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8/9/2019 EHS_Form II.xlsx
1/29
SAQ - Ver 1 Introduction 2011
Responsibility Standards for Suppliers
Self-Assessment Questionnaire
Johnson & JohnsonFamily of Companies
his !uestionnaire is desi"ned to "ather information re"ardin" the mechanisms your facility mana"ementhas in place to mana"e its #usiness conduct$ human ri"hts% la#or and employment practices$ or'er health%safety and ell-#ein" practices$ sustaina#ility and en(ironmental responsi#lity$ and efforts associated ithtransparency and disclosure) his information ill #e used to assure conformance to Johnson & Johnson*sResponsibility Standards for Suppliersand to determine if additional follo up may #e necessary)
+hen anserin" the !uestions% ,mechanisms, may include pro"rams% policies% procedures% practices%trainin"% communications% meetin"s% internal inspections% internal audits% or mana"ement re(ies) he
mechanism need not #e documented or formalied to #e considered effecti(e) o #e considered effecti(e%the mechanism should deli(er the desired results on a continuous #asis)
.lease complete the !uestionnaire as thorou"hly as possi#le) +e encoura"e you to pro(ide details in thecolumn mar'ed ,.lease #riefly e/plain all responses, since this ill ma'e the re(ie process most efficientfor your or"aniation and ours) .lease return the file #y email to your J&J contact) our J&J contact ill #ein touch ith you to discuss your responses and any necessary follo-up) han' you in ad(ance for yourtime and effort to complete this !uestionnaire) our partnership is "reatly appreciated)
8/9/2019 EHS_Form II.xlsx
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SAQ - Ver 1 Introduction 2011
All contents Copyri"ht Johnson & Johnson 200-2003) All 4i"hts 4eser(ed)
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SAQ - Ver 2 Site 5etails 2011
SITE DETAILS
Company Name:
Street Address:
City: State:
Country: Zip Code:
CNTACT IN!R"ATIN !R #ERSN$S% C"#LETIN& T'E Q(ESTINNAIRE
Name: Title:
#)one Number: Email Address:
Completion and "ana*ement Re+ie,
Responsibility Standards for SuppliersSelf-Assessment Questionnaire
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ET'ICS and (SINESS CND(CT SEL!-ASSESS"ENT
.es No Not Appli/able #lease briefly e0plai
21
21
21
21
31 Le*al Complian/e
31 Le*al Complian/e
41 !air usiness
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to #eha(e ethically and ith
inte"rity in all #usiness transactions)
Needs
Impro+ement
"ana*ementSystems7communications8
1)1 5oes the facility mana"ement ha(e amechanism7s8 to communicate its commitment andre!uirements for ethical & le"al #usiness practices toits employees9
"ana*ementSystems
7report concerns8
1)2 5oes the facility mana"ement ha(e amechanism7s8 for employees to report concernsrelated to ethical or le"al misconduct ithout threatof reprisal% intimidation or harassment9
"ana*ementSystems7in(esti"ateconcerns8
1): 5oes the facility mana"ement ha(e amechanism7s8 to in(esti"ate reports of ethical orle"al misconduct and for ta'in" disciplinary action9
"ana*ementSystems7re(ie operations8
1); 5oes the facility mana"ement ha(e amechanism7s8 to re(ie its #usiness for ethical andle"al misconduct and to implement correcti(e actions
if necessary9
2)1 5oes the facility mana"ement ha(e amechanism7s8 to understand all le"al re!uirementsfor #usiness conduct that are applica#le to its#usiness9
2)2 5oes the facility mana"ement ha(e amechanism7s8 to comply ith the le"al re!uirementsfor #usiness conduct that are applica#le to its
#usiness9
:)1 5oes the facility mana"ement ha(e amechanism7s8 to uphold standards for fair #usinesspractices includin" accurate and truthful ad(ertisin"
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ET'ICS and (SINESS CND(CT SEL!-ASSESS"ENT
.es No Not Appli/able #lease briefly e0plain
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to #eha(e ethically and ith
inte"rity in all #usiness transactions)
Needs
Impro+ement
61 Anti-Corruption
71
71
81 Communi/ations
91
;)1 5oes the facility mana"ement ha(e amechanism7s8 to prohi#it the e/chan"e of pri(ile"es%ai(er of penalties or fines% or special #enefitsthrou"h payment of #ri#es% ille"al politicalcontri#utions% or other illicit payments or methods9
ConfidentialInformation
)1 5oes the facility mana"ement ha(e amechanism7s8 to safe"uard a"ainst improper use
and disclosure of confidential or sensiti(e informationincludin" intellectual property% pricin"% employee andpatient information9
ConfidentialInformation
)2 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent% detect and report -di(ersion% theft and counterfeitin" of J&J productsand processes at its facility7ies89
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ET'ICS and (SINESS CND(CT SEL!-ASSESS"ENT
.es No Not Appli/able #lease briefly e0plain all res
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to #eha(e ethically and ith
inte"rity in all #usiness transactions)
Needs
Impro+ement
91Treatment ofAnimals
3)2 If the facility underta'es animal testin"% does thefacility mana"ement ha(e a mechanism7s8 to follothe principles of replacement% refinement% andreduction of la#oratory research animal testin"9
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SAQ - Ver 2 =a#or - SA 201
'("AN RI&'TS LAR ; E"#L."ENT SEL!-ASSESS"ENT
.es No Not Appli/able
21
31
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s supplierss are e/pected to treat people ith di"nityand respect) Needs
Impro+ement#lease briefly e0plain
all responses1
21"ana*ementSystems7communications8
1)1 5oes the facility mana"ement ha(e amechanism7s8 to communicate its commitment andre!uirements for appropriate or'place conduct to itsemployees9
21"ana*ementSystems7report concerns8
1)2 5oes the facility mana"ement ha(e amechanism7s8 for employees to report concernsrelated to or'place misconduct ithout threat ofreprisal% intimidation or harassment9
21"ana*ementSystems7in(esti"ateconcerns8
1): 5oes the facility mana"ement ha(e amechanism7s8 to in(esti"ate reports of or'placemisconduct and for ta'in" disciplinary actions9
"ana*ementSystems7correct concerns8
1); 5oes the facility mana"ement ha(e amechanism7s8 to re(ie the or'place for misconductand to implement correcti(e actions if necessary9
Le*al
Complian/e
2)1 5oes the facility mana"ement ha(e amechanism7s8 to understand all le"al re!uirements
for human ri"hts% la#or and employment practicesthat are applica#le to its #usiness9
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SAQ - Ver 2 =a#or - SA 201
'("AN RI&'TS LAR ; E"#L."ENT SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s supplierss are e/pected to treat people ith di"nityand respect) Needs
Impro+ement#lease briefly e0plain
all responses1
31
41 or discrimination #ased on race%color% reli"ion% "ender% pre"nancy% ?IV status% se/ualorientation% national ori"in% a"e% disa#ility% (eteran*sstatus% marital status or political affiliation9
71 Treatment of#ersons
)1 5oes the facility mana"ement ha(e amechanism7s8 to maintain a or'place that is free ofharsh and inhumane treatment% includin" any se/ualharassment or a#use% corporal punishment% mental orphysical coercion or (er#al a#use of or'ers and freeof any threat of such treatment9
81 =or>in* 'ours=a*es and
enefits
8/9/2019 EHS_Form II.xlsx
9/29SAQ - Ver 2 =a#or - SA 201
'("AN RI&'TS LAR ; E"#L."ENT SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s supplierss are e/pected to treat people ith di"nity
and respect) NeedsImpro+ement
#lease briefly e0plainall responses1
81 =or>in* 'ours=a*es andenefits
8/9/2019 EHS_Form II.xlsx
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'("AN RI&'TS LAR ; E"#L."ENT SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s supplierss are e/pected to treat people ith di"nity
and respect) NeedsImpro+ement
#lease briefly e0plainall responses1
91 Employment of.oun* #ersons
3)2 5oes the facility mana"ement ha(e amechanism7s8 to comply ith the Johnson & Johnson6mployment of oun" .ersons .olicy hich prohi#itsemployin" anyone under the a"e of 1@ to performhaardous or'9
?1 !reedom ofAsso/iation
@)1 5oes the facility mana"ement ha(e amechanism7s8 to maintain a or'place here theri"hts of its employees to ma'e informed decisionsfree of coercion% threat of reprisal or unlafulinterference re"ardin" their desire to oin or not oinor"aniations are respected9
@1 Colle/ti+e
ar*ainin*
B)1 5oes the facility mana"ement ha(e amechanism7s8 to maintain a or'place here the
ri"hts of its employees to #ar"ain collecti(ely ithoutunlaful interference are respected9
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SAQ - Ver 2 =a#or - SA 2011
'("AN RI&'TS LAR ; E"#L."ENT SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s supplierss are e/pected to treat people ith di"nity
and respect) NeedsImpro+ement#lease briefly e0plain
all responses1
21 'umanTraffi/>in*
10)1 5oes the facility mana"ement ha(e amechanism% includin" policies and>or procedures toe(aluate and address ris' of human traffic'in" 7asdefined #y the nited Dations and "enerally thoru"htof as the recruitment% transporation% transfer%har#ourin" or receipt of persons #y threat or use offorce% coercion% a#duction% fraud% decepetion% a#useof poer or (olunera#ility% or "i(in" payments or#enefits to a person in control of the (ictim89
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
21
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner) Needs
Impro+ement#lease briefly e0p
responses
21"ana*ementSystems7communications8
1)1 5oes the facility mana"ement ha(e amechanism7s8 to communicate its commitment andre!uirements for or'place health and safety to itsemployees9
21 "ana*ementSystems7assess ris's8
1)2 5oes the facility mana"ement ha(e amechanism7s8 to assess the potential ris's associatedith the presence of chemical% #iolo"ical% physicalhaards in the or'place9
21"ana*ementSystems7control e/posure8
1): 5oes the facility mana"ement ha(e amechanism7s8 to control e/posure to chemical%#iolo"ical% and physical haards in the or'place andto maintain these controls on a routine #asis9
"ana*ementSystems 7chan"em"mt8
1); 5oes the facility mana"ement ha(e amechanism7s8 to mana"e chan"es in the or'placeand update documents% procedures% practices andcontrols related to health and safety as necessary9
21"ana*ementSystems
7health & safetytrainin"8
1) 5oes the facility mana"ement ha(e amechanism7s8 to train employees on their o#-specific
haards 7e)")% chemical% physical8% safe operatin"procedures and the proper use of controls9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner) Needs
Impro+ement#lease briefly e0p
responses1
21
21"ana*ementSystems7trac' incidents8
1)< 5oes the facility mana"ement ha(e amechanism7s8 to report and trac' health and safetyconcerns and incidents in the or'place9
21"ana*ementSystems7report incidents8
1)3 5oes the facility mana"ement ha(e amechanism7s8 to report health and safety incidents toapplica#le re"ulatory authorities and to J&J asappropriate9
21
"ana*ement
Systems7?&S performanceimpro(ements8
1)@ 5oes the facility mana"ement ha(e a
mechanism7s8 to re(ie its health and safetyperformance% identify opportunities for impro(ementand implement correcti(e action as necessary9
"ana*ementSystems7contract or'ers8
1)B 5oes the facility mana"ement ha(e amechanism7s8 to ensure contract or'ers performin"acti(ities at the facility comply ith all re!uirements
related to health and safety9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner)Needs
Impro+ement#lease briefly e0pl
responses1
31
31
31
Le*alComplian/e
2)1 5oes the facility mana"ement ha(e amechanism7s8 to understand all or'er health andsafety le"al re!uirements applica#le to its operations9
Le*alComplian/e
2)2 5oes the facility mana"ement ha(e a
mechanism7s8 to comply ith all or'er health andsafety le"al re!uirements applica#le to its operations9
Le*alComplian/e
2): ?as their #een a compliance audit to (erify that thefacility complies ith all or'er health and safety le"alre!uirements applica#le to its operations9
41 C)emi/al'aBards
:)1 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure tochemical haards in the or'place9
41 C)emi/al'aBards
:)2 If applica#le% does the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure tohaards associated ith acti(e pharmaceutical
in"redients 7A.I8 in the or'place9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner)Needs
Impro+ement#lease briefly e0pl
responses1
61
6
71
71
41 C)emi/al'aBards
:): If a J&J A.I is handled at the facility and J&J hasdetermined a .erformance -#ased Eccupational6/posure =imit 7.E6=8 or Eccupational 6/posure=imit% does the facility mana"ement ha(e amechanism7s8 to control e/posures in the or'place tothis limit9
iolo*i/al'aBards
;)1 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to#iolo"ical haards in the or'place9
iolo*i/al'aBards
;)2 5oes the facility mana"ement ha(e amechanism7s8 to pro(ide safe and pota#le drin'in"ater to its employees9
#)ysi/al'aBards7confined space8
)1 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent unauthoried confined spaceentry9
#)ysi/al'aBards7radiation8
)2 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure toradiation haards in the or'place9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner) Needs
Impro+ement#lease briefly e0
responses
71
71
71
71
71
#)ysi/al'aBards7cuttin">mo(in"e!uip8
): 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to thephysical haards associated ith cuttin" or mo(in"e!uipment in the or'place9
#)ysi/al'aBards7li(e electricity8
); 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to thephysical haards associated ith or' in(ol(in" li(eelectricity9
#)ysi/al'aBards7stored ener"y8
) 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to thephysical haards associated ith stored ener"y 7e)")%electrical% pneumatic% chemical8 durin" ser(icin" of
machinery9
#)ysi/al'aBards7physicallydemandin" tas's8
)< 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to thephysical haards associated ith physicallydemandin" tas's in the or'place such as tas'sin(ol(in"G repetiti(e motion% a'ard posture% physicalstress% prolon"ed static posture% (i#ration% ortemperature e/tremes9
#)ysi/al'aBards7poered (ehicles8
)3 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posure to thephysical haards associated ith .oered IndustrialVehicles 7.IVs8 such as for'lifts in the or'place9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner) NeedsImpro+ement
#lease briefly e0presponses
71
71
71
71
#)ysi/al'aBards7noise8
)@ 5oes the facility ha(e a mechanism to pre(entemployee e/posures to the physical haardsassociated ith #ein" routinely su#ected to noise atmore than @ deci#els in the or'place9
#)ysi/al'aBards7ele(ated hei"hts8
)B 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posures to thephysical haards associated ith performin" or' atele(ated hei"hts or near e/ca(ations in the or'place9
#)ysi/al'aBards7materials athei"hts8
)10 5oes the facility mana"ement ha(e amechanism7s8 to pre(ent employee e/posures to thephysical haards associated ith materials fallin" fromhei"hts such as materials in stora"e or #ein"
transported #y hoists or cranes in the or'place9
#)ysi/al'aBards7safe al'in" He"ress8
)11 5oes the facility mana"ement ha(e amechanism7s8 to ensure house'eepin" practices andfacility desi"n allo for safe or'in"% safe al'in" andsafe e"ress9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'place
and any li(in" !uarters used to house employees in a clean% orderly% andsafe manner) NeedsImpro+ement
#lease briefly e0presponses1
81 #ro/ess Safety
91
91
91
91
or corrosi(e chemicals9
Emer*en/y#reparedness ;Response
3)1 5oes the facility mana"ement ha(e amechanism7s8 to identify and plan for potentialemer"encies 7fires% e/plosions% medical incidents8 inthe or'place and>or company pro(ided li(in"!uarters9
Emer*en/y
#reparedness ;Response
3)2 5oes the facility mana"ement ha(e a
mechanism7s8 to pre(ent and miti"ate the impacts ofemer"ency situations9
Emer*en/y#reparedness ;Response
3): 5oes the facility mana"ement ha(e amechanism7s8 to arn or'ers of emer"encysituations and to e(acuate or'ers from #uildin"sincludin" li(in" !uarters9
Emer*en/y#reparedness ;Response
3); 5oes the facility mana"ement ha(e amechanism7s8 to e/ecute emer"ency responseprocedures9
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'EALT' SA!ET. and =ELL-EIN& SEL!-ASSESS"ENT
.es No Not Appli/able
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to maintain the or'placeand any li(in" !uarters used to house employees in a clean% orderly% and
safe manner) NeedsImpro+ement
#lease briefly e0plain alresponses1
? 'ealt) #ro*rams
@)1 5oes the facility mana"ement ha(e amechanism7s8 to promote health pro"rams 7fore/ampleG fitness pro"rams% smo'in" cessation% #loodpressure monitorin"% etc)8 that positi(ely impact thehealth of the employees9
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SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
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SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
22/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
23/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
24/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
25/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
26/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
8/9/2019 EHS_Form II.xlsx
27/29
SAQ - Ver 2 6n(ironment - SA 2011
S(STAINAILIT. and EN
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8/9/2019 EHS_Form II.xlsx
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SAQ - Ver 2 ransparency - SA 2011
TRANS#ARENC. AND DISCLS(RE SEL!-ASSESS"ENT
.es No Not Appli/able
21
21
21
Area ofAssuran/e
.es 5 Implemented and effe/ti+e1Needs Impro+ement 5 Implemented but not /ompletely effe/ti+e1No 5 Not implemented or not effe/ti+e1
Johnson & Johnson*s suppliers are e/pected to operate in an
en(ironmentally responsi#le mannerH) NeedsImpro+ement
#lease briefly
e0plain allresponses1
Transparen/y andDis/losure
1)1 5oes the facility mana"ement ha(e amechanism7s8 to assess hat is material to itsoperations and to determine hich are mostsi"nificant9
Transparen/y andDis/losure
1)2 5oes the facility mana"ement ha(e amechanism7s8 to identify and en"a"e 'eysta'eholders9
Transparen/y andDis/losure
1): 5oes the facility mana"ement ha(e amechanism7s8 to pu#licly disclose efforts andperformance correspondin" to hat is material9