Audit

OBSERVATION AREAS: In the areas audited with no deficiencies found, indicate behavior / condition OBSERVED (OB). If the behavior / condition REQUIRES ATTENTION, indicate (RA), and rank most likely result of the problem behavior / condition. Please provide narrative regarding the areas you audit and your findings. If an audited area showed no deficiencies or had notable positive aspects, please state so.

Describe the observation and employee interview. What improvement need was identified and understanding made to achieve it? Did other areas for improvement come out of the interview? Operational management and/or the Safety Dept will determine target dates, responsibility and if further investigation or corrective action is required.

Pre-operation inspection completed

Rank Findings

Entering / exiting safely (3-points)

Rank Findings

Lifting / carrying materials or tools

Rank Findings

Proper use of tools / equipment

Rank Findings

Safe condition of equipment / tools

Rank Findings

Slip / trip avoidance walkways kept clear

Rank Findings

Housekeeping and access maintained

Rank Findings

PPE condition / compliance

Rank Findings

Safe positions of employees

Rank Findings

Safe procedures followed

Rank Findings

Safe procedures established

Rank Findings

Safe equipment operation (forward)

Rank Findings

Safe backing practices used

Rank Findings

Training & knowledge of tasks

Rank Findings

Railing / guarding compliance

Rank Findings

LO / TO Confined space

Rank Findings

Traffic control adequate

Rank Findings

Fall hazards controlled

Rank Findings

Electrical maintenance / labels

Rank Findings

Other

Rank Findings

Conclusion

Who is the responsible manager for any findings in this audit

Site manager signature
Signature of auditor(s)
Date and time audit completed
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.