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3. Formal safety inspections are regularly 18. At my workplace, everyone has the
conducted in my workplace. information they need to work safely.
1 2 3 4 5 1 2 3 4 5
4. There are frequent communications about 19. Co-workers often help and remind each
safety in my workplace. other to work safely.
1 2 3 4 5 1 2 3 4 5
5. Workers are regularly asked about their 20. My workplace values improvements to
safety concerns safety.
1 2 3 4 5 1 2 3 4 5
6. Workers are involved in decisions affecting 21. My workplace regularly has safety
their safety. awareness events.
1 2 3 4 5 1 2 3 4 5
7. New employees at my organization learn 22. The company invests a lot of time in safety
quickly that they are expected to follow safety training for workers.
rules.
1 2 3 4 5
1 2 3 4 5
23. At my workplace, there are rules and
8. My workplace has a safety committee that is procedures about how to work safely.
effective at improving safety.
1 2 3 4 5
1 2 3 4 5
24. I know how the safety rules affect me.
9. Safety is given a high priority in training
programs. 1 2 3 4 5
1 2 3 4 5
25. Please rate your level of agreement with
this statement, “Workplace injuries and
10. Where I work, I feel free to report safety accidents are inevitable part of life.”
concern.
1 2 3 4 5
1 2 3 4 5
26. Which describes your role within the
11. At my workplace, there are rules and company?
procedures about how to work safely.
Worker Yes | No
1 2 3 4 5
Supervisor/Middle Management Yes | No
12. In my workplace everyone has the tools and Senior Management Yes | No
equipment they need to do their job safely.
1 2 3 4 5