Canada’s Safest Employers Awards 2023 - Key Media Inc. Nomination

Canada’s Safest New Employer

This award recognizes a company — in any industry — that has been in operation for no more than 10 years and has already established an exemplary safety record in this short tenure.

Technical Guidelines

The information you include in this form will be the only documentation provided to the judging panel for winner selection. All finalist submissions will remain confidential and are protected by the Non-Disclosure Agreement signed by all judges, and will only be shared with the judging panel except where stated otherwise. You can save your submission as a draft and return to it multiple times, however, we recommend that you save your work externally and upload your entire submission once complete, to avoid any loss of data that can be caused by possible technical/server/connectivity issues. Please adhere to the due date of Friday, April 21st, 2023 11:59 pm ET. By submitting this form and the information within it, you confirm you have the right to do so on behalf of the finalist individual or organization and you verify that all information within it is true, complete and accurate.

Organization *

Industry *

Number of full time employees in Canada *

Contact person *

Job title *

Contact email *

Contact phone *

Kindly upload a Company Logo (if finalist is a company) or Formal Headshot (if finalist is an individual)- Upload Limit: 5MB; 5000 pixels by 5000 pixels; PNG, JPEG or PDF formats only *

1. Eligibility:

a. Please state the number of years that you been an employer in Canada *

b. Do you have more than 20 employees?: *

Yes

c. Are you willing to administer an employee perception survey provided by the Canada’s Safest Employers organizing committee to your workforce should you be shortlisted? (See FAQ section for details.): *

Yes

Note: If you answered No to any of the questions above, you are not eligible to participate in the selection process for Canada’s Safest Employers Awards

d. In the last five years, has your company been charged under occupational health and safety, workers' compensation and/or the Criminal Code legislation? (If yes, please give details): *

Yes

(If yes, please explain. If no, write N/A) *

e. In the last five years, have you incurred any workplace fatalities? (If yes, please explain): *

Yes

(If yes, please explain. If no, write N/A) *

f. In the last five years, has your company been convicted under the occupational health and safety, workers' compensation and/or the Criminal Code legislation? (If yes, please explain.): *

Yes

(If yes, please explain. If no, write N/A) *

2. OHS Management System

In fewer than 500 words, describe your company’s occupational health and safety management system.: *

3. Hazard/Risk assessment

In fewer than 500 words, describe any hazard / risk assessments that have been done for specific role / jobs in the organization, or within the overall work environment.: *

4. Training

In fewer than 500 words, describe how you ensure that employees are adequately trained to perform their work effectively and safely.: *

5. Workplace inspections

In fewer than 500 words, describe how often inspections are conducted, the inspection process, and follow-up processes.: *

6. Employee engagement

In fewer than 500 words, describe the initiatives and activities that you do to keep your workers engaged in safety *

7. Communication strategies

In fewer than 500 words, describe how you are communicating safety messages: *

8. Injury Statistics in the last three years;Lost-time injury (LTI rate)

2020 *

2021 *

2022 *

If you wish, you may upload any supplementary materials to support your answers. - Upload Limit: 5GB in total; PNG, JPEG, PDF, DOC formats only

Nominator Name: *

Nominator Job Title: *

Nominator Organization: *

Nominator Email: *

Nominator Telephone: *