JSA Auditing

The following score sheet is available on SharePoint and should be used as a coaching guide

when performing a JSA Audit. Categories are ranked 1-5 and the form will calculate a score

based on the ranking given.

JJ White, Inc.      JSA Audit Form
Activity	1	2	3	4	5
Task Assignment	Crew Assigned to a location without pre- discussion on task	Vague, difficult to clearly identify task or exact location	Clear, but not reviewed with all crew members	Clear review with all crew members	Clear review with all crew members, tested for understanding
Information Availability	Conducted or started without all required information				All required info avail. – Permit, dwgs., etc.
Location	Discussion outside of work location without pre inspection			Discussion outside of work location with pre inspection	Discussion at the work location with pre inspection of area
Interactive Discussion	Discussion without all crew members present – One person writing, others missing or engaged elsewhere	Discussion with most crew members present	All crew members present, no group discussion	Most crew members present, with group discussion	All crew members present, with a good, interactive group discussion that enhanced JSA.
Steps to Perform Work	Generic Work Steps only: – “Get Tools” – “Place fire blankets” – “Work safe” – “Clean up work area”	Generalized Work Steps not in sequence related to work activities: – “Place ladder in excavation”                           – “Use air-kife for initial excavation” – “Assign spotter for all excavator placement”		Good listing of Work Steps with interactive discussion on their sequence and explination of their order.	Excellent and detailed listing of Work Steps w/ interactive discussion – What could go wrong if work steps not sequenced properly –  Changes in Work Steps noted at time of revaildation – Trade or Operational impacts
Hazard Identification	Generic Hazards only: – Cuts/Lacerations – Slips & falls – Weather – Pinch points	Mostly generic Hazards: – H2S/Toxics – Burns due to sparks – Slips & Falls due to wet surfaces – Pinch points associated from chain fall		Somewhat generic but only some distinct hazards included for some corresponding Work Steps	Specific hazards clearly identified and documented including any SIF’s for each Work Step. – “What if” – “Worst case” – “If this happens”
Documented Controls	Some attempt to document risk control. – Wear H2S monitor – Watch footing – Watch pinch points – Wear PPE			Somewhat generic but some distinct controls documented. JSA clearly revalidated.	Clear “instructional” controls documented which could include “stop and reevaluate” for possible condition changes. All SIF’s mitigated.