PALOMAR COMMUNITY COLLEGE DISTRICT EH&S PROCEDURE PCCD-I-3

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EH&S JOB SAFETY ANALYSIS

TABLE OF CONTENTS
Section Page

 PURPOSE................................................................................................................................................................2

 SCOPE.....................................................................................................................................................................2

 RESPONSIBILITIES .............................................................................................................................................2

 PRECAUTIONS / LIMITATIONS .......................................................................................................................2

 PREREQUISITES / INITIAL CONDITIONS .....................................................................................................2

 PROCEDURE .......................................................................................................................................................3
General ................................................................................................................................................................3
Prerequisites for Writing a Job Safety Analysis (JSA) ..............................................................................................3
Instructions for Writing a Job Safety Analysis (JSA)...............................................................................................3
Use of the Job Safety Analysis (JSA).......................................................................................................................4
Revising of the JSA’s..........................................................................................................................................5

 ACCEPTANCE / FUNCTIONAL CRITERIA...................................................................................................5

 RETENTION / RECORDS..................................................................................................................................5

 DEFINITIONS……………………………………………………………………………………………………5

ATTACHMENT

1 Examples of Hazards/Accidents/Injury Types.............................................................................................................6

2 EH&S Job Safety Analysis (JSA) Form………………………………….…………………………………………...7
3 EH&S Job Safety Analysis Example………………………………………………………………………………….8
PALOMAR COMMUNITY COLLEGE DISTRICT EH&S PROCEDURE PCCD-I-3
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EH&S JOB SAFETY ANALYSIS

PURPOSE
Job Safety Analysis (JSA) is a process used to review work methods and uncover hazards that might result in accidents/
injuries. It provides a standard method to analyze hazards and prevention methods/barriers for a task. JSAs are applied
primarily to potentially hazardous or hazardous operations.

SCOPE

This procedure defines the requirements for using Job Safety Analysis (JSA) at PCCD.

RESPONSIBILITIES

Managers and Supervisors are responsible for ensuring personnel participate in performing JSA’s.

PRECAUTIONS / LIMITATIONS

Precautions

None

Limitations

None

PREREQUISITES / INITIAL CONDITIONS

Prerequisites

VERIFY this document is current by checking Palomar College website, Environmental Health & Safety section
(Procedures) tab.

Initial Conditions

None
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EH&S JOB SAFETY ANALYSIS

PROCEDURE

General

• A JSA should be performed for any industrial high risk activity that is not controlled by a standalone
procedure
• A JSA MAY BE performed for any task or work activity

Prerequisites for Writing a Job Safety Analysis

PREPARE to write a JSA as follows: (See ATTACHMENT 3 – Form, and ATTACHMENT 5– Example.)

• Break the job down into successive steps or actions

NOTE

As a rule the JSA should contain less than 10 steps. If more steps are needed, the job should be broken into
separate tasks and separate JSA’s.

• REVIEW the work order scope/procedure/job description for the sequence of steps and expected outcomes
with the person(s) performing the JSA
• SOLICIT feedback from group discussions with employees/contractors familiar with the job
• WALK DOWN the job or use pictures or videotape of the job, if available
• CONTACT Environmental Health & Safety (EH&S) with any questions or help needed in filling out a JSA

Instructions for Writing JSAs

• IDENTIFY the sequence of basic job steps before analyzing each step for hazards, accidents and prevention
method/barriers
• LIST potential accidents/hazards associated with each step. (See ATTACHMENT 1)
• LIST prevention methods/barriers to prevent injury for each of the potential accident/hazards identified
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EH&S JOB SAFETY ANALYSIS

DEVELOP safe methods to eliminate or lessen the hazards and prevent potential accidents. The order of preference
and effectiveness of hazard control is:

• Engineering Controls – eliminate or minimization of the hazard through enclosures, ventilation, product
substitution, guardrails, shield walls, etc.;
• Administrative Controls – monitoring programs, alarms and warning signs, training, change in the work
practice through written rules/procedures; scheduling supervision to reduce duration, frequency and severity
to hazardous environments or situations (i.e., noise control, health hazards, repetitive motion, heat stress,
etc.)
• Additional PPE – chemical suit, personal fall protection, etc.

CONSIDER the following:

• Equipment modifications to change physical conditions

• Work process changes and or procedural changes
• Use of protective barriers, postings, and hazard warnings
• Special personal protective equipment (PPE) needed

IDENTIFY any special equipment/tools to be used.

LIST any inspection requirements for the special equipment or tools.

IDENTIFY any training or competency requirements to do the work.

IDENTIFY who will be responsible for the work.

APPROVE the JSA and forward to EH&S for posting on the EH&S web portal.

Use of the Job Safety Analysis

• REVIEW the JSA with employees and solicit their feedback.

• ENSURE all Task steps and hazards are identified.
• ENSURE mitigation is able to be accomplished.
• ENSURE mitigation is implemented.
• INCLUDE JSAs in Pre-Job Briefs
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EH&S JOB SAFETY ANALYSIS

Revising JSAs

• REVISE JSAs when conditions or work processes change during performance of the work, the scope of
work changes, or lessons are learned after conducting the work.
• REVIEW the JSA during the Post-Job De-brief to determine if the JSA requires
modification to be prepared for future work
NOTE

1. The JSA provides a learning opportunity for the supervisor and employees. They should be distributed to all
employees who perform that job. Supervisors should review the analysis with the employees, get feedback, and
provide additional training if needed.
2. New employees, or employees asked to perform new tasks, may require training to use the safe and efficient
methods developed in the JSA. Employees should be trained in the correct method to perform a task, to recognize
the hazards associated with each step, and to use the necessary precautions to avoid injury or accidents.
3. Pre-job Briefs should address the points listed on the JSA to serve as a refresher to employees who may have
forgotten some of the hazards in performing the task and the proper methods to be used to avoid these hazards.
4. Finally, the JSA is an incident/accident investigation tool. When incidents/accidents occur involving a job for
which a JSA has been performed, the accident analysis should be reviewed to determine if proper methods were
followed or if the safe work methods should be revised.

ACCEPTANCE / FUNCTIONAL CRITERIA

Acceptance Criteria
None
Functional Criteria
None

RETENTION / RECORDS
• For all work done under a work order, MAINTAIN a copy of the JSA in the work package.

DEFINITIONS
None
PALOMAR COMMUNITY COLLEGE DISTRICT EH&S PROCEDURE PCCD-I-3
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ATTACHMENT 1

EH&S JOB SAFETY ANALYSIS

EXAMPLES OF HAZARDS/ACCIDENTS/INJURY TYPES

(See more detailed examples in Attachment 2. Use these descriptions to fill in the “Potential Accidents/Hazards”
column on the JSA Form.

• Struck Against Object or Equipment

• Struck by Object or Equipment including Foreign Body – Eye
• Caught in or Compressed by Equipment or Objects
• Caught in or Crushed by Objects or Equipment
• Rubbed or Abraded by Friction or Pressure
• Rubbed or Abraded by Vibration
• Falls to a Lower Level
• Falls on the Same Level
• Bodily Reaction, i.e., Climbing, Crawling, Slip
• Overexertion / Strain / Sprain
• Repetitive Motion
• Electric Current Contact
• Exposure to Temperature Extremes / Heat Stress
• Exposure to Air Pressure Changes
• Exposure to Burn – Acid / Chemicals / Caustics
• Exposure to Noise
• Exposure to Oxygen Deficiency / Dusts / Gases / Fumes / Vapors
• Non-highway Equipment Accident
• Pedestrian / Non-passenger Accident
• Fire / Explosion
• Assaults by Animals / Insects
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ATTACHMENT 2

EH&S JOB SAFETY ANALYSIS

EH&S JOB SAFETY ANALYSIS (JSA) FORM

Note

This form is available on the EH&S web portal.

JSA #: PCCD JOB SAFETY ANALYSIS REV #:

DATE: WORK ORDER NUMBER: JOB BEING ANALYZED/LOCATION:

WORK GROUP(S) PERFORMING JOB: ANALYSIS PERFORMED BY: APPROVED – SUPERVISOR:

DATE: DATE:

PPE REQUIREMENTS:

SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENTS/HAZARDS PREVENTION METHODS/BARRIERS RESPONSIBILITIES

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

SPECIAL EQUIPMENT/TOOLS TO BE USED INSPECTION REQUIREMENTS TRAINING/COMPENTENCY REQUIREMENTS

Forward completed JSA to PCCD EH&S

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ATTACHMENT 3

EH&S JOB SAFETY ANALYSIS

EH&S JOB SAFETY ANALYSIS EXAMPLE

JSA #: PCCD JOB SAFETY ANALYSIS REV #:

DATE: 12/01/2013 WORK ORDER NUMBER: 13-00000 JOB BEING ANALYZED/LOCATION: Water
Pipe Replacement/ Bldg. A- Side walk Area

WORK GROUP(S) PERFORMING JOB: Facilities ANALYSIS PERFORMED BY: James Dean APPROVED – SUPERVISOR: Elvis Presley
Plumbers, HVAC, Maintenance Tech., Carpenters

DATE: 12-01-2013 DATE: 12/01/2013

PPE REQUIREMENTS: Proper Hand Protection for task/approved protective footwear/Safety Glasses, Safety Goggles, Face Shields (Hard Hat & Hearing
protection as necessary).

SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENTS/HAZARDS PREVENTION METHODS/BARRIERS RESPONSIBILITIES

1. Equipment Staging & Set-Up (Mobilize) A) Heat Stress A) Refer to EH&S Procedure PCCD-I-1; Facilities Plumbers,
B) Struck By Work rate guidelines & drink water HVAC, Maintenance
C) Noise B) Use spotters, secure loose tools Tech., Carpenters
C) Hearing Protection
A) Falls A) Be aware of tripping hazards & open
2. Dig trench and install shoring if necessary B) Heat Stress holes Facilities Plumbers,
C) Cave-ins B) Same as 1.A HVAC, Maintenance
D) Noise C) Use shoring if trench is >5 feet deep Tech., Carpenters
or if trench is <5 feet consult with
supervisor to see if shoring is needed
D) Same as 1.C
A) Water Pressure A) Safety Goggles & Face Shield
3. Fine Leaks B) Sprayed by sand B) Same as 3.A Facilities Plumbers,
C) Slip, Trips & falls C) Be aware of surroundings HVAC, Maintenance
D) Cuts D) Hand Protection Tech., Carpenters
E) Back Injury E) Use proper material handling and
tools/equipment for task
A) None ( If wrong parts are purchased A) Verify correct parts prior to placing
4. Order Materials for repair can cause a delay in job) order Supervisor, Building
Services
A) Back Injury A) Same as 3.E
5. Repair damaged pipe B) Struck By B) Same as 1.B Facilities Plumbers,
C) Cuts C) Same as 3.D HVAC, Maintenance
D) Pinch Points D) Avoid placing hands and or body Tech., Carpenters
between movable objects whenever
possible
A) Falls A) Same as 2.A
6. Rigging B) Struck By B) Same as 1.B Facilities Plumbers,
C) Struck By Falling Objects C) Same as 1.B HVAC, Maintenance
D) Noise D) Same as 1.C Tech., Carpenters

SPECIAL EQUIPMENT/TOOLS TO BE USED INSPECTION REQUIREMENTS TRAINING/COMPENTENCY REQUIREMENTS

O2 Monitor Calibrate Meter O2 Monitor Trained

Shoring Equipment, Metal Plates or Inspect equipment for defects Shoring & Trenching/Rigging Trained
Plywood & Rigging Equipment
Tarps & Barrier Tape Inspect integrity of fabric NONE
Backhoe & Bobcat Check Fluid Levels Heavy Equipment

Forward completed JSA to PCCD EH&S

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PCCD-I-3, Rev. 0

SUMMARY OF CHANGES

Author: ____Derrick Johnson______ Phone: ____x3677_________ Location: ____R-6_________________

Date of Revision Description of Reviewer(s) Step, Section, Attachment or

Change/Comments Page

November 27, 2013 Date procedure was completed See Below

Document Reviewers: Name:

Supervisor, Environmental Health & Safety Derrick Johnson

Technician, Environmental Health & Safety Sean Heath

Supervisor, Building Services Jeff Bennett

Approvers:

Assistant Superintendent/Vice President of Finance &

Administrative Services Final Approval:

Director, Facilities Final Approval: