HSE ADVISOR CANADA

Safety Program Gap Assessment Checklist

Twelve program elements, scored. This is the assessment we run before quoting a safety program build, and it tells you the same thing it tells us: which parts of your program exist on paper, which exist in practice, and which do not exist at all.

How to use it. Score each element 0–3 using the maturity scale. Be honest about the difference between written and practised — a documented procedure nobody follows scores 1, not 3. Total at the end and read the band.
To print: Click "Print" below → select Portrait orientation → enable Background graphics in print settings → Print.
To fill in: Print and complete by hand, or use your browser's "Save as PDF" and fill the fields in any PDF editor.

Want us to run this assessment with you?

HSE Advisor Canada is CRSP Certified, COR & ISO 45001 Lead Auditors. We will review what you have written, confirm it lines up with the requirements in your province, and help you close the gaps. The first conversation is free.

✆ (647) 620-5278 ✉ info@hseadvisor.ca → hseadvisor.ca/contact

Want our most-requested checklists by email?

This resource is free to read, print and use right here — no sign-up. We can also email you our most-requested free checklists and templates. The full library is always at Free HSE Resources.

We send occasional Canadian OHS updates. Unsubscribe any time.

Safety Program Gap Assessment

Twelve-element scored self-assessment · Canadian employers

HSE ADVISOR CANADA
hseadvisor.ca

Employer / company:

Industry:

Completed by:

Position:

Date:

Worker count:

Maturity scale

Score	Level	What it means
0	Absent	Does not exist in any form.
1	Informal	Happens sometimes, depends on individuals, not written down.
2	Documented	Written and mostly followed, but not verified or consistently recorded.
3	Managed	Written, practised, recorded, reviewed, and improved on evidence.

The twelve elements

#	Element	A managed program has
1	Policy and commitment	A signed, dated policy, posted, reviewed annually, with visible senior management involvement.
2	Roles and responsibilities	Written duties for management, supervisors and workers, understood by the people holding them.
3	Hazard identification and risk assessment	A documented method, current assessments for every task, and reassessment on change.
4	Safe work practices and procedures	Written procedures for high-risk tasks, accessible at the point of work, followed in practice.
5	Training and competency	A training matrix by role, delivery records, refresher tracking and competency verification.
6	Inspections	A schedule, a checklist, findings assigned to an owner with a date, and verified closure.
7	Incident reporting and investigation	Reporting that captures near misses, root-cause investigation, and corrective actions that close.
8	Emergency preparedness	Plans for the emergencies you can actually have, trained responders, and drills with records.
9	Contractor and visitor management	Prequalification, orientation, and oversight of contractors while they are on your site.
10	Joint committee or representative	Correct structure for your size, meeting on schedule, minutes posted, recommendations answered.
11	Records and document control	Current versions, retention periods met, and any record retrievable on request.
12	Program review and improvement	An annual management review that changes something, driven by leading and lagging indicators.
Total (out of 36)

Reading your score

Total	Where you are	What to do next
0 – 11	Program in name only	Start with elements 1, 3 and 5. Everything else depends on them.
12 – 23	Documented, not embedded	Close the gap between what is written and what happens. Focus on any element scoring 1.
24 – 30	Working program	Push the 2s to 3s. Verification and review are usually what is missing.
31 – 36	Audit-ready	You are in range for a COR or ISO 45001 audit. Confirm against the specific audit tool.

Any single element scoring 0 is a priority regardless of your total. A strong average hides a missing element, and regulators and auditors assess elements individually, not on average.

Priority actions

Rank	Element	Gap	Action	Owner	Due

Completed by

Date

Reviewed by (management)

Date

Safety Program Gap Assessment Checklist · HSE Advisor Canada · Free to use and adapt.

hseadvisor.ca · (647) 620-5278

This resource is general guidance, not legal advice. Confirm every requirement against the current regulation in your jurisdiction before relying on it.