Checklist

 of  Required  OSH  Permits  and  Policies  

 
No.   Particulars   Reference   Y   N   Proof  of  Compliance  
1   Registration  of  Establishment   Rule  1020       No.   &   D ate   approved  
 
 
 
2   Training  of  Safety  Officers,  OSH   Rule  1030       Name  of  appointed  Safety  Officers  and  
Practitioners’/OSH  Consultants’   BOSH/COSH  Training  completed;  List  of  
accredited  OSH  Practitioner(s)/  Consultant  
Accreditation   and  their  accreditation  no  and  validity.  
 
 
 
 
 
 
 
3   Report  of  Safety  Organization   Rule  1040       Date  submitted:  
 
 
 
4   Minutes  of  the  Meeting  of   Rule  1040       Date  submitted:  
Safety  &  Health  Committee    
 
(Quarterly)    
5   Employee’s  Work  Accident/Illness   Rule  1050       If  applicable,  date  submitted:  
Exposure  Data  (for  every    
 
accident)      
6   Annual  Work  Accident/Illness     Rule  1050       Date  submitted:  
Exposure  Data  Report    
 
 
7   Work  Environment  Measurement     Rule  1070       Conducted  by  and  date:  
(WEM)    Report    
 
 
8   Annual  Medical  Report   Rule  1960       Date  submitted:  
 
 
 
9   Certification  of  Certified  First   Rule  1960       Name  of  certified  First  Aiders  with  PNRC;  
Aiders   Date  of  Training  including  8  hrs  refresher  
training.  
 
 
 
 
10   BOSH  Training  of  Nurses   Rule  1960       Name(s)  and  Date  of  Training  and  by:  
 
 
 
 
 
11   BOSH  Training  of  Physician   Rule  1960       Name(s)  and  Date  of  Training  and  by:  
 
 
 
  
12   MOA  of  Health  Care  Provider   Rule  1960       Name  of  Service  Provider  and  period:  
 
 
 
13   MOA  with  nearest  hospital(s)   Rule  1960       If  applicable,  name  and  date:  
 
 
 
 
14   Fire  Safety  Inspection  Certificate   Rule  1940;       FSIC  No,  date  signed  and  validity:  
(FSIC)   RA  9514    
 
 
 
15   Fire  Exit  and  Drills   Rule  1940;       Date  of  drills  and  coverage:  
RA  9514    
 
 
 
16   Policy  and  Programs  for  the     DO  No.  53-­‐     Policy  No  and  date  approved:  
Implementation  of  Drug-­‐Free   03    
 
Workplace    
 
17   Policy  for  the  HIV  and  AIDS   DO  No.       Policy  No  and  date  approved:  
Prevention  And  Control  in  the   102-­‐10    
 
Workplace    
 
18   Implementation  of  a  Workplace   Dept.       Policy  No  and  date  approved:  
Policy  And  Program  on  Hepatitis   Advisory  
B     No.  05  
series  of  
2010  
19   Implementation  of  Policy  and   DO  No.  73-­‐     Policy  No  and  date  approved:  
Program  On  TB  Prevention  and   05    
 
Control    
 
20   Anti  Sexual-­‐Harassment  Policy   RA  7877       Policy  No  and  date  approved:  
 
 
 
 
21   Breastfeeding  Policy   RA  10028       Policy  No  and  date  approved:  
 
 
 
Location  of  Lactation  Room(s):  
 
 
 
 
22   Family  Welfare  Policy  and   DO  No.  55-­‐     Policy  No  and  date  approved:  
Programs   03    
 
 
 
23   Sanitation  Permits  of  Food   PD  856       If  applicable,  Permit  No.  and  validity:  
  Handlers  And  Canteen    
 
  Concessionaire(s)    
   
   
   
   
 
 
 
 
 
 
24   Permit  to  Operate  (Boiler,   Rules  1160,       If  applicable,  Permit  No.  and  validity:  
  Pressure  Vessels,  etc.)     1170  and    
 
  1180  
 
 
 
25   Permit  to  Operate  (Elevator,  etc.)   Rule  1220       If  applicable,  Permit  No.  and  validity:  
 
 
 
 
 
 
26   Registration  of  subcontractors    DO  174;       If  applicable,  Permit  No.  and  validity:  
(e.g.  DO  174,  PCAB)   DO  13;      
 
RA  4566    
 
 
 
 
 
 
 
Name  of  Organization:  ____________________________________________________________________  
Address:  ____________________________________________________________________________________    
                                   ____________________________________________________________________________________  
Nature  of  Business:  _________________________________________________  
Number  of  Direct  Employees:  ______________________    (as  of  _________________________  )  
 
List  of  Subcontractors/Outsourced:  
No.   Name   Service  Provided   No.  of  employees  
deployed  
1        
2        
3        
4        
5        
 
Prepared  by:  ____________________________________________________        Date:  ____________________  
Position:  ___________________________________________  Dept.:  ___________________________________