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208x Filetype XLSX File size 0.17 MB Source: wash4work.org
Sheet 1: Cover
| Worksheet (Click to Navigate) | Description |
| Cover | Cover page |
| Contents | Table of contents |
| Self-Assessment | Self-Assessment Tool for Evaluating Access to Water, Sanitation and Hygiene (WASH) at the Workplace |
| Summary Output | Data summary of aggregated category scoring |
| Self-Assessment Tool for Evaluating Access to Water, Sanitation and Hygiene (WASH) | ||||||||||||
| Water, Sanitation and Hygiene (WASH) at the Points of Reference | ||||||||||||
| Category/Dimension | Scoring Detail Per Individual Category/Dimension | Multi-Variable Individual Dimension Score | Scoring Detail Multi-Variable Category/Dimension | Current State (0-2) | Category/ Pledge Compliance | Gap Analysis | Scoring Comments and Rationale (esp. when scoring '1' or 'n/a' in column H) | Self-Identified Recommendations | ||||
| GE1 | General | Y=1, N=0, N/A | 1.8 | 2.0 | ||||||||
| GE1.1 | Compliance with local and national laws/regulations for all permanent workplace facilities | n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., the facility comply with all local and national laws/regulations (e.g., local/State/National laws, Companies/Factories Acts) related to WASH |
2.0 | 2.0 | ||||||||
| GE1.2 | Policies and procedures for temporary and mobile work sites, including agriculture | n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., appropriate WASH policies and proceduresfor all temporary and mobile work sites under direct company control are in place. This also means WASH provisions are included in contracts for third parties/contractors. |
2.0 | 2.0 | ||||||||
| GE1.3 | Policies and procedures for other worksite facilities | n/a = Dimension not relevant or applicable 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., policies and procedures addressing WASH for other worksite facilities used by workers - crèches, canteens, kitchens, if existing - are in place. |
1.0 | 2.0 | ||||||||
| GE 1.4 | WASH monitoring mechanisms are in place | n/a = Dimension not relevant or applicable 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., monitoring mechanisms are in place to monitor compliance and functionality of systems, as per regulations and standards. Ideally, business has data on baseline conditions, and has disaggregated data. For example, WASH facilities respond to the specific needs of women or those living with a disability. |
2.0 | 2.0 | ||||||||
| GE 1.5 | Business has mechanism to measure change in WASH | n/a = Dimension not relevant or applicable 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., business has mechanisms in place to measure impact of WASH Pledge activities on WASH access for workers. |
2.0 | 2.0 | ||||||||
| WWS2 | Workplace Water Supply | Y=1, N=0, N/A | 1.5 | 2.0 | ||||||||
| WWS2.1 | Availability of sufficient, free, physically accessible drinking water | A. Sufficient quantity of water to provide adequate hydration for workers, sensitive to worksite conditions | 1 | Total Category Score Possible = 5 n/a = Dimensions not relevant or applicable (see column K) 0 = No Dimensions implemented 1 =Dimensions partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable five dimensions are met |
1.0 | 2.0 | ||||||
| B. Convenient proximity to workers (within 500 metres and/or workers allowed to have water at work stations) | 1 | |||||||||||
| C. Physically accessible drinking water facilities, including for workers with diabilities | 'n/a' | |||||||||||
| D. Drinking water is free of charge | 1 | |||||||||||
| E. Drinking water is available to workers at any time during work period | 0 | |||||||||||
| Total | 4 | |||||||||||
| WWS2.2 | Access to safe water that meets quality standards | A. Drinking water is from an improved drinking-water source | 1 | Total Category Score Possible = 5 n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the of the applicable five dimensions are met |
1.0 | 2.0 | ||||||
| B. Drinking water source is known to meet government quality standards (if raw water source does not meet standards, it is treated before being consumed by workers) | 1 | |||||||||||
| C. Drinking water taste is acceptable to workers | 1 | |||||||||||
| D. Safe method(s) for drinking water distribution (clean fountain/vessel) are in place | 0 | |||||||||||
| E. Drinking water is taken from the storage vessel/source in a way that avoids contamination of the water (e.g. clean cup) | 1 | |||||||||||
| Total | 4 | |||||||||||
| WWS2.3 | Drinking water facilities are clean and appropriately disinfected | n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all drinking water fountains, water coolers and other storage vessels/sources within the facility are positioned in appropriate clean areas and are cleaned, recharged and disinfected at a minimum of once every two months (or at an increased frequency if heavily used) |
1.0 | 2.0 | ||||||||
| WW2.4 | Drinking water is tested to ensure quality and safety | A. Drinking water provided within the facility is regularly tested by appropriately trained staff |
'n/a' | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable three dimensions are met |
2.0 | 2.0 | ||||||
| B. Drinking water testing is conducted when environmental conditions change or there is a waterborne disease outbreak (periodic training of staff for water testing is needed) | 1 | |||||||||||
| C. If drinking water quality testing indicates water is not meeting standards, mitigative actions are taken, including the workers being notified | 1 | |||||||||||
| Total | 3 | |||||||||||
| WWS2.5 | Water supply system cleaning, maintenance and conservation | A. Appropriate provisions are made for the regular cleaning of all water supply systems under direct company control a minimum of 2 to 4 times per year (note: cleaning is not mandatory if residual disinfection is provided and therefore this would be n/a) |
'n/a' | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable three dimensions are met |
2.0 | 2.0 | ||||||
| B. Appropriate provisions are made for the regular inspection, maintenance and repair of all water supply facilities and drainage systems under direct company control (at least annually for water supply systems) | 1 | |||||||||||
| C. Water saving technologies are deployed within facilities and other relevant work areas to conserve water used by operations and workers. | 1 | |||||||||||
| Total | 3 | |||||||||||
| WWS2.6 | Other Workplace Facility Water Supply | n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e. If the workplace provides childcare, food from canteens/kitchens or healthcare (health clinic) these facilities also have in place sufficient and safe drinking water |
2.0 | 2.0 | ||||||||
| WS3 | Workplace Sanitation | Y=1, N=0, N/A | 0.7 | 2.0 | ||||||||
| WS3.1 | Access to adequate, improved, convenient tolet facilities | A. All employees, regardless of work location, have access to at least ‘improved’ toilet facilities with adequate superstructures to protect from elements to make sanitation safe and convenient (e.g. at a minimum provision of flush or pour-flush toilet, septic tank, pit latrine, ventilated improved pit-latrine) | 1 | Total Category Score Possible = 7 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable seven dimensions are met |
2.0 | 2.0 | ||||||
| B. Minimum 2 toilet seats and 2 urinal facilities per 45 male workers are provided in facilities | 1 | |||||||||||
| C. Minimum of 4 toilet seats per 50 females are provided within facilities | 1 | |||||||||||
| D. Toilet facility design is in line with local customs, religious and social traditions | 1 | |||||||||||
| E. Facilities are accessible to workers with mobility challenges, e.g. the disabled and elderly workers | 'n/a' | |||||||||||
| F. If relevant, toilet facilities are provided to agricultural, field and mine workers | 'n/a' | |||||||||||
| G. Ventilation is in place in toilet facilities to remove odours | 1 | |||||||||||
| Total | 7 | |||||||||||
| WS3.2 | Wastewater, drainage and toilet/urinal waste management safety | A. All wash basins, sinks, showers, toilet facilities under direct company control are provided with adequate drainage and disposal systems to prevent contamination in the immediate and broader environment i.e., wastewater is conveyed into a municipal sewer and/or pre-treated within the company’s own premises. |
1 | Total Category Score Possible =2 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable two dimensions are met |
1.0 | 2.0 | ||||||
| B. All faecal waste is safely managed, i.e., it is treated before its returned to the environment or conveyed into a municipal sewer system. | 0 | |||||||||||
| Total | 1 | |||||||||||
| WS3.3 | Toilet/urinal lighting and locks for safety | n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., design and construction of toilet/urinal facilities under direct company control ensures adequate lighting for safety purposes (200 lumens per square meter - lux) and doors are lockable |
0.0 | 2.0 | ||||||||
| WS3.4 | Toilet/urinal cleaning and maintenance | A. Provisions are in place to clean all toilet facilities under direct company control at least once a day | Total Category Score Possible = 4 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e. all of the applicable four dimensions are met |
0.0 | 2.0 | |||||||
| B. Cleaning includes disinfection of all sanitary facilities under direct company control and is carried out at least once a week. | ||||||||||||
| C. Appropriate provisions are made for the inspection, maintenance and repair of toilet facilities under direct company control at least monthly, with more frequent maintenance and repairs, if issues are reported by employees. | ||||||||||||
| D. System is in place for workers to report cleanliness and/or maintenance issues related to toilet facilities. | ||||||||||||
| Total | 0 | |||||||||||
| WS3.5 | Sanitary product and disposal | A. Appropriate provisions are provided within women’s toilet facilities for the safe disposal of sanitary products in waste containers that are properly lined with plastic, wax paper or other appropriate bags |
Total Category Score Possible =2 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable two dimensions are met |
0.0 | 2.0 | |||||||
| B. Sanitary products are available at the worksite in vending machines or free of charge | ||||||||||||
| Total | 0 | |||||||||||
| WS3.6 | Medical waste disposal | n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., appropriate provisions are provided at the worksite for the safe disposal of medical waste (for instance: disposal of blood, urine and other bodily secretions in dedicated bags; disposal of scalpels, sharps, needles and broken lab glass in specially made sharps containers labelled with medical waste warning labels) |
1.0 | 2.0 | ||||||||
| WS3.7 | Other workplace facility sanitation facilities | n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., if the workplace provides childcare facilities, food in canteens/kitchens or healthcare (in health clinics) these facilities also have in place adequate, improved sanitation, convenient facilities as outlined in WS3.1. |
1.0 | 2.0 | ||||||||
| WH4 | Workplace Hygiene | Y=1, N=0, N/A | 0.1 | 2.0 | ||||||||
| WH4.1 | Personal hygiene/hand washing facilities | A. Soap is available at handwashing facilities | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e.. all toilet and washroom facilities under direct company control have appropriate provisions to ensure personal hygiene, including all three dimensions are met) |
0.0 | 2.0 | |||||||
| B. Mechanism for hand and face drying is in place at handwashing facilities | ||||||||||||
| C. Water at a standard acceptable for cleansing hands (if non-potable water is used for washing, it is clearly communicated at the point of use) is available at handwashing facility | ||||||||||||
| Total | 0 | |||||||||||
| WH4.2 | Appropriate hand washing behaviour awareness signage | A. Critical times for hand-washing are posted (times include: before food preparation, eating, and after using the toilet, contact with bodily fluids and contact with any potential contaminants). | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., signage for appropriate hand washing behaviour, including both critical times and technique, has been provided within the facility, particularly at toilet facilities and eating/cooking areas, for all three of applicable dimensions are met |
0.0 | 2.0 | |||||||
| B. Hand-washing techniques are posted at handwashing facilities includes use of water and soap or ash, washing both hands, rubbing hands together at least three times, and drying hands hygienically - by air drying or using a clean cloth/paper. | ||||||||||||
| C. Provision of information is in place on how workers exposed to hazardous substances should clean after exposure. | ||||||||||||
| Total | 0 | |||||||||||
| WH4.3 | Showers and bathing facilities | A. One shower is provided for every 10 employees of each gender required to shower during the same shift, | Total Category Score Possible = 4 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., where necessary, workers that are exposed to hazardous substances and/or dirty work conditions are provided with showers and bathing facilities at the workplace and are equipped appropriately, for all four of applicable dimensions. |
0.0 | 2.0 | |||||||
| B. Body soap or other appropriate cleansing agents are provided, | ||||||||||||
| C. Showers have hot and cold water feeding a common discharge line, | ||||||||||||
| D. Employees who use showers are provided with individual clean towels. | ||||||||||||
| Total | 0 | |||||||||||
| WH4.4 | Hygiene training and WASH awareness behaviour change | A. Hygiene training provided to all new employees; | Total Category Score Possible = 2 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., regular training and awareness building processes have been implemented for all workers at the indicated two times. (See Column M for Topics to be covered) |
0.0 | 2.0 | |||||||
| B. Annual refresher courses for all workers with special attention given to employees and other staff involved in food preparation). | ||||||||||||
| Total | 0 | |||||||||||
| WH4.5 | Personal protective equipment (PPE) provision | A. Appropriate personal protective equipment, such as gloves and non-slip rubber soled shoes, is provided to all those involved in the cleaning and maintenance of toilet washrooms/associated facilities under direct company control; | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all of the applicable three dimensions are met. |
0.0 | 2.0 | |||||||
| B. Workers involved in cleaning and maintenance facilities wear personal protective equipment and it is worn at all times when cleaning urinals, toilet bowls, showers, hand basins, mirrors, and other associated facilities | ||||||||||||
| C. Method for managing used personal protective equipment are in place at the work place to avoid exposure to worker’s families/community. | ||||||||||||
| Total | 0 | |||||||||||
| WH4.6 | Training for cleaning and maintenance staff | A. Cleaners are trained in the proper cleaning techniques/standards and the proper use of all cleaning materials for WASH facilities; and | Total Category Score Possible = 2 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance; i.e., all of the applicable two dimensions are met for those involved in cleaning and maintenance in the company’s own operations. |
0.0 | 2.0 | |||||||
| B. Employers ensure that workers and relevant contractors follow the specific instructions associated with each WASH facility cleaning product | ||||||||||||
| Total | 0 | |||||||||||
| WH4.7 | Cleaning equipment storage | A. WASH cleaning equipment is stored in appropriate conditions that meet the guidelines on the cleaning supplies’ packaging | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., cleaning equipment and materials meet all three of the applicable dimensions. |
0.0 | 2.0 | |||||||
| B. WASH cleaning equipment is stored in places dedicated for this purpose (own operations) | ||||||||||||
| C. Facilities have a dedicated storage unit for WASH cleaning products outside of common areas | ||||||||||||
| Total | 0 | |||||||||||
| WH4.8 | Monitoring and reporting on water-related diseases | n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., monitoring and reporting on WASH-related diseases in the workforce is implemented where workplaces are under direct company control, and in collaboration with local and national public health bodies. (This indicator is particularly important for those involved in food and beverage handling or medical staff workers.) |
1.0 | 2.0 | ||||||||
| VSC5 | Value/Supply Chain WASH | Y = 1, N = 0, N/A | 0.0 | 2.0 | ||||||||
| VSC5.1 | Written policies (Code of Conduct) are in place that outline expectation for water, sanitation and hygiene for supply chain workplaces | Policy addresses water | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., policies written for all three of the applicable dimensions |
0.0 | 2.0 | |||||||
| Policy addresses sanitation | ||||||||||||
| Policy addresses hygiene | ||||||||||||
| Total | 0 | |||||||||||
| VSC5.2 | If policies exist there is a strategy to promote implementation and self-monitoring by the company's suppliers | Promoted policy implementation/monitoring by suppliers for water | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., promoted policy implementation and monitoring by suppliers for all three of the applicable dimensions |
0.0 | 2.0 | |||||||
| Promoted policy implementation/monitoringby suppliers for sanitation | ||||||||||||
| Promoted policy implementation/monitoring by suppliers for hygiene | ||||||||||||
| Total | 0 | |||||||||||
| CW6 | Community WASH | Y = 1, N = 0, N/A | 0.0 | 2.0 | ||||||||
| CW6.1 | Community household WASH assessment | A. Level 1 - secondary data. Business has knowledge of their workplace workers and/or surrounding communities’ in which their workers live access to WASH through acquired secondary data that is no more than 2 years old. | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented (see Column K) 1 = Pledge Compliance, i.e., company has completed at least one dimension "assessment level". |
0.0 | 2.0 | |||||||
| B. Level 2 - data from government or organizations. Business has visited and collected information directly from a local source (e.g. government, NGO, other) on their workers/workplace surrounding communities’ access to. | ||||||||||||
| C. Level 3 - primary data. Business has conducted worker and/or local workplace community household survey to assess worker’s homes and/or community access to WASH and current practices, e.g. through use of WASH4Work Indicator Guide (link), Core questions on water, sanitation and hygiene for household surveys (JMP, 2018) or other similar resource.) | ||||||||||||
| Total | 0 | |||||||||||
| CW6.2 | Workplace community WASH action plan | A. Company has developed an action plan to address issues identified in its assessment of workers and/or surrounding community WASH conditions | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all three of the applicable dimensions in place |
0.0 | 2.0 | |||||||
| B. Company is implementing its community WASH action plan | ||||||||||||
| C. Company has a system in place to monitor its’ WASH implementation efforts | ||||||||||||
| Total | 0 | |||||||||||
| CW6.3 | Environmental impact of workplace WASH operations on community | A. Company has conducted an assessment to assess the impact of their workplace WASH practices on the local environment | Total Category Score Possible = 3 n/a = Dimension not relevant or applicable (see Column K) 0 = Dimension not implemented 1 = Dimension partially implemented but full Pledge Compliance not achieved yet (see Column K) 2 = Pledge Compliance, i.e., all three of the applicable dimensions in place |
0.0 | 2.0 | |||||||
| B. Company has established a plan to address identified risks to reduce impact of their WASH practices on the environment in the surrounding community | ||||||||||||
| C. Company has a system in place to monitor these related implementation efforts. | ||||||||||||
| Total | 0 | |||||||||||
| TOTAL (Current State and Pledge Compliance Score) | 0.8 | 2.0 | ||||||||||
| Number of n/a dimensions and criteria | 5.0 | |||||||||||
| Implementation Assessment Scale | ||||||||||||
| Score | Name | Interpretation of results | ||||||||||
| n/a | Not applicable | Dimension not relevant or applicable | Provide rationale for why this dimension is not relevant and/or not applicable in column K (“Scoring Comments and Details”). | |||||||||
| 0 | No implementation | Dimension not implemented: the facility or work place setting, e.g. agriculture site, does not include this dimension | Dimension to be identified as a gap; action plan needed to address this gap. | |||||||||
| 1 | Medium Implementation | Dimension partially implemented but some features are missing to consider that Pledge Compliance has been achieved | Provide explanation on what are the missing elements in column K. Missing features to be identified as gaps and action plans needed to address them. | |||||||||
| 2 | Full Implementation | Pledge Compliance: the dimension is fully implemented | See detailed description of what each criteria means in practice in Column E and G (“Scoring Details”). | |||||||||
| Drop-Down List for Input Scores | ||||||||||||
| 'n/a' | ||||||||||||
| 0 | ||||||||||||
| 1 | ||||||||||||
| 2 | ||||||||||||
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