C. International Health & Safety Evaluation Form
國際健康與安全評估表（一）
(This form is available in excel Format)
This self-evaluation form has been created to help suppliers prepare for the Code of Conduct assessment by identifying
and properly addressing critical areas of Health & Safety non-compliance.
VENTILATION AND SANITATION 通風和衛(wèi)生
YES NO Must Improve
* Facilities adequately ventilated, cooled or heated for the local environment?
* Windows, fans, air conditioners or heaters are operational for air circulation,
ventilation and provide an acceptable work floor temperature. (Recommended 16 C-30 C.)
* Exhaust fans are kept clean of accumulated dust and debris.
* Exhaust fans are operational at all times during work hours.
* Chemicals are contained in a separate, well-ventilated room with open windows available.
* Are hazardous fumes neutralized or scrubbed?
* Is there sufficient ventilation in enclosed spaces where heat generation is operated?
* Is there appropriate ventilation in areas where workers engage in strenuous activity
such as continuous lifting of heavy objects?
* A sufficient number of toilet facilities are made available.
Ratio (toilet facilities/employee population): Employees Water closets
1 – 15 1
16 – 35 2
36 – 55 3
56 – 80 4
81 - 110 5
111 - 150 6
* Toilets are cleaned daily.
* Toilets are provided with appropriate privacy (stalls with doors).
* Toilets are plumbed with running water and basic supplies (western toilets).
* Supplies: soap, towels, toilet paper.
* Non-Western or squat toilets provide clean running water.
* Toilets are lighted and ventilated.
* Unrestricted access to toilets at all times.
* Toilets are available on each floor, and are separated according to gender.
* Employees have access to clean water for washing within close proximity to toilet..
* Food preparation areas are separate from the work area.
* Eating facilities are covered protecting the employees from the elements (sun and rain).
* There are adequate facilities for eating and is well lighted—tables and chairs provided.
* Food preparation area has a refrigeration unit, fire equipment, and potable water.
* Unrestricted potable water is provided all employees.
* Food preparation area is cleaned and disinfected daily
* Canteen or food service personnel are outside contractors and not considered
employees of the production facility.