• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Stop and Think

  • What are the activities involved in completing my task? Is there an existing Risk Assessment ? If so , have l reviewed? What are the risks l am facing? What can l do to minimise my risk? What's changed since the last time l performed this task?

Assess your Risks

  • Splash Hazards

  • Mechanical / Pinch Points

  • Lifting/Turning/Fall

  • Confined Space

  • Pressure

  • Contact Hazards

  • Slippery or wet surfaces

  • Chemical Exposure

  • Pushing / Pulling

  • Working at Heights (>1.2 m)

  • Electrical

  • Other Energy Sources

  • Chemical Compatibility

  • Roof Top Hazards

  • Extreme Temperatures

  • Other

Familiarise Yourself

  • Exit

  • Eye Wash

  • Safety Shower

  • Moving Objects (on Floor , Overhead)

  • Emergency Alert System

  • Evacuation Route / Assembly Point

  • Trip Hazards

  • Closest Personnel - Do they know where you are?

  • Other

Establish a Plan

  • What PPE is required?

  • Safety Boots

  • Safety Goggles/Glasses

  • Protective Clothing / Hi Vis

  • Hard Hat

  • Hearing Protection

  • Other

  • Do l have the appropriate permits?

  • Have l completed appropriate checks?<br>(LOTO, Confined space, etc

  • Do l need a safety watch?

  • Did l clear my work area of all hazards?

  • Other

  • Actions taken to minimise or eliminate hazards?

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.