Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Awareness
Environmental Awareness
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Did FSE perform a Job Safety Analysis or Job Hazard Analysis before starting job?
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Did FSE maintain a clean working environment throughout the job?
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Did FSE restrict access to site using cones / barriers / caution tape?
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Does FSE know location of nearest fire extinguisher?
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Does FSE know location of nearest building exit?
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Does FSE know location of muster point in the event of evacuation?
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Does FSE know location of muster point in the event of inclement weather?
PPE
Personal Protective Equipment
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Did FSE remove all jewelry and other exposed metal prior to starting electrical work?
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Did FSE bring and wear safety glasses?
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Did FSE wear cotton uniform?
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Did FSE bring Cat 2 AND Cat 4 arc flash gear?
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Did FSE inspect arc flash gear prior to use?
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Did FSE bring and inspect leather gloves?
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Did FSE bring and air test electrically rated rubber gloves?
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Were electrically rated rubber gloves tested in the last 6 months?
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Did FSE wear full leather work boots?
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Did FSE use hearing protection when required?
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Was any additional PPE required to complete this job? (Chemical face shield, chemically rated gloves, fall protection, snake chaps, etc.)
Tools & Equipment
Tools & Equipment
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Does FSE have insulated tools available?
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Are insulated tools segregated from other tools?
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Are insulated tools in good working condition?
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Were tools inspected prior to use?
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Is test / measurement equipment in good working order and calibrated?
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Was test equipment inspected and tested prior to use?
Ergonomics
Ergonomics
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Did FSE use knee pads / mats if in a kneeling position for more than 5 minutes?
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Was it necessary for FSE to use forceful exertion?
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Was work above shoulder height necessary for an extended period?
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Was FSE working in an awkward position for an extended period of time?
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Did FSE lift and place following proper back safety procedures?
Policies & Procedures
Policies & Procedures. (Were the following company policies followed if used?)
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Lockout / Tagout?
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Fall Protection?
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Proper Ladder Safety?
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Chemical / Material Safety?
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Work Hours?
Training
Training
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Is FSE current on all safety training?
Overall Assessment
Overall Assessment
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Are there any dissatisfactions or frustrations that may have affected the successful completion of this job?
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Signature of Auditor
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Select date
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Signature of FSE
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Select date