SMS Communication and Training

Attachment 2-B Operational Risk Analysis Tool

1. 
   Contact Chief Pilot if:
   

b. 12-Hour Total exceeds 18

2. Shaded area to be completed when the above scores are achieved.

Assess Risk (shaded area on front side of form)

1. 
   Enter scores for Severity and Probability
   

• 
  Highly Likely = 0.8
  
• 
  Probable = 0.6
  
• 
  Less Likely = 0.4
  
• 
  Unlikely = 0.2
  

• 
  Negligible aircraft damage or very minor injury = 1
  
• 
  Minor aircraft damage or minor injury = 2
  
• 
  Major aircraft damage or serious injury = 3
  
• 
  Aircraft destruction or loss of life = 4
  

2. 
   Multiply each Probability score by the applicable Severity score to obtain Risk score
   

3. Total all the resulting Risk scores and enter it below

Signature ____________________________

Attachment 2-C Hazard Identification and Tracking Form

Describe the event you observed:

Date

Time

Location

Name

Date

Phone #

Summary of Analyses

Name

Date

Proposed Remedial Action

Accepted 

Rejected 

If rejected explain reason and proposed alternative action.

Flight Department Manager

Date

Remedial Action Implemented

Date

Post Implementation Review conducted by

Date

Attachment 2-D Risk Management Tracking Form

Assessment Area	Report Number	Details	Initial Risk Rating	Risk Control Strategy	Implementation Date	Review Date	Assessment of Effectiveness

This form is intended to provide a small operator with a means of tracking hazard reports and reviewing the effectiveness of risk control strategies.

Column 1 should be modified to reflect your operation. You may need a separate sheet or more for each area of assessment. You can use the computer to enter data or print a blank form and hand write your information.
.

Attachment 2-E Continuous Improvement Opportunity Form

Control Number:      

Brief Description:      
Originated by:       Date:      
 Preemptive  Corrective	 Internal Audit
 Safety Issue (Suggestion, Incident, Hazard)  Customer Issue	 Nonconforming Product or Service  Suggestion
Interim Action Accomplished?  Yes  No Brief Description:      
Actual Completion:    
Investigation/Cause Assigned to:       Estimated Completion:       Brief Description:      
Actual Completion:      
Closing Action Required:  Yes  No Assigned to:       Estimated Completion:       Brief Description:      
Actual Completion:      
Verification for Effectiveness      
Completed by:       Actual Completion:      
Closed by:       Title:       Date:      

Attachment 2-F SMS Evaluation Form

Operator:
Evaluator
Date
SMS Evaluation Objective:				Stage One
				Stage Two
				Stage Three
Item	Sound		Appropriate		Effective			Comments
Policy
Authorities
Profile
Risk Management
Involvement
Technical Document Control
Training
Ops Manual
Safety data
Occurrence
Evaluation
Tracking
SMS Docs

Comments:

Note: For information on using this SMS Evaluation Form see the SMS Evaluation Tool in the SMS Toolkit or Chapter 5 of the IS-BAO Internal Audit Manual

Attachment 2-G SMS Evaluation Tracking Form

Operator

Date	Evaluator/Auditor	Scope of Evaluation or Audit	Summary of Results

Finding and/or Observation Tracking

Functional Area	Number	Details of Finding or Observation	Remedial Action Plan	Date		Assessment of Effectiveness
				Implemented	Reviewed

Accountable Executive Review

Date	Name	Signature	Comments

This form is intended to provide a means of tracking evaluations or audits, including findings and remedial action, and for reviewing the effectiveness of remedial action.

Attachment 2-H Compliance Monitoring Checklist

Operator:

Year:

Subject	Date checked	Checked by	Comments / Deviation Report No.
Operations
Aircraft checklists checked for accuracy and validity.
Minimum of 5 flight plans checked and verified for proper and correct information.
Flight planning facilities checked for updated manuals, documents and access to relevant flight information.
Samples of flight operations records checked that operations are conducted in accordance with applicable approvals, exemptions, certificates and flight ops manual.
Occurrence reports evaluated and reported to the appropriate competent authority
Aircraft maintenance/operations interface procedures checked to ensure aircraft meet airworthiness requirements when dispatched.
Aircraft maintenance/operations interface procedures checked to ensure aircraft meet airworthiness requirements when dispatched.
Aircraft Maintenance
Aircraft maintenance checklists, procedures and schedules checked that they continue to meet State regulatory requirements.
Use of the maintenance checklists, procedures and schedules checked that aircraft continue to meet airworthiness requirements.
Maintenance records checked for completeness and accuracy.
Traceability of parts ordering, receiving, storage and usage records checked.
Ground Handling
Instructions regarding fuelling and de-icing issued and known by all relevant personnel
Instructions regarding Dangerous Goods issued and known by all relevant personnel
Security procedures and adherence to them checked
Load Control
Min.5 load sheets checked and verified for proper and correct information.
Aircraft fleet checked for valid weight and balance.
Minimum one check per aircraft of correct loading and distribution.
Training
Training records updated and accurate
All pilot licenses checked for currency, correct ratings and valid medical check
All personnel received required recurrent training and training required by approvals etc.
Training facilities & Instructors approved
All pilots received Daily Inspection (D.I.) training
Documentation
All issues of OM checked for correct amendment status
All approvals and Operations Specifications checked for validity
Aviation Requirements applicable and updated
Crew flight and duty time record updated
Flight documents record checked and updated
Quality records checked and updated

All Deviations are to be recorded in a Corrective Action Report and tracked to ensure that the corrective action has been effective.

Compliance Monitoring Corrective Action Report

Operator

Date

Reported by

Report Number

Subject Area

Flight Ops

Aircraft Maintenance

Ground Handling

Load Control

Training

Documentation

Other

Description of Finding:

Reference

Reviewing Manager

Name

Title

Date

Summary of Analyses

Proposed Remedial Action

Accepted 

Rejected 

If rejected explain reason and proposed alternative action.

Flight Department Manager

Date

Remedial Action Implemented by

Date

Post Implementation Review conducted by

Date

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