QUESTIONNAIRE

I am Prashant.V.Hiremath, pursuing MBA at Dr. D. Veerendra Heggade Institute of

Management Studies and Research, Dharwad. I am undertaking a project titled “A Study on
Safety and health management in FASTENER AND ALLIED PRODUCTS PVT.LTD. I request
you to please co-operate and fill the questionnaires on your opinion to facilitate my study. Your
response is useful and crucial for my academic study, and will be used only for academic
purpose. I assure you that the valuable information will be kept confidential.

Personal Information:
a. Name of Respondent :
b. Designation:
c. Department:
d. Marital Status :
Single
Married
e. Age :
20-30
30-40
40-50
Above 50
f. Gender:
Male
Female
g. Educational qualification
School level
Graduates
Diploma
Professional

I
 h. How long have you been working in
this company?
a) less than 1 yr
b) 1-3 yrs
c) 3-5yrs
d) 5-10yrs
e) above 10yrs

[1] Are you aware of the health and safety policy?

A) Yes

B) No

[2] What do you feel are the objectives of health and safety policy?

SL.NO Particulars Yes No To

some
extent
a] To provide adequate control of the health and safety
risk arising from work activities
b] To provide and maintain safe equipments
c] To ensure safe handling and use of hazardous
substances.
d] To provide information and instruction on safety and
health
e] To prevent accidents and work related ill-health
f] To maintain safe and healthy working condition

II
A] Safety

[1] What you feel are the cause of accidents in your organization?

SL.NO Particulars To great Some Not at

extent what all
A] Unsafe condition

a] Improperly guarded equipment

b] Defective equipment
c] Unsafe storage
d] Inadequate safety devices
e] Wrong and faulty layout
f] Improper illumination
g] Improper ventilation
B] Unsafe Acts

a] Operating without authority

b] Failing to use attire/PPE
c] Throwing material on floor carelessly
d] Operating at unsafe level of speed
e] Using unsafe procedure
f] Taking unsafe position
g] Distraction, quarrels, Day-dreaming
C] Other Causes

a] Untrained or new workers

b] Employees addicted alcohol and drugs
c] Employees suffering fatigue
d] More occurrence during nightshifts

III
2] Does the company have safety committee that oversees workplace?

a] Yes

b] No

c] Not sure

3] If “YES”, go to question no.4 and 5

4] According to you who are the employee in the safety committee?

SL.NO Particulars Yes No

a] Safety personal
b] Senior management
c] Human resource personal
d] Doctor and nurse
e] Department heads
f] Any other specify

5] Are the following equipments provided in the organization?

SL.NO Particulars Yes No

a] Safety shoes
b] Safety helmet
c] Safety gloves
d] Safety masks
e] Safety goggles

IV
6] Do you agree that the following are employer responsibility in selection and provision
of PPE?

SL.NO Particulars Agree Disagree

a] Employer must select the PPE required for the
employee doing the job
b] Employer must provide the PPE's at no cost and
appropriate equipment that fits the employee
c] Employer should maintain PPE used by the employees
d] If it can’t be prepared it must be discarded and replaced
e] The employer should arrange the training sessions
conducted on PPE

7] Do you agree that the following are employee’s responsibility on PPE?

SL.NO Particulars Agree Disagree

a] Employee responsibility for attending all the PPE
training session
b] Responsible for wearing assigned PPE
c] Following all the precautions and warnings the appear
on tools and equipments
d] Listening and following the directions of the supervisor
or safety manager
e] Reporting about unsafe condition found in the
workplace

V
8] When is the safety meetings conducted?

a) Once in a week

b) Once in 15 days

c) Once in a month

d) Any other specify

9] Are the following discussed at the safety meetings?

SL.NO Particulars Yes No To some

extent
a] Accidents injuries near miss
b] Results of safety allowance
c] New training to be imparted
d] Date time and placed of the next meeting

10] What are the following measures taken by the organization to promote workplace
safety?

SL.NO Particulars Yes No To

some
extent
a] Training/Orientation program on safety and
health
b] Workplace injury prevention
c] Hearing conversation
d] Management of hazardous chemicals
e] Fatigue management

VI
11] How is the safety measure in the organization communication to the employees?

SL.NO Particulars Yes No Sometimes

a] Through bulletin and board
b] Pamphlets
c] Booklet
d] Posters
e] Magazine

B) Health

1) Are the employee’s involved in taking workplace health initiative?

a) Yes

b) No

2] If “YES”, who are the people involved in occupation or workplace health initiative?

SL.NO Particulars Yes No To Some

extent
a] Safety personal
b] Senior management
c] Human resource personal
d] Doctor and nurse
e] Department heads
f] Any other specify

VII
3] Does the organization provide to the below provisions regarding health?

SL.NO Particulars Yes No To

Some
extent
a] Clean work space
b] Effective disposal of waste
c] Appropriate ventilation
d] Appropriate room temperature
e] Artificial humidification
f] Clean drinking water
g] Spittoons
h] Toilet facility separate for men and
women

4] Do you agree that the following measures taken by the organization for promotion of
employee health?

SL.NO Particular Agree Disagree

a] Programs on healthy living
b] Programs on eating wisely
c] Exercise and physical fitness
d] Smoking cessation
e] Stress management

VIII
C] Safety and health management

1] What are the preventative action, taken to promote health and safety? Reporting the
concerned officers?

SL.NO Particulars Always Usually Never

a] About events on such as dangerous
occurrence [failure in equipments, firing
workplace]
b] Near miss accidents
c] Occupational disease
d] Work related injuries

2] Do you agree the following records maintained in the organization?

SL.NO Particulars Agree Disagree

1.Data
a] General health examination
b] Results of medical examination
c] Results of hygiene surveillance
d] Risk assessment on documents of preventive
control measures
e] Lifestyle and behavior survey.
2. Statistics
a] On dangerous occurrence
b] On near miss
c] On occupational disease
d] On work related injuries
e] On sickness absences
f] On employees health safety and lifestyle behavior

IX
3] What do you think are the barriers in adoption of health and safety among workers?

SL.NO Particulars Not a Somewhat Extreme

Barrier Barrier Barrier
a] Lack of knowledge about health and
safety among workers
b] Slackness in implementing health and
safety provisions
c] Shortage of funds
d] Inadequate training facility
e] Difficulty in objective assessment

4] What do you think of role of HR in implementing health and safety overseas?

SL.NO Particulars To Some Not

great what much
extent
a] He acts as a link between management and the
employee
b] He communicate the different policies
regarding health and safety
c] Responsible for the inspecting on health and
safety in organization on regular base
d] HR needs to plan out on the new training
programs and new measure to promote health
and safety