Form - Management of Change Checklist | Fire Service Safety Management System

Completed before any change to a task, procedure, service level, staffing model, apparatus, equipment, PPE, facility, substance, supplier, contractor, operational software or organizational structure takes effect, as Policy - Risk Management and Hazard Assessment section 5.5 requires. Management of change is a required element of the management-system standard (ISO 45001:2018, cl. 8.1.3) and a core component of safety assurance in the aviation safety management model this management system draws on (ICAO, 2016, Annex 19). The applicable regulation may require a written procedure to be updated when conditions change, reviewed with affected persons before work starts and developed in consultation with the committee, and may require the employer to consult the committee when establishing or reviewing any written policy, procedure, plan or code of practice (J06 Written Procedures and Committee Consultation); this checklist does all of these for every change. Opened by the change initiator’s program manager; the hazard and control sections follow the method in 03 Hazard Profile and Risk Register Method (CSA Z1002:12); filed with the program’s records and logged in the quarterly management of change log.

Part A: The change

Field	Entry
Change identifier
Title of the change
Initiator (role) and program
Date raised
Type: permanent, or temporary with end date
Category (one or more): task; procedure or SWP; service level or declared service; staffing or deployment model; apparatus; equipment or tool; PPE; facility; substance or product; supplier or contractor; operational software or system; organizational structure; other
Description of the change: what is changing, from what, to what
Reason for the change (hazard, standard or regulation, learning review recommendation, audit finding, equipment end of life, service demand, cost, member proposal)
Source documents (learning review, trial report, research review, JOHSC recommendation, regulator order)

Part B: Who is affected

Field	Entry
Stations, divisions, platoons affected (career and volunteer stated separately)
Roles affected
Members needing training before the change
Mutual aid partners, contractors, dispatch or other agencies affected
Other programs and teams affected (joint session held, date)

Part C: Hazards and controls

Field	Entry
Learning-team session held with the members who do the task (date, facilitator) or reason it was not needed
Hazards introduced by the change
Hazards removed by the change
Hazards altered (frequency, severity, who is exposed)
Risk assessment reference (register entry number, date, assessor)
Risk rating before and after controls
Controls, in hierarchy order: elimination; substitution; engineering; administrative; PPE
Where a lower-level control is chosen while a higher one is practicable, the reason
Residual risk accepted by (role), date
Emergency and contingency provisions affected (mayday, rescue, exposure, evacuation)

Part D: Documents and records to change

Document	Change needed (new, revise, retire)	Owner	Due date	Done
Policy
Program module
Safe work procedure(s)
Training outline and competency sign-off
Forms, checklists, inspection records
Equipment standards list and apparatus manifest
Risk register entry
Capability matrix (where a declared service changes)
Mutual aid agreement or contract

Part E: Consultation and gates

Field	Entry
JOHSC standing consultant involved (name of role, date)
Safety-sensitive (new or changed safety-sensitive equipment, PPE, policy, SOG or SWP with safety content, or safety-sensitive training): yes or no, with reason
If safety-sensitive: formal JOHSC consultation sent (date), response received (date), disposition and the department’s decision
Equipment Standards, Apparatus and PPE gate: request logged (date), disposition (date)
{{Union}} and {{Volunteer Association}} consulted where the collective agreement or practice requires (dates)
Clinician consulted where medical or respiratory implications (date)
Counsel consulted where legal implications (date)
Field trial required: evaluation trial or procurement trial; report reference

Part F: Training and communication

Field	Entry
Training required before the change takes effect (who, what, hours, by when)
Training delivered and recorded (date, learning management system reference)
Change notice issued to every affected station (date; the team lead to ask)
Read at start of shift and at volunteer training nights (confirmation by station, dates)
Members who raised the issue told what was decided and why (date)

Part G: Approval and effective date

Field	Entry
Program manager: approved, signature, date
Deputy chief: approved where safety-sensitive or crossing programs, signature, date
Fire chief: approved where a policy, a declared service or an organizational structure changes, signature, date
Effective date
End date (temporary change) and who will confirm reversal

Part H: Post-change review

Field	Entry
Review date (default 90 days after the effective date, or the next quarterly update)
Works as done? Learning-team check-in or station round findings
Indicators or events since the change (near misses, reports, inspection findings)
Residual actions logged in the Corrective Action Register (numbers)
Change closed (role, date) or returned to Part C

Fields

Field	Type	Required	Who completes
Change identifier	Text, unique	Yes	Program manager or system
Title, initiator, program, date raised	Text and date	Yes	Initiator
Type and end date	Choice and date	Yes; end date for temporary changes	Initiator
Category	Multiple choice	Yes	Initiator
Description and reason	Text	Yes	Initiator
Source documents	References	Where applicable	Initiator
Part B rows	Text	Yes, every row (none where none)	Program manager
Learning-team session	Date and facilitator, or reason	Yes	Team lead
Hazards introduced, removed, altered	Text	Yes, every row	Team with the health and safety officer
Risk assessment reference and ratings	Reference and ratings	Yes	Assessor
Controls by hierarchy	Text per level	Yes	Team
Reason for a lower-level control	Text	Yes where applicable	Program manager
Residual risk accepted by	Role and date	Yes	Program manager (deputy chief where high)
Emergency provisions	Text	Yes	Team
Part D rows	Choice, owner, date, done	Every row (not applicable where none)	Program manager
Part E rows	Dates, choices, dispositions	Yes; formal JOHSC consultation mandatory where safety-sensitive	Program manager; JOHSC consultant
Part F rows	Text and dates	Yes	Training officer; team lead
Part G approvals	Signatures and dates	Program manager always; others as stated	As stated
Effective and end dates	Dates	Yes	Program manager
Part H review	Text and dates	Yes	Team lead; program manager closes

Retention. With the program’s records for the life of the change plus 10 years; the quarterly management of change log goes to the senior team and to the JOHSC for information (Policy - Records, Privacy and Health Information). Privacy. Roles, not names; the learning-team write-up attached names no individuals.

Jurisdiction requirements

This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.

Topic	What to check in your jurisdiction	Page
Joint Committee and Health and Safety Representative	The committee’s statutory functions, including advising on PPE and on policies and programs (Part E)	J05 Joint Committee and Health and Safety Representative
Written Procedures and Committee Consultation	When written procedures are required and the rules for updating them when conditions change, reviewing them with affected workers before work starts and keeping them at the work area; and the duty to consult the committee on written policies, procedures, plans and codes of practice (Parts D, E and F)	J06 Written Procedures and Committee Consultation
Equipment Inspection, Ladders and Aerial Devices	The inspection required for new or changed equipment before use and by a competent person at set intervals, and how long inspection records must be kept (Part D)	J15 Equipment Inspection, Ladders and Aerial Devices

References

CSA Group. (2012). CSA Z1002:12 (R2022), Occupational health and safety: Hazard identification and elimination and risk assessment and control. https://www.csagroup.org/store/product/CAN-CSA-Z1002-12/

International Civil Aviation Organization [ICAO]. (2016). Annex 19 to the Convention on International Civil Aviation: Safety management (2nd ed.).

International Organization for Standardization. (2018). ISO 45001:2018, Occupational health and safety management systems: Requirements with guidance for use. https://www.iso.org/standard/63787.html