Title Page

Introduction

  • Location

  • Inspectee Name

  • Inspector Name

  • Site Activities

  • Inspectee Role

  • Date

Completion Notes:

  • 1. Every item must be covered and a comment placed either Yes, No or N/A box. 2. All noncompliant items must have a unique numerical reference (e.g. 1, 2, 3, etc.) recorded in the text box, even if the issue is resolved on site. 3. Any Notes must be in the txt box but shown as notes, these can be used as required to facilitate the inspection. 4. On completion of the inspection, each noncompliant NC Ref must be written up in the Corrective Action Plan on the last page. 5. The Done box in the Corrective Action Plan should only be ticked if the noncompliance is resolved on site. 6. The Inspectee and Inspector must both sign-off the inspection on the last page. 7. Once all pages have been completed, the yellow Corrective Action Plan sheet will be Emailed to the Inspectee, the Inspector should make sure an email is sent to the Compliance Department.

1.0 Site Arrangements

  • 1.1 Is the site adequately segregated from other worksites, traffic or the general public?

  • 1.2 Is the site secure? E.g. Are access gates/doors locked shut?

  • 1.3 Have all personnel received a site briefing or induction and did it include the below:

  • 1.4 who the key people are on site (e.g. Site Supervisor, First Aider, etc.)

  • 1.5 Emergency arrangements

  • 1.6 First aid arrangements and location of first aid kit

  • 1.7 Fire safety

2.0 Health and Safety Documentation

  • 2.1 Is a copy of the current signed-off method statement available on site?

  • 2.2 Has the method statement been briefed to all persons on site (check briefing record)?

  • 2.3 Are signed-off task / site-specific risk assessments available at the site and have they been briefed?

  • 2.4 Are task / site-specific COSHH assessments available at the site and have they been briefed?

  • 2.5 Are permits to work (where required) in place and adequate for the activities?

  • 2.6 Is there an accident book and/or accident report forms on site?

IF site is a deemed to be a construction environment THEN:-

  • 2.7 Has a Project Induction record been completed for all staff on site and details held at the depot/site?

  • 2.8 Is a copy of the Construction Health & Safety Plan available on site?

  • 2.9 Are statutory notices on display?

3.0 Personal Protection Equipment (PPE)

An item should only be compliant if the PPE is in good condition and appropriate for the tasks and environment. An item should always be noncompliant if it is not being used in accordance with mandatory requirements and those identified in applicable risk and COSHH assessments.

  • 3.1 Head protection?

  • 3.2 Foot protection?

  • 3.3 Eye / face protection?

  • 3.4 Ear / hearing protection?

  • 3.5 Hand protection?

  • 3.6 Respiratory protection?

  • 3.7 Fall (harness) protection?

  • 3.8 Specialist protection?

4.0 Communications

  • 4.1 Does the Site Supervisor have a functioning company mobile phone with sufficient battery power for the remainder of the shift?

  • 4.2 Are all personal mobile phones switched off?

5.0 Environmental Protection

  • 5.1 Are personnel aware of environmental emergency plans?

  • 5.2 Are environmental emergency contact details readily available?

  • 5.3 Is waste separated and stored in appropriate containers?

  • 5.4 Are emergency spillage kits available?

  • 5.5 Are vehicles parked correctly and not causing inconvenience?

  • 5.6 Are vehicle engines switched off when not in use?

  • 5.7 Is plant/equipment turned off when not in use?

  • 5.8 Are noise control measures being followed?

  • 5.9 Are environmental controls included in Method Statements?

  • 5.10 Have protected areas been suitably fenced?

  • 5.11 Are hand/powered tools available and fit for purpose?

6.0 Equipment

  • 6.1 Have portable appliances been tested (PAT)?

  • 6.2 Has measuring equipment been calibrated and is it in date?

  • 6.3 Has test equipment not requiring calibration, been labelled as “For Indication Purposes Only”?

7.0 Working at height

  • 7.1 Is access equipment suitable for use (height, SWL, duration)?

  • 7.2 Is access equipment non-conductive (where in use on railway environment)?

  • 7.3 Has scaffolding been erected / inspected by a competent person and are scaff-tags fitted?

  • 7.4 Have mobile scaffold/platforms been erected / inspected by a competent person?

  • 7.5 Are toe boards and handrails fitted on all working platforms?

  • 7.6 Are internal access ladders fitted and being used?

  • 7.7 Are anchor devices fitted and being used with MEWP’s

  • 7.8 Is equipment being used / erected on level and stable ground?

  • 7.9 Are wheels locked on mobile scaffolding?

  • 7.10 Are ladders/steps in a good condition and in date (check ladder-tag fitted)?

  • 7.11 Are ladders/steps non-conductive (where used on railway)

  • 7.12 Are mobile platforms being operated by certified personnel?

8.0 Workplace and Site Facilities

  • 8.1 Is access and egress suitable?

  • 8.2 Are floors clear and free from slip/trip hazards?

  • 8.3 Is there adequate lighting?

  • 8.4 Is there adequate ventilation?

  • 8.5 Are personnel free from excessive noise?

  • 8.6 Are personnel free from dust/fumes?

  • 8.7 Are there adequate welfare facilities e.g. toilets, hand washing, etc.?

9.0 Competences

  • 9.1 Do all site personnel hold the relevant competences to carry out the work?

Check the SSOW for requirements. May include

  • • Check the SSOW for requirements. May include Protection - PWT-EH / PWT-TH / COSS

  • • Track – Basic Track Awareness / IWA

  • • IPAF if using MEWP / PASMA for towers

  • 9.2 Do personnel have leptospirosis cards

10.0 Additional Comments

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11.0 Photos

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12.0 Corrective Action Plan

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Inspector Sign Off

  • Name

  • Add signature

Inspectee Sign Off

  • Name

  • Add signature

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.