Tickets & Documents Falling Supervisor Certification Assessment Falling Supervisor's Name Falling Supervisor's Faller Certification # Auditor's Name Date Phone # Multiple Employer Workplace? Current Faller Certification Tickets for All Fallers Current First Aid Tickets Fire S100 BC Forest Safety Council Supervisor Training Faller's ERP Level 1 2 3 Ground Conditions Licensee/Owner Falling Contractor Prime Contractor Notice of Project # Location (Cutblock/Road) Species Group Blasting Ticket/Log DT Blaster's Certification Number Crew Boat Ticket WorksafeBC Clearance Letter Shirt Size S M L XL XXL Company Name Legal/Trade name WorksafeBC Account # Months Worked in Previous 12? J F M A M J J A S O N D Company Contact Person Evaluation Purpose SAFE Companies # O = Observed D = Demonstration I = Interview P = Photo PART 1: FALLING SUPERVISOR'S DOCUMENTATION 1.a Assessor observes that Falling Supervisor is mentally able to perform the work. The Falling Supervisor acknowledges that it is his/her responsibility to instruct, direct and control fallers. NOTES:. 1.b Falling Supervisor's job duties have been described to him in a written format. NOTES:. BC Forest Safety Council Page 1 Version 2, revised Oct. 25, 2012
1.c Falling Supervisor has walked the block and identified all known or reasonably foreseeable hazards. Documentation provided. NOTES:. 1.d Falling Supervisor can describe how known or reasonably foreseeable hazards have been addressed or controlled before work commences. NOTES:. 1.e Falling Supervisor can describe means to control selected hazard examples (e.g.: How to deal with a particular hang up). NOTES:. 1.f The written falling plan is documented and includes: 1) number of fallers 2) faller placement and 3) other workers in the area. NOTES:. 1.g Falling Supervisor has access to alternative falling means (e.g.: blasting and machine assist). NOTES:. 1.h Documentation confirms Falling Supervisor is inspecting at least once a week and/or at time intervals according to level of risk. NOTES:. 1.i Block binder and daily journal demonstrate that the Falling Supervisor does not undertake activities that interfere with the performance of his/her duties. NOTES:. 1.1 Falling Supervisor is prepared to be assessed. 1.2 Falling Supervisor drives a vehicle which is correctly equipped and maintained according to the WorksafeBC Regulation. 1.3 Falling Supervisor can effectively and accurately describe the benefits of a block binder and accessible documentation regarding the Falling Plan and an ERP (including radio frequencies). 1.4 Falling Supervisor has a written ERP and can demonstrate that it is regularly reviewed and updated as required. 1.5 Falling Supervisor can describe Pre-Work documentation, employee records, processes, communication and policies. 1.6 Falling Supervisor confirms Pre-Work was conducted on-site, including face-to-face meeting with Prime Contractor and that the site map was reviewed. 1.7 Falling Supervisor informs the Prime Contractor who the on-site Falling Supervisor is. 1.8 Falling Supervisor acknowledges responsibility to conduct Pre-Work site inspections and has documentation available. 1.9 Falling Supervisor has documentation to show emergency evacuation drills have been completed. 1.10 Falling Supervisor has documented safety meetings and other discussions including sign off. BC Forest Safety Council Page 2 Version 2, revised Oct. 25, 2012
1.11 Falling Supervisor has provided and reviewed Safe Work Procedures (SWPs), Infoflips, and review of the 6 Deadly Sins to each faller. Documentation provided. 1.12 Falling Supervisor provides documentation of regular maintenance and inspection of crew vehicles. 1.13 Falling Supervisor follows up on concerns raised by fallers in crew meetings or one on one. Documentation provided. 1.14 Falling Supervisor can provide documentation about how safety alerts and fatality reports are incorporated into safety meetings as a learning tool. 1.15 Falling Supervisor confirms that sign off on the pre-work occurs only after full discussion. 1.16 Falling Supervisor can produce a Pre-Work package including client and Falling Supervisor sign off. 1.17 Falling Supervisor can provide documentation and corrective action taken when encountering poor work procedures while inspecting fallers. 1.18 Falling Supervisor can describe situations which would create the requirement to take a faller "off a saw" and has written procedure available. The Falling Supervisor has reviewed this procedure with the faller. 1.19 Falling Supervisor has a copy of Worker Compensation Act and WorksafeBC Regulation available and can name the sections relevant to falling. 1.20 Falling Supervisor can recognize and describe the signs of impairment. 1.21 Falling Supervisor has documentation recording that each faller on-site received operation or company policies and procedures. 1.22 Falling Supervisor has documentation to record process of handing over supervisory responsibilities to new charge hand or supervisor trainee including checklist and JSPs. 1.23 Falling Supervisor provides written guidelines for shutdown and can accurately describe the process. Can describe weather monitoring system. 1.24 Falling Supervisor can describe a "visitor" and provide written policy confirming that a visitor is to report to the Falling Supervisor before being admitted onsite. 1.25 Falling Supervisor can confirm and produce documentation that a visitor receives and signs off on an orientation checklist. 1.26 Falling Supervisor can provide documentation that records all visitors are accompanied through active falling areas. 1.27 Falling Supervisor can describe the correct procedure for reporting accidents/incidents, unsafe practices and unsafe conditions. 1.28 Falling Supervisor can describe the Falling Supervisor's role in accident/incident investigations and which incidents need to be investigated. 1.29 Falling Supervisor can describe their responsibilities in a JOH&S Committee. 1.30 Falling Supervisor can produce incident reports and crew reports of unsafe work when recorded and the Corrective Action Log (CAL). 1.31 Falling Supervisor can confirm specific approval or discussion has occurred regarding the plan for each individual faller's work area where falling will be required. PART 1 SCORE: /31 PART 2: SITE & PRE-WORK BC Forest Safety Council Page 3 Version 2, revised Oct. 25, 2012
2. a Work site observation confirms that first aid coverage (attendants and equipment) meets the requirements for the site. NOTES:. 2.1 Falling Supervisor ensures proper signage is in place. 2.2 Falling Supervisor can confirm that the emergency vehicle is strategically placed as visible, stable, and facing the exit. 2.3 Falling Supervisor has contact information available and can describe the contact procedure for the nearest available qualified blaster. PART 2 SCORE: /3 PART 3: ON-SITE BLOCK PLAN & ERP 3.a Falling Supervisor wears falling gear and is physically able to instruct, direct, and control fallers where they are falling. NOTES:. 3.1 Falling Supervisor has emergency procedures including specific safe work procedures and accurate contact information readily available at the work site. 3.2 Falling Supervisor can explain and justify the time spent supervising/training fallers relative to risk and inspects the fallers regularly. Understands the responsibility to inspect at time intervals appropriate to the risk. 3.3 Falling Supervisor ensures that required firefighting tools are available and acknowledges responsibility for coordinating firefighting if required. 3.4 Falling Supervisor has documentation recording that each faller on-site received site information. 3.5 Falling Supervisor can provide a falling plan or other record to illustrate that each new faller was placed independently in their block. 3.6 Falling Supervisor can describe the process for communicating new developments or changes in conditions to the crew. 3.7 Falling Supervisor demonstrates the ability to read a map including identifying potential hazards. 3.8 Falling Supervisor can identify the location of each faller on the map. 3.9 Falling Supervisor acknowledges responsibility for participating with other phases on the same site in planning for safe work for the entire site. 3.10 Falling Supervisor has documentation verifying that communication (worksite falling plan, unsafe practices and unsafe conditions) was shared with other phases on the site. 3.11 Falling Supervisor acknowledges that other workers in the area have been accurately identified. 3.12 Falling Supervisor has available documentation that the Falling Plan has been explained to and accepted by fallers and signed off. PART 3 SCORE: /12 PART 4: FALLING SUPERVISOR QUALIFICATIONS BC Forest Safety Council Page 4 Version 2, revised Oct. 25, 2012
4.a Falling Supervisor can demonstrate that he/she can fall trees to the BC Faller Training Standard. Falling Supervisor must demonstrate falling ability. NOTES:. PART 5: CREW INTERVIEW 5.1 Does your Falling Supervisor wear full PPE and inspect your PPE and tools? (Falling Supervisor's crew to answer this section) 5.2 Does your Falling Supervisor hold regular safety meetings that are worthwhile, meaningful, positive and professional including Pre-Work safety meeting? 5.3 Does your Falling Supervisor provide positive messages and constructive feedback to crew members? 5.4 Does your Falling Supervisor appear receptive to crew members bringing forward positive ideas for discussion and possible implementation? 5.5 Does your Falling Supervisor clearly outline site-specific safe work procedures and explain the relevance to the operation? 5.6 Does your Falling Supervisor review and conduct the ERP with you to test the program and clarify any concerns? 5.7 Does your Falling Supervisor provide Infoflips, SWPs and outline the 6 Deadly Sins so that you can explain them? 5.8 Does your Falling Supervisor inform the crew that all incidents/close calls/unsafe work practices/conditions must be reported and will be followed up with feedback? 5.9 Does your Falling Supervisor notify the crew of any new developments or changes in conditions 5.10 Does your Falling Supervisor provide a clear explanation of the man-check procedure? Can you can describe it? 5.11 Does your Falling Supervisor assure that each faller is aware of his/her rights and responsibilities according to the Workers' Compensation Act? 5.12 Can your Falling Supervisor identify and control hazards? Does he/she ensure that you can control, deal with and describe hazards? 5.13 Does your Falling Supervisor provide you with site maps and ensure that you can describe the Falling Plan? 5.14 Does your Falling Supervisor specifically approve the plan for each faller's individual work area where falling is taking place? 5.15 Does your Falling Supervisor review the falling site with you to provide clear understanding of hazards etc.? 5.16 Does your Falling Supervisor know, practice, follow, and enforce company-specific policies and procedures? Does he/she review these procedures with you to provide clear understanding? 5.17 Does your Falling Supervisor NOT allow other duties to interfere with Falling Supervisory duties? PART 5 SCORE: /17 PART 6: FALLING PLAN BC Forest Safety Council Page 5 Version 2, revised Oct. 25, 2012
6.a Work site observation confirms that the written Falling Plan supports worker safety and meets regulatory requirements. Criteria: 1) Fallers are working two tree lengths apart. 2) Qualified assistance meets BC Faller Training Standard and Regulation. 3) Fallers are not left alone in an area. 4) Other workers in the area have been accurately identified. NOTES:. 6.b Falling Supervisor correctly conducts a standardized audit of a faller to the BC Faller Training Standard and provides feedback to the faller (assessor validates quality of audit). NOTES:. 6.1 Falling Supervisor provides documentation to identify that helipads have been built and marked to the applicable standard. Can provide helipad specification card. 6.2 Falling Supervisor observes the fallers as they work. 6.3 Falling Supervisor confirms that access/egress trails are in place and clearly marked. 6.4 Falling Supervisor can prove that work is being done in agreement with the Falling Plan. 6.5 Falling Supervisor can identify danger trees and describe the hazard they present and has a documented plan available to address any known and/or foreseeable hazards (including sign off). 6.6 Falling Supervisor provides any new hire with the BC Faller Training Standard audit document in advance and the purpose and process is clearly explained. 6.7 Falling Supervisor stays with a newly hired faller for a period of time on their first day. Provides evidence of observing them falling trees, and commenting or correcting any concerns. 6.8 Falling Supervisor informs fallers of consequences due to improper work habits or behavior, potential disciplinary actions and procedures. 6.9 Falling Supervisor reviews ERP with fallers and conducts emergency response drills to test program. PART 6 SCORE: /9 PART 7: TRAINING 7.1 Falling Supervisor acknowledges responsibility for training and assessment of trainees. 7.2 Falling Supervisor can describe the selection of a training site based on analysis of workers skills, safety of faller, safety of the trainer, risks and opportunities on the site and links these decisions to the faller's evaluation. 7.3 Falling Supervisor can describe the approach to training a faller on new skills, techniques and systems. 7.4 Falling Supervisor has documentation to record teaching workers new skills when required. 7.5 Falling Supervisor can describe how trainer skills, trainer suitability and other factors are considered when selecting the appropriate trainer for a new faller. PART 7 SCORE: /5 SCORING: Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part 7 BC Forest Safety Council Page 6 Version 2, revised Oct. 25, 2012
/32 /3 /12 N/A /17 /9 /5 TOTAL % A mark of 75% or higher must be achieved in order to receive a passing grade on assessment. /77 NOTES: Falling Supervisor Signature Date Falling Supervisor Assessor Signature Date BC Forest Safety Council Page 7 Version 2, revised Oct. 25, 2012