Not in the US? Country * Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cabo Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao North Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Territory * Yukon Northwest Territories Nunavut

Local

Community

1. Does your workplace have a Health and Safety Committee and/or a Safety Representative? Yes No Not Sure

2. Do you know when the Health and Safety Committee meets? Yes No Not Sure

3. Do Health and Safety Committee meetings always include an equal number of managers and workers? Yes No Not Sure

4. Do you know where the Health and Safety Committee's meeting Minutes are located? Yes No

5. Does the Health and Safety Committee conduct workplace inspections? Yes No Not Sure

6. Are the findings of the inspections made available? Yes No Not Sure

7. Does the Health and Safety Committee include members from more than one work site? Yes No Not Sure Not Applicable

8. Have Worker Representatives received training for their role on the Health and Safety Committee? Yes No Not Sure

9. Do you think your employer or Health and Safety Committee have considered the impacts of climate change on safety in your workplace? Yes No Not Sure

10. Do you think your employer or Health and Safety Committee have considered workplace psychological risk factors on mental health? Yes No Not Sure

11. Have you completed Workplace Hazardous Materials Information System (WHMIS) training? Yes No Not Sure

12. Approximately when was the last time you received?

13. Does your workplace provide a Safety Orientation for new hires? Yes No Not Sure

14. Are the required number of people trained for First Aid at your workplace? Yes No Not Sure

15. Do your Supervisors receive Health and Safety training? Yes No Not Sure

16. Do you think workers receive the safety training they need at your workplace? Yes No Not Sure

17. What kind of safety training do you think is needed at your workplace?

18. Does your workplace conduct Safety Talks? Yes No Not Sure

19. How often do Safety Talks occur? Daily Weekly Monthly Quarterly Less Often Not Sure

20. Does your workplace have a Health and Safety Policy posted? Yes No Not Sure

21. Does the Policy include measures around Fatigue Management? Yes No Not Sure

22. Does the Policy include measures around Working Alone? Yes No Not Sure

23. Does the Policy include measures around Impairment? Yes No Not Sure

24. Does your workplace have a Harassment and Violence Policy posted? Yes No Not Sure

25. Do you think your employer values client safety more than worker safety? Yes No Not Sure

26. Do you think your employer values money/productivity more than worker safety? Yes No Not Sure

27. Do you think your employer worries more about public opinion than worker safety? Yes No Not Sure

28. Do you think mental health is an important factor in your workplace's Health and Safety program? Yes No Not Sure

29. Is there anything else you would like to tell us about health and safety in your workplace?

30. Would you like to know more about Health and Safety in your workplace? Yes No

31. Would you like to know more about mental health in the workplace? Yes No