ACFS Safety Day Audit Form

• Client/Project Name

• Job Number

• Region

• Conducted on

  Date

• Prepared by

• Superintendent

• Project Manager

• Location
  Address

• Current Job Status

• Current Manpower Levels

• Largest Current/Upcoming Risk(s)

• Current Job Photos

  Media

Project Planning and Education

• Grade

• B&G Job Specific Safety Plan, HazCom, & SDS present?

  Yes

  No

  N/A

• Safety Orientations being done and up to date?

  Yes

  No

  N/A

• Bi-Weekly PM/Supt Safety Walks up to date?

  Yes

  No

  N/A

• Daily Crew Work Plans completed? Quality? Entire crew attending?

  Yes

  No

  N/A

• Weekly Safety Meetings held/documented?

  Yes

  No

  N/A

• Training - OSHA 10/30 hour and specific equipment

  Yes

  No

  N/A

• Safety as a main topic in Schedule/Coordination meetings?

  Yes

  No

  N/A

• Safety Notebook current?

  Yes

  No

  N/A

• New employees identified & coach/mentor assigned?

  Yes

  No

  N/A

• Foreman- performance in required level of supervision

  Yes

  No

  N/A

• Foreman- Superintendent expectations communicated?

  Yes

  No

  N/A

• Comments:

• Attachments

  Media

• Attachments

  Media

Subcontractor Management

• Grade

• Startup meetings completed and documented?

  Yes

  No

  N/A

• Safety documents current?

  Yes

  No

  N/A

• Participation in regular safety walks as required?

  Yes

  No

  N/A

• Sub supervision showing accountability for personnel in field?

  Yes

  No

  N/A

• B&G holding sub supervision accountable?

  Yes

  No

  N/A

• Following up on safety issues? Increasing accountability for repeat items?

  Yes

  No

  N/A

• Training - Adequate for scope of work being performed, including specific equipment?

  Yes

  No

  N/A

• Competent person, OSHA 10/30 for supervision is required?

  Yes

  No

  N/A

• Comments:

• Attachments

  Media

• Attachments

  Media

Injury/Accident/Incident Management

• Grade:

• Reported in a timely manner?

  Yes

  No

  N/A

• Accident/Incident report(s) complete?

  Yes

  No

  N/A

• Root cause reports complete?

  Yes

  No

  N/A

• Corrective actions implemented

  Yes

  No

  N/A

• Actively managing employee return to work, modified duty provided

  Yes

  No

  N/A

• Injury diary maintained for injured employee(s)

  Yes

  No

  N/A

• Injury log maintained job wide

  Yes

  No

  N/A

• Current Stats

• # of recordables

• # of lost time days

• # of first aids

• Comments:

• Attachments

  Media

• Attachments

  Media

Current Site Conditions/Behaviors

• Grade:

• Jobsite Postings & Documentations

  Yes

  No

  N/A

• Housekeeping/Sanitation/Material Storage

  Safe

  At Risk

  N/A

• Personal Protective Equipment

  Yes

  No

  N/A

• Fall Protection

  Safe

  At Risk

  N/A

• Aerial Lifts

  Safe

  At Risk

  N/A

• Scaffolding

  Safe

  At Risk

  N/A

• Stairways/Ladders

  Safe

  At Risk

  N/A

• Trenches/Excavations

  Safe

  At Risk

  N/A

• Fire Protection/Prevention

  Safe

  At Risk

  N/A

• Fuel Storage

  Safe

  At Risk

  N/A

• Welding/Cutting/Hot Work

  Safe

  At Risk

  N/A

• Mobile/Heavy Equipment

  Safe

  At Risk

  N/A

• Concrete/Masonry

  Safe

  At Risk

  N/A

• Electrical (including weekly GFCI inspections)

  Safe

  At Risk

  N/A

• Hand/Power/Powder Actuated Tools

  Safe

  At Risk

  N/A

• Cranes/Rigging/Signaling

  Safe

  At Risk

  N/A

• Confined Spaces

  Safe

  At Risk

  N/A

• Traffic Control

  Safe

  At Risk

  N/A

• Public Protection

  Safe

  At Risk

  N/A

• Other

  Safe

  At Risk

  N/A

• Comments:

• Attachment

  Media

Presence of Safety Summary:

• Overall Grade:

• Project Manager Signature:

  Sign

• Superintendent Signature:

  Sign

• Safety Manager Signature:

  Sign