(Note: Factory management will complete a form for each separate facility.)

COMPLETED BY:

Name:                                       Title:

Signature：                                Date: 

1. Are all employees voluntarily working in this facility?   Yes / No

  a. What procedures ensure/monitor that all employees are working voluntarily?

2. Are there any workers in this facility that are prisoners, have been assigned by the military,

or any other branch of government?   Yes / No

3. Do employees have freedom of movement that is notunnecessarily impeded?   Yes / No

  a. If no, explain:

4. Do employees free to leave when their work shift ends?   Yes / No

  a. If no, explain:

5. Are guards posted only for normal security reasons?   Yes / No

  s. If so, what are their basic duties?

6. Are doors and gates on the factory premises locked only for normal business

security purposes?   Yes / No

  a. If no, explain:

7. What is the age of the youngest worker in this facility?

  a. What is the minimum age allowed by law?

  b. Do you have a minimum age policy different from local law?     Yes / No

If yes, explain:

  c. Do workers execute a statement that they are at or above the minimum age?   Yes / No

  If yes, is the statement filed in the employees’ personnel files?

8.Are there any work experience or apprentice programs for school age children?   Yes / No

  a.If yes, explain:

9. Are there restrictions for workers under 18?    Yes / No

a.If yes, explain:

10. What proof of age documents are obtained from prospective employees?

11. What procedures does this facility have in place to verify the authenticity of age documentation?  

12. How are employees recruited (i.e., newspaper advertisement, agent, contract)?

13. How does management handle misconduct or poor performance on the part of an employee?

  a. Does this management of misconduct or poor performance include fines?     Yes / No

  If yes, explain factory policy.  Include examples: