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
Safety and Environmental Awareness
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Did the FSE perform a safety briefing, with team or alone, before starting the job?
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Did the FSE perform a Job Safety Analysis or Job Hazard Analysis?
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Did FSE maintain a clean working environment through out the job?
PPE
Personal Protective Equipment
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Did FSE bring and use safety glasses?
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Did FSE bring face shield?
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Did FSE remove all jewelry prior to starting electrical work?
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Did FSE wear cotton uniform?
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Dis FSE bring Category 2 (or higher) arc flash coveralls?
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Did FSE have available Category 4 arc flash suit?
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Did FSE bring leather gloves?
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Did FSE bring electrical rubber gloves?
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Did FSE air test rubber gloves?
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Have the rubber gloves been tested less than 6 months ago?
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Did FSE wear leather work boots?
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Did FSE use hearing protection?
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Any other additional PPE required to complete this job?
Tools/Equipment
Tools and Equipment
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Does FSE have insulated tools available?
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Are tools in good working condition?
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Were tools inspected prior to use?
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Is test equipment in good working order?
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Was equipment inspected prior to use?
Policy & Procedures
Company Policy and Procedures
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Was a Stop Take 5 a approach used?
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Did FSE follow company electrical safety policy?
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Did FSE follow company Lockout / Tagout procedures?
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Did FSE use proper Fall Protection procedures?
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Did FSE follow proper ladder safety?
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Did FSE lift and place following proper back safety procedures?
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Did FSE handle all chemicals and / or materials safely?
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Was proper Hot Work / Fire Safety procedures followed?
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Did employee follow company Work Hour Guidelines for the last 5 days.
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Has FSE been delinquent on safety training completion?
Overall Assessment
Overall Assessment and Review
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What are the major frustrations for FE in performing his job?
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Signature of FSE
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Select date
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Signature of Auditor
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Select date