The Holistic Safety Guidelines outline key principles of holistic safety. The Holistic Safety Sample Questions provide probing questions you can use to found out whether you are meeting the principles of the Guidelines.

Fill in these fields for keeping records and documents control.

Use this tool in conjunction with the Holistic Safety Guidelines and the Holistic Safety Sample Questions
Date:		
Area(s) examined:		
Follow-up actions:		

This 5-level rating system helps differentiate and discriminate between the weaknesses and strengths of each attribute. Change the resolution as to your requirements (e.g. a score out of 100, 30, 10 etc.).

RATING CRITERIA	
Not applicable	VERY LOW	LOW	MEDIUM	HIGH	VERY HIGH	
NA	1	2	3	4	5	

Use this weighting factor to take into account the relative importance and risk of the attribute being assessed. For example, training (attribute 1.2) may be given an initial rating of ‘medium’ (3). However, because in your operations training may be an extremely important component, it may be necessary that this be decreased by a factor of 1 to show its relative importance compared to the other attributes assessed.

RELATIVE WEIGHTING FACTOR	
LOWER RISK	NO CHANGE	HIGHER RISK	
+1	0	-1	

These are the main characteristics taken directly from the Holistic Safety Guidelines.

1—Human Aspects	A safe organisation will possess processes and controls that take account of weaknesses and strengths in human performance	INITIAL RATING	WEIGHTING FACTOR	FINAL RATING	OBSERVATIONS AND JUSTIFICATION	
1.1	The selection of suitably qualified and experienced, competent personnel				
These are the main attributes taken directly from the Holistic Safety Guidelines. Modify or adapt these to your own situation

1.2	The provision of appropriate training					
1.3	Equipment and machine design that accounts for human factors					
1.4	Process design that accounts for human factors					
1.5	Operational environment design that accounts for human factors					
	
2—Non-Technical Skills	A safe organisation will possess and utilise effective non-technical skills.	INITIAL RATING	WEIGHTING FACTOR	FINAL RATING	
Place the initial rating here.

OBSERVATIONS AND JUSTIFICATION	
2.1	The non-technical skill of communication					
2.2	The non-technical skill of leadership				
Include a weighting factor here if necessary. Change the weighting to suit the operations of your own organisation.

2.3	The non-technical skill of team-working					
2.4	The decision-making process					
2.5	The non-technical skill of situation awareness				
Place the final rating here. This is the result of adding the initial rating and weighting factor together. 

	
	
4—Defence-in-depth
(use the Regulatory Assessment Principles Guide)	A safe organisation will apply defence in depth throughout	INITIAL RATING	WEIGHTING FACTOR	FINAL RATING	
To complete this part, refer to the defence-in-depth sections of the Regulatory Assessment Principles for Controlled Facilities (section 5).

OBSERVATIONS AND JUSTIFICATION	

4—Management system
(use Plans and Arrangement Guide)	A safe organisation will integrate safety and environmental protection seamlessly into an integrated management system.	INITIAL RATING	WEIGHTING FACTOR	FINAL RATING	
To complete this part, refer to the Regulatory Guide: Plans and Arrangements for Managing Safety. 

OBSERVATIONS AND JUSTIFICATION	

5—Resilience	A safe organisation will build or engineer resilience into the system.	INITIAL RATING	WEIGHTING FACTOR	FINAL RATING	
This space is for making notes or noting down any answers or observations. It can also be used to provide justification for the rating given.

OBSERVATIONS AND JUSTIFICATION	
5.1	The ability to respond					
5.2	The ability to monitor					
5.3	The ability to anticipate					

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This part can be filled in to for record keeping.