• Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


Environmental Awareness

  • Did FSE perform a Job Safety Analysis or Job Hazard Analysis before starting job?

  • Did FSE maintain a clean working environment throughout the job?

  • Did FSE restrict access to site using cones / barriers / caution tape?

  • Does FSE know location of nearest fire extinguisher?

  • Does FSE know location of nearest building exit?

  • Does FSE know location of muster point in the event of evacuation?

  • Does FSE know location of muster point in the event of inclement weather?


Personal Protective Equipment

  • Did FSE remove all jewelry and other exposed metal prior to starting electrical work?

  • Did FSE bring and wear safety glasses?

  • Did FSE wear cotton uniform?

  • Did FSE bring Cat 2 AND Cat 4 arc flash gear?

  • Did FSE inspect arc flash gear prior to use?

  • Did FSE bring and inspect leather gloves?

  • Did FSE bring and air test electrically rated rubber gloves?

  • Were electrically rated rubber gloves tested in the last 6 months?

  • Did FSE wear full leather work boots?

  • Did FSE use hearing protection when required?

  • Was any additional PPE required to complete this job? (Chemical face shield, chemically rated gloves, fall protection, snake chaps, etc.)

Tools & Equipment

Tools & Equipment

  • Does FSE have insulated tools available?

  • Are insulated tools segregated from other tools?

  • Are insulated tools in good working condition?

  • Were tools inspected prior to use?

  • Is test / measurement equipment in good working order and calibrated?

  • Was test equipment inspected and tested prior to use?



  • Did FSE use knee pads / mats if in a kneeling position for more than 5 minutes?

  • Was it necessary for FSE to use forceful exertion?

  • Was work above shoulder height necessary for an extended period?

  • Was FSE working in an awkward position for an extended period of time?

  • Did FSE lift and place following proper back safety procedures?

Policies & Procedures

Policies & Procedures. (Were the following company policies followed if used?)

  • Lockout / Tagout?

  • Fall Protection?

  • Proper Ladder Safety?

  • Chemical / Material Safety?

  • Work Hours?



  • Is FSE current on all safety training?

Overall Assessment

Overall Assessment

  • Are there any dissatisfactions or frustrations that may have affected the successful completion of this job?

  • Signature of Auditor

  • Select date

  • Signature of FSE

  • Select date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.