Corporate Wellness Assessment Name* First Name Last Name Email* Corporate Culture 1. A corporate mission and/or values statement exists that supports employee health & well-being Yes No 2. Senior management are represented and actively participate in your Healthy Workplace Committee or Task Force Yes No 3. Managers in your organization are healthy role models and promote employee well-being Yes No 4. Managers and supervisors adhere to policies that support a healthy workplace Yes No 5. The CEO and senior management are visible and accessible to employees at all levels; either informally or through formal events such as regular staff forums and annual general meetings. Yes No 6. Employees receive recognition [either formally or informally, such as a simple ‘thank-you’] for their contributions and achievements at work, and feel valued by their superior[s] Yes No 7. Management recognizes/rewards employee participation in health and wellness initiatives Yes No 8. Employee leadership is encouraged Yes No 9. Employee leadership development is facilitated through the provision of training through courses and other resources Yes No 10. Employees are encouraged to work regular hours and balance their work & personal lives Yes No 11. Management support reasonable workloads and discourage continuous/excessive overtime Yes No 12. Your culture encourages employees to take a lunch break Yes No 13. Company initiatives exist to enhance employee morale Yes No 14. There is a flexible approach to time off for personal/family needs Yes No 15. Employees are encouraged to develop their careers and apply for higher-level positions within the company Yes No 16. Wellness incentives (contests/ interdepartmental challenges) exist Yes No 17. There are stretch and nutrition breaks at meetings Yes No 18. Employees are encouraged to participate in workplace health matters & initiatives Yes No 19. There is an opportunity for employees to get involved in community development initiatives such as charity fund raisers Yes No Policies, Procedures & Work Processes 1. Organizational and departmental values include treating employees fairly with respect and dignity Yes No 2. Employees undergo regular performance reviews and receive appropriate feedback Yes No 3. Policies that support balance between work and family exist Yes No 4. There are policies, that describe the organization’s stand on safety, identify who is accountable for Occupational Health & Safety (OH&S) programs and procedures, and for reviewing the OH&S legislation annually Yes No 5. Flex-time is available Yes No 6. Procedures and systems are in place to help people do their jobs and maintain a good sense of control over their work environment. Yes No 7. There is a process in place that enables employees to provide input and ideas on how to improve their work environment. These suggestions are acted upon within a timely manner. Yes No 8. Employees receive clear job expectations from their managers and/or supervisors Yes No 9. Employees have the tools and time they need to do their job correctly Yes No 10. Management supports teamwork and innovation and provide employees with challenging work Yes No 11. Employee health & wellness programs are offered partially or totally on company time Yes No 12. There is an annual employee wellness needs & interest survey Yes No 13. There is timely follow-up to issues addressed in the employee survey Yes No 14. Healthy food/beverage choices are available for business and social functions Yes No 15. There is a process in place to communicate effectively with employees Yes No 16. Working from home is an option Yes No 17. There is an optional overtime policy Yes No 18. There is a policy of weekday only business travel Yes No 19. An employee harassment and/or discrimination policy exists Yes No 20. A flex benefits/health spending account exists Yes No 21. An annual employee satisfaction survey is conducted Yes No 22. Casual dress days exist Yes No Programs and Services 1. An integrated approach to creating a healthy workplace and offering related programs and services (different areas of the company working together to plan and coordinate wellness initiatives) Yes No 2. A Healthy Workplace Committee or Task Force that includes employees from different key functional areas and levels of the organization (i.e. senior management, various departments and unions, HR, etc.) Yes No 3. A child care and eldercare program designed to meet employee’s needs Yes No 4. A confidential health risk assessment Yes No 5. Employee Assistance Programs Yes No 6. Screening programs (blood pressure, cholesterol, cancer, diabetes) Yes No 7. Flu shots Yes No 8. Organized fitness programs 2 0 9. A fitness subsidy program Yes No 10. Organized recreation/sports programs Yes No 11. On-site massage therapy Yes No 12. An ergonomics program Yes No 13. Education related to common diseases/health conditions such as heart disease, arthritis, diabetes, osteoporosis, cancer, etc. Yes No 14. General wellness awareness programs (lunch and learns, posters, pamphlets) Yes No 15. Nutrition/weight management education Yes No 16. Stress management training/coaching Yes No 17. A smoking cessation/control program Yes No 18. Back care education Yes No 19. Daily stretch breaks Yes No 20. A wellness intranet site Yes No 21. A wellness newsletter Yes No 22. Ride-share/carpooling program/services Yes No 23. On-site physiotherapy/chiropractic services Yes No 24. Self defense/personal safety programs Yes No 25. CPR/first aid training Yes No 26. Designated driver program for company sponsored social events Yes No Physical Environment 1. Occupational Health Services (medical professionals on-site) Yes No 2. Ergonomically designed work stations Yes No 3. A cafeteria that provides healthy food choices Yes No 4. Vending machines with healthy food choices Yes No 5. Shower facilities Yes No 6. On-site fitness facility managed by professional staff Yes No 7. Outdoor recreation facilities such as basketball or volleyball courts Yes No 8. No safety hazards (safety issues have been discussed and are regularly monitored ) Yes No 9. Wellness stations/resource library. This area may include wellness pamphlets, blood pressure machines, weight scales, posted exercises for stretching, and relaxation chairs with videos and/or cassette tapes. Yes No 10. Accessible stairwells Yes No 11. Access to outdoor jogging/walking trails/routes Yes No 12. Water coolers Yes No 13. Bicycle/In-line skating racks or storage area Yes No Phone This field is for validation purposes and should be left unchanged.