) Vendor code: MK64 Organization and Rep. name: Mr. Pramod Kumar Mallik- Proprietor

Email id Mobile number:

( E ) Name of theAssessor and signature: Mr. Abhishek Vishal- DNV.GL
Assessor Name and signature: abhishek

4.Audit Date - 23.09.2020…Time- 09.30AM Location - WB

Incase of online audit please ask the CO to download the participant list and mail it for the purpose of attendance
Else take a print screen

1. Mr. Pramod Kumar Mallik- Proprietor.

2. Mr. Arjun Karmali- safety sup.