Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Perimeter Control and Perception

  • 1. Is the area clean and organized outside the fence line and is the fence line well maintained? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 2. Are the gates being managed as required to protect workers and pedestrians during deliveries?

  • Add media

  • 3. To the extent that the owner contract allows, is the perimeter fence posted with signage related to IFE/PPE/check-in procedures? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 4. Is the public protected from safety hazards (overhead protection, barriers, designated walkways, signage, etc.)? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 5. Are signalmen present managing deliveries as well as pedestrian traffic? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

Inside The Fence Line But Outside The Building

  • 6. Is there a culture of cleanliness on site? Solicit responses from several workers. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 7. How well organized are materials and equipment within the fence line? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 8. Rank the proportion of AP personnel that participate in Stretch and Flex, with a 0 being one AP representative and a 4 being every AP representative on the project.

  • 9. Is there a general attitude of employees wanting to follow the rules instead of being forced to? Solicit responses from employees on site. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • 10. How would you rank compliance with PPE? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 11. Solicit some discussion from employees about how well they know those that are working around them. Rank with a 3 being they know others by name and seek to work with each other. 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average

  • 12. Are pathways through the site clear and well maintained? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 13. Are barricades being appropriately used, maintained, respected and removed when no longer in use? Solicit some feedback from a subcontractor. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 14. Is the emergency preparedness plan clearly posted on site? Interview an employee to determine if the subcontractors understand it. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 15. Are back up alarms on equipment working?

  • 16. Rank the status of impalement protection on site. Gain feedback from subcontractors. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average

  • Add media

  • 17. Are spill kits visible and do subcontractors know where they are and procedures for use?

  • Add media

  • 18. Rank the overall feel of the logistics within the fence line. (Roadways, dumpster locations, loading/unloading areas, employee travel paths, etc.). Solicit feedback from a subcontractor. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

Within The Building Footprint

  • 19. Evaluate extension cord management. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 20. Are pathways well defined and maintained clear? Solicit feedback from a subcontractor. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 21. Observe ladder use and evaluate. (Condition of ladders, appropriate length for use, ladders last, etc.) 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

  • 22. How are we managing fall prevention? (Harness use, handrails, hole covers, etc.) 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • Add media

The Atmosphere Inside the Field Offices and Overall Culture

  • 23. Are all subcontractors going through site specific safety orientation prior to starting work. Solicit opinions from subcontractors.

  • 24. Does EHS have a place in the trailer for the organization of subcontractor site specific safety plans, Pre Task, OSHA 300 log, etc. and does the team know where to access them?

  • Add media

  • 25. What percent of the site employees have been through an IIF Orientation? 1 = 25% 2 = 50% 3 = 75% 4 = 100%

  • 26. Is the field office organized in such a way that facilitates team collaboration? 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • 27. When accidents or near misses occur is an accident investigation conducted to determine the root cause?

  • 28. Is this information shared with the subcontractor team? Solicit feedback from subcontractors.

  • 29. Is a pre-construction meeting held with all subcontractors before their work begins?

  • 30. If a subcontractor brings a safety concern to AP, is action taken promptly? Solicit feedback from subcontractors. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • 31. Do subcontractors feel they can stop work without retaliation. Ask a subcontractor.

  • 32. Do the subs know the AP superintendents by name? Rank based on several queries. 0 - Non-existent 1 - Needs Improvement 2 - Meets Minimal Requirements 3 - Above Average 4 - Outstanding

  • 33. Do the subs feel AP would put safety before production?

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.