Questionnaires

Questionnaires include those for chemical hazards, confined space programs, long term care, LOTO, machine guarding, trenching and excavation, fall protection, eyewash stations, electrical safety and heat stress.

Title and Description	Document Number	Effective Date
Long Term Care Employee Interview Questionnaire This questionnaire contains sample employee interview questions and is meant to serve as an investigatory aid for CSHO. It is not part of the...	LTC 1	2017-06-02
Long Term Care Opening Conference Questionnaire This questionnaire is intended to serve as an investigatory aid for CSHOs conducting inspections of long term care facilities. It is not comprehensive...	LTC 2	2017-06-02
Chemical Hazards Questionnaire Questionnaire for the hazard communication standard.
Confined Space Program Questionnaire Questionnaire for the confined space standard.
Determining Employer/Employee Relationship Questionnaire Questionnaire to help determine if an individual is an employee of an employer.	Questionnaire
Determining Host Employer-Staffing Employment Questionnaire Questionnaire for evaluating the host employer-staffing agency employment structure, determining the obligations each employer has and the delegation...
Electrical Safety Questionnaire Electrical safety questionnaire can be used to gather information during an inspection involving electrical hazards; 29 CFR 1910, Subpart S -...	ES
Eye Wash Station Questionnaire Questionnaire for evaluating eye wash stations. Also reference OPN 143 - Suitable Facilities for Drenching or Flushing the Eyes or Body.	EW
Fall Protection Questionnaire Questionnaire for evaluating fall protection in Construction based on 1926, Subpart M - Fall Protection. Also reference OPN 109 - Interim Fall...	FP
Heat Stress Questionnaire Questionnaire for evaluating heat stress. Also reference OPN 141 - Enforcement Guidance for Heat-Related Illness Inspections and Citations.	HS
Lockout/Tagout Questionnaire Questionnaire for lockout - tagout based on 1910.147 - The Control of Hazardous Energy.	LOTO
Machine Guarding Questionnaire Questionnaire for machine guarding based on 29 CFR 1910, Subpart O - Machinery and Machine Guarding and 29 CFR 1926, Subpart I - Tools - Hand and...	MG
Trenching and Excavation Questionnaire Questionnaire for trenching and excavations based on 1926, Subpart P - Excavations.	TE