Area Safety and Health Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

PPE

• Are PPE requirements sufficient

  Yes

  No

  N/A

• Is PPE supplied adequate for the task?

  Yes

  No

  N/A

• Is PPE being worn properly

  Yes

  No

  N/A

• Is PPE readily available to employees

  Yes

  No

  N/A

• Are employees being exposed to dust, fumes or gas

  Yes

  No

  N/A

Tools

• Are employees trained and certified in Cadweld?<br>

  Yes

  No

  N/A

• Power tools:<br>Free of frayed cords, missing guards

  Safe

  At Risk

  N/A

• Are powder actuated tools being used?<br>are employees trained and certified for the tool being used

  Yes

  No

  N/A

• Have all instruments and test equipment been calibrated

  Safe

  At Risk

  N/A

• Are tools being used/stored properly

  Yes

  No

  N/A

Hazard Communication

• Confined spaces?<br>Will employees be entering these confined spaces?

  Safe

  At Risk

  N/A

• Do confined spaces require an entry permit

  Safe

  At Risk

  N/A

• Are employees engaged in confined space entry trained and certified?

  Yes

  No

  N/A

• Will employees be exposed to hazardous chemicals?

  Safe

  At Risk

  N/A

• Are all MSDS for all on-site chemicals available

  Yes

  No

  N/A

• Employees know how to find MSDS and understand the hazards of the chemicals they work with. (Interview >=2 employees)

  Safe

  At Risk

  N/A

• Ventilation adequate for the airborne health hazards?<br> -Industrial hygiene sampling results on file?<br> -Employee complaints about "fumes" or "nausea/dizziness"

  Safe

  At Risk

  N/A

• Chemicals are stored in proper containers and labeled properly?<br> -Secondary containers that are not in control of current shift labeled with HMIS label or equivalent?<br> -Labels legible and accurately indicates the chemical that is inside the container?

  Safe

  At Risk

  N/A

• Incidental spills cleaned up immediately?<br> -No evidence of spills being left?<br> -Chemicals being tracked on employees' shoes and/or mobile equipment?

  Safe

  At Risk

  N/A

• Chemicals stored properly?<br> -Flammable materials not in use stored in proper cabinet/safety container?<br> -Incompatible materials stored away from each other?

  Safe

  At Risk

  N/A

Walking/Working Surfaces and Fall Protection

• Is there a fall protection competent person

  Yes

  No

  N/A

• Do employees engaging in use of fall protection have awareness training?

  Safe

  At Risk

  N/A

• Handrails secure and free of excessive defects?<br> -Heavily damaged handrails that require replacement? Loose? Broken welds? Bent handrails and/or toe boards?<br> -Handrails do not contain excessive oil/grease?

  Safe

  At Risk

  N/A

• Proper labels in place and legible?<br> -Portable ladders and stairways require labeling indicating weight limits.

  Yes

  No

  N/A

• Handrails installed where a fall from a height of four feet or greater exists?

  Safe

  At Risk

  N/A

• Fall protection equipment available for working at heights greater than 6 feet from the working surface below it where fall prevention is not available?

  Safe

  At Risk

  N/A

• Harnesses, lanyards, SRL, and lifelines maintained in good condition and inspected properly?<br> -Inspection labels present and legible?<br> -Webbing free of frayed, cut or broken fibers?<br> -Quick connect buckles working properly?

  Safe

  At Risk

  N/A

• Is Rescue plan available?<br>Are all employees aware of the rescue plan?

  Safe

  At Risk

  N/A

• Floors and work platforms free of excessive debris and clutter?<br> -Excessive oil, trash, etc. in the work are?<br> -No items stored on stairs?

  Safe

  At Risk

  N/A

Emergency Response/Fire Protection

• Is there an employee on-site trained in First aid/CPR

  Yes

  No

  N/A

• Fire extinguishers inspected monthly and unblocked?

  Safe

  At Risk

  N/A

• Is employee trained in use of fire extinguishers?<br>

  Yes

  No

  N/A

• Employees aware of emergency procedures and where assembly areas are? (Interview >=2 employees)

  Yes

  No

  N/A

• Eyewash/Safety Shower stations inspected and unblocked?

  Yes

  No

  N/A

• Spill kits are available where needed and are equipped/inspected as required?

  Safe

  At Risk

  N/A

• Sufficient emergency equipment installed in the area?<br> -Fire extinguishers, eyewash, safety shower, spill kits, alarm pull stations, etc.

  Safe

  At Risk

  N/A

Trenching and excavation

• Is there a trenching/excavation competent person on site<br>

  Yes

  No

  N/A

• Has Dig alert been called

  Yes

  No

  N/A

• Is soil type known?

  Yes

  No

  N/A

• Is depth of trench known?

  Yes

  No

  N/A

• If over 5', has activity notification been made through OSHA

  Yes

  No

  N/A

• What type of cave-in protection is being used

  Safe

  At Risk

  N/A

• Do any special measures need to be taken to protect the public

  Safe

  At Risk

  N/A

Mobile Equipment

• Is each employee operating equipment trained?

  Yes

  No

  N/A

• Equipment inspected per inspection frequency requirements?

  Safe

  At Risk

  N/A

• Operators using horns and warning devices where required?

  Safe

  At Risk

  N/A

• No passengers on equipment designed for operators only?

  Safe

  At Risk

  N/A

Scaffolding

• Will you being using scaffolding

  Yes

  No

  N/A

• Is responsible person for the daily inspection known

  Yes

  No

  N/A

• Is there a competent scaffold employee on site

  Yes

  No

  N/A

• Are waivers/insurance available

  Safe

  At Risk

  N/A

Electrical Hazards/Arc Flash

• Are all electrical cords in good condition?

  Safe

  At Risk

  N/A

• Are Temporary power Boxes being used?<br>Are they being inspected on a monthly bases?<br>Is the GFCI inspection form available?

  Safe

  At Risk

  N/A

• High voltage signs in place and visible?

  Safe

  At Risk

  N/A

• Debris/Tools stored on top of electrical cabinets?

  Safe

  At Risk

  N/A

• Electrical cabinets closed and in good repair?<br> -Do the cabinets close securely?<br> -Knock-outs all in place?<br> -Large dents in the housing/door?

  Safe

  At Risk

  N/A

• Electrical cabinets not blocked?<br> -Nothing within 36 inches of the front of the cabinet?<br> -Clear access/pathway to electrical cabinets?

  Safe

  At Risk

  N/A

• Arc flash signage in place?<br> -Indicates arc flash category?

  Safe

  At Risk

  N/A

• Proper arc flash PPE available and in use?

  Safe

  At Risk

  N/A

Hazardous Energy Control (Lockout/Tagout)

• Employees expected to conduct lockout trained and equipped properly?<br> -Employees understand their role and requirements?<br> -Employees have locks available if needed?

  Safe

  At Risk

  N/A

• Employees locked out during a change over and/or other tasks that require lockout?<br> -All employees who are working on the equipment have their own lock affixed to the proper energy source(s)?<br> -Lockout was verified, stored energy was dissipated and equipment will not operate?

  Safe

  At Risk

  N/A

• Energy control procedures exist for all equipment in the area and employees know where to find them?

  Safe

  At Risk

  N/A

• Lockout exceptions have been adequately evaluated and determined safe?<br> -Do regular tool/machine adjustments introduce hazards with unacceptable risk?<br> -Other exceptions?

  Safe

  At Risk

  N/A

Crane/Hoist Safety

• Are employees properly trained and certified?

  Yes

  No

  N/A

• Inspections completed as per requirements?<br> -Operator inspections completed?<br> -PM's completed as per the schedule?

  Safe

  At Risk

  N/A

• Are employees working under suspended loads?

  Safe

  At Risk

  N/A

• Are cranes working within their operating limits?<br> -Capacity not exceeded?<br> -Upper limit switch not used as a stop?

  Safe

  At Risk

  N/A

General Safety and Housekeeping

• Trash, debris, and equipment not left laying around?

  Safe

  At Risk

  N/A

• Equipment free of excessive dust, oil and/or soot?

  Safe

  At Risk

  N/A

• Floor surfaces covered in oil/dust covering the painted surface?

  Safe

  At Risk

  N/A

• General tripping hazards due to housekeeping, equipment layout, and/or workstation design?

  Safe

  At Risk

  N/A

Site conditions

• Sanitary facilities

  Yes

  No

  N/A

• Hand wash stations

  Yes

  No

  N/A

• Is lighting adequate and in safe operating condition

  Yes

  No

  N/A

Documentation

• Safety program available?

  Yes

  No

  N/A

• OSHA 300 log?

  Yes

  No

  N/A

• Medical clinic maps available?

  Yes

  No

  N/A

• Emergency numbers posted/known

  Yes

  No

  N/A

• Cal/OSHA postings/permits

  Yes

  No

  N/A

• Weekly safety meetings

  Yes

  No

  N/A

• Jobsite inspections

  Yes

  No

  N/A

Signature and Finalization

• I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.

  Sign

• Select date

  Date

• General Comments

• Overall Safety Score