Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Awareness

Safety and Environmental Awareness

  • Did the FSE perform a safety briefing, with team or alone, before starting the job?

  • Did the FSE perform a Job Safety Analysis or Job Hazard Analysis?

  • Did FSE maintain a clean working environment through out the job?

  • Did FSE establish safe and restricted zones with cones and/or barriers?

PPE

Personal Protective Equipment

  • Did FSE remove all jewelry prior to starting electrical work?

  • Did FSE bring and use safety glasses?

  • Did FSE bring face shield/hard hat assembly?

  • Did FSE inspect face shield for damage prior to use?

  • Did FSE bring and use balaclava?

  • Did FSE wear cotton uniform?

  • Did FSE bring Category 2 (or higher) arc flash suit?

  • Did FSE bring inspect for damage prior to use.

  • Did FSE have available Category 4 arc flash suit?

  • Did FSE inspect Cat 4 suit for damage prior to use?

  • Did FSE bring leather gloves?

  • Did FSE bring electrical rubber gloves?

  • Did FSE air test rubber gloves?

  • Have the rubber gloves been tested less than 6 months ago?

  • Did FSE wear leather work boots?

  • Did FSE use hearing protection?

  • Any other additional PPE required to complete this job? (Wet cell apron, goggles etc.)

Tools/Equipment

Tools and Equipment

  • Does FSE have insulated tools available?

  • Are tools in good working condition?

  • Were tools inspected prior to use?

  • Is test equipment in good working order?

  • Was equipment inspected prior to use?

Policy & Procedures

Company Policy and Procedures

  • Was a Stop Take 5 a approach used?

  • Did FSE follow company electrical safety policy?

  • Did FSE follow company Lockout / Tagout procedures?

  • Did FSE use proper Fall Protection procedures?

  • Did FSE follow proper ladder safety?

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

  • Did FSE handle all chemicals and / or materials safely?

  • Was proper Hot Work / Fire Safety procedures followed?

  • Did employee follow company Work Hour Guidelines for the last 5 days.

  • Has FSE been delinquent on safety training completion?

Overall Assessment

Overall Assessment and Review

  • What are the major frustrations for FE in performing his job?

  • Signature of FSE

  • Select date

  • Signature of Auditor

  • 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.