C. International Health & Safety Evaluation Form

   国际健康与安全评估表（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 通风和卫生

 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.