Audit / Inspection Details

  • Title of Compliance Audit

  • Audited/Inspected by:

  • Department / Client (PCBU)

  • Department Line Manager

  • Team Leader

  • Worksite Supervisor

  • Health and Safety Representative (HSR)

  • Contact Name and Details (PCBU)

  • Date and time of compliance inspection

  • Location
  • Yes - Compliant (Green) No - Not Compliant (Red) Not Yet Verified (Yellow) Not Applicable (Blue)

1. Worksite Access (Road and signs)

1. Worksite Access (Road access and signage)

  • 1. Is there sufficient signage in place advertising work in progress?<br>

  • 2. Are traffic controller ahead signs in place (Stop / Slow)?

  • 3. Are flashing hazard lights being used and working?

  • 4. Are sufficient traffic cones or bollards in use?

  • 5. Are all access and side tracks secured from unauthorised public entry?

  • 6. Other

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

2. Worksite Entry (Report site office etc)

2. Worksite Entry and Traffic Control (Vehicle and Pedestrian)

  • 1. Is signage in place for "No Unauthorised Entry"?<br>

  • 2. Are all persons must report to site office or site controller displayed?

  • 3. Is PPE required for site displayed?

  • 4. Worksite speed limit displayed?

  • 5. Site contact names and numbers displayed?

  • 6. Is the site secure from unauthorised entry of vehicles and/or traffic?

  • 7. Are spotters provided to control and direct pedestrian and vehicle traffic (where required)?

  • 8. Is a formal traffic management plan (TMP) available for the worksite (If required)?

  • 9. Other

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

3. Site Office / Crib Hut

3. Site Office / Crib Hut

  • 1. Are there designated parking areas for plant, workers and visitors?

  • 2. Is there a WHS notice board displayed?

  • 3. WHS policy displayed, signed by senior management and current?

  • 4. Is a site induction conducted?

  • 5. Are responsible persons names and titles displayed?<br>Site Manager<br>Superintendent<br>WHS Officer<br>Worker Safety Representative<br>Work Health and Safety Representative (HSR)<br><br><br>

  • 6. Other

Comments, Corrective Actions, and Person Responsible (Insert number and details i.e 1.1)

  • Comments / Recommendations / Corrective Action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective Action

4. Visitor Controls

4. Visitor Controls

  • 1. Are visitors required to formally sign-in and out?

  • 2. Is the visitor to be escorted at all times while on site? (If yes, a basic induction is only required).

  • 3. Is a means of identifying visitors implemented?

  • 4. Are visitors advised of emergency procedures?

  • 5. Are areas where visitors are not permitted clearly identified / explained?<br><br><br>

  • 6. Is suitable PPE provided to visitors?

  • Other issues

Comments, Corrective Actions, and Person Responsible (Insert number and details i.e 1.1)

  • Comments / Recommendations / Corrective Action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective Action

5. Sub Contractors

5. Sub Contractors

  • 1. Are contractors made aware of company WHS policies and rules before commencing work<br>

  • 2. Do engaged contractors provide adequate insurances (Workers Compensation and Public Liability to 20 Million)?

  • 3. Are sub-contractors safety systems and consultation arrangements harmonised with the engaging PCBU?

  • 4. Are sub-contractors management systems provided to the principle PCBU?

  • 5. Are checks made of the contractors plant and equipment for compliance and safety?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

6. Emergency Procedures

6. Emergency Procedures

  • 1. Are emergency procedures displayed?

  • 2. Emergency services 000 and PCBU names and numbers?

  • 3. Site map available?

  • 4. Are training drills conducted periodically, verbally at toolbox talk and practically exercised (6 monthly)?

  • 5. Muster / Assembly point identified?

  • 6. Fire equipment available and tagged for currency?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

7. Communication

7. Communication

  • 1. Is communication available (Phone, radio, satellite)?

  • 2. Does the worksite have agreed radio contact numbers for various locations?

  • 3. Do all workers on-site know the radio numbers for locations?

  • 4. Do workers understand basic hand signals (i.e. Stop)?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

8. First Aid

8. First Aid - First Aid Code of Practice

  • 1. Qualified first aid names displayed (First aid level).

  • 2. Medical supplies checked for currency and expiry date?

  • 3. First aid kits for workers on-site within easy access?

  • 4. Medical supplies and facilities are adequate for the nature, location and composition of workers on site?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

9. Workplace Amenities

9. Workplace Amenities

  • 1. Toilets available on site?

  • 2. Are toilets provided for each gender?

  • 3. Washing facilities provided?

  • 4. Are toilets and shower areas cleaned regularly?

  • 5. Are sufficient consumables made available in washrooms and toilets?

  • 6. Are sufficient tables and chairs provided?

  • 7. Are lunchroom, kitchen facilities clean and hygienic?

  • 8. Is clean drinking water provided?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

10. Consultation (Pre-start briefs, toolbox talks)

10. Consultation (Pre-start briefs, toolbox talks)

  • 1. Is there a WHS project or site specific plan in place?

  • 2. Do all workers have their General Construction Card on-site?

  • 3. Are pre-start shift meetings conducted?

  • 4. Are toolbox talks conducted periodically to discuss safety issues between worker and management?

  • 5. Are there worker safety representatives I.e. HSR

  • 6. Do workers understand the PCBUs legal responsibilities for consultation?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

11. Personal Protective Equipment (PPE)

11. Personal Protective Equipment (PPE)

  • 1. PPE allocated to workers specific to activities (Australian Standard)?

  • 2. Workers wearing PPE required by company policy?<br>

  • 3. High visibility clothing?

  • 4. Hard hat and wide brim hat?

  • 5. Fully enclosed footwear?

  • 6. Are signs displayed where specified PPE must be worn?

  • 7. Is PPE fitted correctly, serviceable and in good condition?

  • 8. Do workers wear PPE when mandated in SWMS?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

12. Manual Handling

12. Manual Handling (Hazardous Manual Tasks Code of Practice)

  • 1. Is a risk assessment conducted for manual tasks (heavy lifting or strenuous work)?

  • 2. Are workers trained in lifting practices?

  • 3. Do workers request assistance for heavy or awkward lifting tasks?

  • 4. Do workers warm before heavy lifting to avoid strain injuries?

  • 5. Are adequate rest breaks allocated to allow workers time to recover?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

13. Safety Issue, Hazard Reporting and Controls

13. Safety Issue, Hazard Reporting and Controls (Hierarchy of control)

  • 1. Are safety issue / hazard and near miss reporting forms available on-site

  • 2. Do workers understand the procedure for reporting safety concerns (Stop work, apply control or report to supervisor)?

  • 3. Are risk assessments conducted to identify site hazards with controls implemented?

  • 4. Do workers know and refer to the hierarchy of control?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

14. Incident Reporting and Investigation

14. Incident Reporting and Investigation

  • 1. Are incident / injury forms available on site?

  • 2. Do workers report all incidents ASAP?

  • 3. Are all incidents fully investigated and effective remedial action implemented?

  • 4. Are WorkCover NSW "Notifiable Incidents and Preservation Site", regulations clearly understood by the PCBU?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

15. Safe Work Method Statements (SWMS)

15. Safe Work Method Statements (SWMS) - Code of Practice for Construction Work

  • 1. Have workers been inducted and consulted, in the development of SWMS?

  • 2. Are SWMS systematic with steps, hazards and controls?

  • 3. Are SWMS specific to the activity and easy for workers to understand?

  • 4. Do all workers understand SWMS and are they signed off?

  • 5 Are SWMS monitored and reviewed for effectiveness?

  • 6. Are SWMS provided to the principle contractor?

  • 7. Do SWMS meet the minimum standards required by applicable Codes of Practice?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

16. Plant (General)

16. Plant (General) - (Evidence required i.e. documentation)

  • 1. Has plant been assessed as safe to use and complaint to Australian standards?

  • 2. Are operators trained and Verified as Competent (VOC); is evidence available?

  • 3. Are daily pre-start checklist completed and faults reported?

  • 4. Are repairs and maintenance conducted in a timely manner (Risk rated)?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

17. Safe Operating Procedures (SOP)

17. Safe Operating Procedures (SOP)

  • 1. Are worker safe operating procedures (SOP)in place specific to plant?

  • 2. Are operators provided with periodic checks on SOPs?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

18. Plant used to Lift Loads

18. Plant used to Lift Loads

  • 1. Loads requiring calculation must be slung by a competent person i.e a licensed dogman?

  • 2. Are all ropes, slings, chains and lifting attachments inspected daily before use?

  • 3. Are loads properly calculated before lifting commences?

  • 4. Does the Crane operator and Dogman communicate effectively?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

19. Isolation: Tag-out, Lockout

19. Tag-out, Lockout Procedure (SWMS)

  • 1. Do operators understand the initial tag-out procedure?

  • 2. Are tags available in the machine or location?

  • 3. Do mechanics apply their own locks when working on machinery?

  • 4. Are all locks issued to a person keyed identically?

  • 5. Are operators notified of return to service?

  • 6. Are there procedures or SWMS for Isolation, tag-out and lock-out.

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

20. Environmental Controls

20. Environmental Controls

  • 1. Is there an environmental plan in place?

  • 2. Are work practices designed to reduce impacts to the environment?

  • 3. Are sediment barriers used around perimeters of earthworks and waterways?

  • 4. Is dust suppression available (E.g. Water carts)?

  • 5. Are vehicles and plant purchased and maintained to reduce emission levels?

  • 6. Are procedures available for the disposal of waste and used hazardous substances E.g. Safety Data Sheets?

  • 7. Does the company have a recycling policy?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

21. Plant Exclusion Zones

21. Plant Exclusion Zones

  • 1. Permit completed?

  • 2. Signs in place to identify exclusion zone?

  • 3. Exclusion zones secured?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

22. Storm Water Run-off

22. Storm Water Run-off

  • 1. Weather monitored to implement controls to minimise soil erosion?

  • 2. Silt control fences in place or other?

  • 3. Waterway traps inserted to contain and remove contaminants?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

23. Occupational Noise

23. Occupational Noise

  • 1. Have all areas been assessed for the presence of harmful noise levels?

  • 2. Are all workers in the presence of harmful noise levels wearing hearing protection?

  • 3. Are noise hazard locations identified by safety signs or stickers?

  • 4. Are workers wearing hearing protection provided with hearing tests (Every 2 years if wearing hearing protection)?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

24. Site Rehabilitation

24. Site Rehabilitation

  • 1. Are work plans available to include procedures for re-instatement of work sites?

  • 2. Are all locations rehabilitated to meet EPA standard?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

25. Hazardous Substances (Chemicals)

25. Hazardous Substances (Chemicals) - Code of Practice for Hazardous Substances

  • 1. Are hazardous materials identified and control measures implemented?

  • 2. Are Safety Data Sheets available for all substances used in the workplace?

  • 3. Are all safety data sheets current (not over 5 years old)?

  • 4. Have risk assessments been conducted to eliminate or minimise the type of chemicals used?

  • 5. Are workers trained in the safe handling and application of hazardous chemicals?

  • 6. Do workers follow SDS procedures when handling chemicals?

  • 7. Are chemicals stored properly ( E.g. 110% bunded and in-compatible separation)?

  • 8. Are all containers used for handling chemicals labeled correctly?

  • 9. Is the product identified correctly?<br>- Australian address, business telephone number and manufacturer / import identified?<br>- hazardous chemical pictograms consistent with correct classification?<br>

  • 10. Are first aid treatment and emergency procedures available relevant to the chemical?

  • 11. Do workers using hazardous chemicals require health monitoring (Refer chemical)?

  • 12. Are workers wearing PPE as prescribed by the safety data sheet (SDS) for chemical used?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

26. Electrical and Power Tools

26. Electrical and Power Tools

  • 1. Is electrical equipment tagged and tested for currency?

  • 2. Is the site shed protected by Residual Current Device (RCD) Electrical circuit breaker?

  • 3. Are power boards used (no double adaptors or piggy backs)?

  • 4. Do portable power tools have RCDs?

  • 5. Are leads inspected daily for damage (Hostile environment)?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

27. Portable Power Tools

27. Portable Power Tools?

  • 1. Are power tools in good condition?

  • 2. Are adequate storage facilities provided?

  • 3. Are all guards in place?

  • 4. Is hearing protection worn if over 85dB?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

28. Hotwork

28. Hotwork

  • 1. Permit to conduct hot work (Usually encompasses a risk assessment)?

  • 2. Have risk assessments been conducted where hot work presents a risk?

  • 3. Is fire fighting equipment available for fire prone locations?

  • 4. Are flammables or explosive substances removed from location prior to hot work?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

29. Gas Cylinders

29. Gas Cylinders (Oxy and Acetylene etc)

  • 1. Are gas cylinder properly stored (chained and secured)?

  • 2. Gas cylinders properly turned off and hoses wound up?

  • 3. PPE available and used for welding or oxy cutting?

  • 4. LPG - Is the LPG cylinder stamped as current (Within 5 years) and in serviceable condition?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

30. Working at Heights

30. Working at Height (Generic)

  • 1. Risk assessment conducted?

  • 2. Are workers trained in working at heights?<br> - Evidence provide e.g. tickets?

  • 3. Height of work and regulations checked?

  • 4. Is there electricity power cables in close proximity to the work?<br>- Have effective controls been implemented?<br>- Essential energy notified 13 20 80 to conduct preliminary risk assessment if required?

  • 5. Correct edge protection in place and to a structural strength?<br>AS/NZS 1576 Scaffold Series?

  • 6. Fall protection device includes AS/NZS 1891.1<br>- a secure fence<br>- edge protection<br>- working platforms and;<br>- covers

  • 7. Surfaces are structurally capable of supporting all persons and things that may be located or placed on it?

  • 8. Surface materials not brittle?<br>- skylights identified?<br>

  • 9. Pitch of roof assessed?<br>- less than 15 degrees?<br>- worker no closer than 3 metre from edge?<br>- how is this controlled?

  • 10. If no edge protection and the roof is flat and is less than 15 degrees the following applies:<br>1. Conduct a risk assessment?<br>2. Floor sound and not slippery?<br>3. No person is to be within 3 metres of the edge?<br>4. Optional - 3 metre line is identified with a barrier or adequate controls that ensures a person cannot cross?

  • 11. Loose objects secured from falling?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

31. Portable Ladders

31. Portable Ladders

  • 1. AS/NZS 1892 Portable Ladder?

  • 2. Load rating of 120kg?

  • 3. Ladder placed at 1:4 or no more than 1:6 slope?

  • 4. Is the ladder secure at top and bottom?

  • 5. Does ladder extend 900mm to 1 metre above the landing platform?

  • 6. Fall protection at stepping of point?

  • 7. Are temporary ladders not > 6 metres between successive ladder landings?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

32. Elevated Platform

32. Elevated Platforms

  • 1. Are workers trained and competent in the safe operation of plant?

  • 2. Manufacturers or suppliers instructions are consulted on safe operation of plant?

  • 3. Platforms are used as a working platform and not as a means of entering and exiting the work area?<br>Unless the conditions set out in AS 2550.10 Cranes, hoists and winches - Safe use - Mobile elevated platforms are met.

  • 4. Unless designed for rough terrain, the platforms are used only on solid level surface?

  • 5. Workers are licensed (HRWL) when operating boom type elevating work platforms with a boom length of 11 metres or more?

  • 6. Are persons in travel towers, boom lifts, or cherry pickers wearing a properly anchored safety harness?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

33. Scaffolding - Documentation

33. Scaffold - Documentation

  • 1. Handover certificate on-site E.g. Scaff tag?

  • 2. Has steel wire mesh/shade cloth or containment sheeting been erected to protect members of the public or workers from falling objects?

  • 3. Where the working platform is less than 4 metres, was it erected by a competent person? Are procedures in place to inspect scaffolding every 30 days?

  • 4. System in place in place to inspect after trades have used scaffolding e.g. Form workers, concreters, brick layers, tillers etc?

  • 5. Is a work method statement or appropriate documentation available for management on-site once erected?

  • 6. Is there a system in placed to prevent damage to the scaffolding from loads suspended from a crane and is it recorded in SWMS?

  • 7. Have trades been inducted on the safe use of the scaffolding?

  • 8. Is metallic scaffold a minimum of 4 metres from overhead powerlines?

  • 9. Where overhead powerlines (up to and including 1000 volts) cannot be de-energised and isolated, are tiger tails installed by the network operator for the full length of the scaffold plus a minimum distance beyond each end of the scaffold of 5 metres?

  • 10. Has the network operator e.g. Essential Energy, been contacted to conduct a risk assessment where uncertainty exists or scaffold is within 4 metres or above 1000 volts of powerlines?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

34. Scaff-Supporting Structure

34. Scaffold - Supporting Structure and Foundation

  • 1. Is supporting structure in good condition and adequate strength?<br>Has it been assessed by a competent person / engineers certificate?

  • 2. Is there a risk of the supporting structure being overloaded from other sources adequately controlled?

  • 3. Is there a system in place to prevent scaffolding being struck by vehicles and or plant e.g. Concrete blocks, guards, fenders, traffic management?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

35. Scaff-Foundation

35. Scaffold - Foundation

  • 1. Scaffolding erected on suitable foundation/footing e.g. Not adjacent to excavations, trenches, underground services or soft ground?

  • 2. Base plates used are a minimum 100mm x 100mm and 6mm thick?

  • 3. If on soft ground are sole boards being used to distribute the weight evenly e.g. Unstable ground, gaps?

  • 4. Are the sole boards continuous and where ever possible support two standards?

  • 5. Are the sole boards a minimum 220mm wide?

  • 6. Is packing used under sole boards e.g. Hardwood?

  • 7. Screw jacks not extended more than 600mm or a a manufacturers requirements?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

36. Scaff-Mesh Shade Cloth/Sheeting/Signage

36. Scaffold - Steel wire mesh/ shade cloth/ containment sheeting/ signage

  • 1. Has scaffold been designed for wind loading where signage is being tied to the scaffolding?

  • 2. Are the sheets adequately fixed/tied?

  • 3. Are there tears or gaps in the sheeting?

  • 4. Is the an engineering ticket for ties?

  • 5. Is there a minimum 50mm overlap?

  • 6. Signs on scaffolding - any engineering calculations - wind design?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

37. Scaff-Overhead Powerlines

37. Scaffold - Overhead power lines (OHPL)

  • 1. Is the scaffold erected close to OHPL within 4 metres?

  • 2. Has the service provider been contacted to conduct a risk assessment for controls e.g. Disconnect service lines, erect tiger tales?

  • 3. If the OPHL have not been de-energised is there a system of work to ensure the scaffold complies with local requirements during erection, altering, use and dismantling?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

38. Scaff-Ties and Mixed Components

38. Scaffold - Ties and mixed components?

  • 1. Are mixed components being used?

  • 2. Are they compatible?

  • 3. Engineers certificate available if required?

  • Other issues

Scaffold Ties

  • 4. Have ties been installed as per manufacturers/suppliers instructions/information and AS/NZS 1576?

  • 5. System in place to monitor ties as other trades progress e.g. Form workers, brick laying, tilers etc?

  • 6. System in place to monitor ties as the structure is dismantled?

  • 7. Do the ties pick-up two standards or legs?

  • 8. Are single leg ties used - is relevant documentation available?

  • 9. Have 90 degree fittings been used (Swivel fittings not to be used)?

  • 10. Are ties provided every 4 metres (Vertically) in height?

  • 11. Are ties provided as per AS/NZS 1576 - Vertical = 4 metres?

  • 12. Height of scaffolding < 15 metres (horizontal ties required)<br>- Between ground and 15 metres = Every 3rd standard<br>- Between 15m and 30m = zero<br>- Between 30m and 45m = zero

  • 13. Height of scaffolding 15 metres and 30 metres (horizontal ties required)<br>- Between ground and 15 metres = Every 2nd standard<br>- Between 15m and 30m = Every 3rd standard<br>- Between 30m and 45m = zero

  • 14. Height of scaffolding > 30 metres (horizontal ties required)<br>- Between ground and 15 metres = Every standard<br>- Between 15 and 30 metres = Every 2nd standard<br>- Between 30m and 45m = Every 3rd standard

  • 15. Where drilled-in anchors are being used; are engineering drawings/calculations etc available on site?

  • 16. Do the ties obstruct access along the full length of the working and access platforms?

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

39. Scaff Platforms (General)

39. Scaff-Platforms (General)

  • 1. Are platforms free from obstruction?

  • 2. Are planks in good condition and a minimum of 220mm wide?

  • 3. Do planks overhang supports by 150mm - 300mm?

  • 4. Are planks adequately secured where they overlap?

  • Other issues

Site Address

  • 5. Are loads on any given platform evenly distributed?

  • 6. Are standards correctly positioned i.e. Staggered?

  • 7. Is the duty of the scaffolding suitable for the task i.e. Heavy, medium or light?

  • 8. Is the scaffold width appropriate for the duty e.g. Heavy duty 5 planks?

  • 9. Are signs erected on the bays indicating duty of the bay(s)?

  • 10. Are any of the platform bays being used to stack/store materials e.g. Bricks, formwork?

  • 11. Does the weight of these materials exceed the rated WLL per platform bay?

  • 12. Is there any material etc. being stacked/stored above the height of the guardrail?

  • 13. Is there any signage indicating scaffolding incomplete where required?

  • 14. Are openings at working platform level covered and secured e.g. Plywood (17mm), planks?

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

40. Scaff Temporary Stairways

40. Scaffold Temporary Stairways

  • 1. Has separate stairway access been provided to access scaffold?

  • 2. Is the stairway a minimum of 500mm wide?

  • 3. Is the access landing a minimum 500mm x 450mm?

  • 4. Is a handrail provided on each side of the stairway?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

41. Scaff Bracing

41. Scaffold - Bracing

  • 1. Has face bracing been provided i.e. Longitudinal at no more than 3 bays apart, unless otherwise specified?

  • 2. Has bracing been provided at the end of scaffolding i.e. Transverse bracing

  • 3. Does the bracing extend the full height of the scaffold?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

42. Scaff Access and Hop-up Brackets

42. Scaffold - Access and Hop-up Brackets

  • 1. If hop up brackets are 500mm above or below the working platform, has adequate fall prevention been provided?

  • Other issues

Access

  • 2. Is the access along the working platform - 450mm wide for persons and tools only 2 planks?

  • 3. Is the access along the working platform - minimum 675mm wide for persons and materials (3planks)?

  • 4. Are incomplete scaffolding platforms etc. blocked off and/or signs used?

  • 5. Is there suitable access to and from the working platform e.g. From the building to the platform?

  • 6. Is there safe access between working platform during use , erection and dismantling?

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

43. Scaff Edge Protection

43. Scaffold - Edge Protection

  • 1. Is edge protection provided where a person or object could fall (2m or) more?

  • 2. Handrail, mid rail and toe board or brick guard provided?

  • 3. Where guard rails and toe boards (150mm) only are being used, is a suitable infill such as brick guards or infill panels being used?

  • 4. Are guard rails being erected, between 900mm and 1100mm above the platform?

  • 5. Where brick guards are being used, is the mesh aperture no > 50mm x 50mm?

  • 6. Where the gap between scaffolding and supporting structure is > 225mm, has edge protection been provided?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

44. Scaff Trades Using

44. Scaffold - Trades using scaffold

  • 1. Do the trades on site using scaffolding alter the scaffolding themselves?

  • 2. Are trades on site that are using the scaffolding aware that any alterations to the scaffold is to be done by the scaffolder?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

45. Fall Arrest System

45. Fall Arrest System

  • 1. Do restraint systems conform to AS/NZS 1891 industrial fall arrest systems and devices?

  • 2. Does each anchorage point conform to AS/NZS 1891.4 industrial fall arrest systems devices - selection, use and maintenance?

  • 3. Are fall arrest systems and devices inspected by a competent person at regular intervals to manufacturers specifications?

  • 4. Is there a minimum of two persons on site to activate an emergency rescue in the event of a person falling?

  • 5. Are the fall arrest systems adequate for the type of working at height activity?

  • 6. Are workers trained in working at height? Provide evidence?<br>Competence person providing full supervision for untrained workers?<br>

  • 7. Is a safe work method statement available for the activity of high risk construction work?<br>Excluding minor work exemptions and those definitions?

  • 8. Do persons in charge have access to the Code of practice for Falls<br>Are they aware of the Code of Practice for Falls?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

46. Scaffold-Mobile

46. Mobile Scaffold

  • 1. Are details available for scaffold WLL and/or a compliance plate?

  • 2. No unauthorised alterations prevalent?

  • 3. Kickboards or toe boards in place to prevent falling objects?

  • 4. Scaffold level and plumb at all times?

  • 5. Kept well clear of powerlines, open floor edges and penetrations?

  • 6. Is not accessed until castors are locked to prevent movement?

  • 7. Is never moved while anyone is on it?

  • 8. Is only accessed using external ladders?

  • 9. Has a trap door for a hazard free platform?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

47. Confined Spaces

47. Confined Space

  • 1. Code of Practice for Confined Space available on-site?<br>SWMS states COP to be made available on entry sites.

  • 2. SWMS available on-site, signed by all workers?

  • 3. Emergency rescue plan discussed and adequate?

  • 4. Emergency rescue equipment/trailer and medical supplies available on-site?

  • 5. Communication system in place?

  • 6. Entry permit available and progressively completed as required for activity?

  • 7. Risk assessment completed and necessary controls are in place e.g. Ventilation, gas monitoring, barriers in place etc?

  • 8. Workers are nominated for positions e.g. Worker entering space, competent worker in charge and 3rd worker to assist with spotting or activating emergency response plan?

  • 9. Access and egress are clear as is reasonable practicable?

  • 10. Permit completed and all equipment removed?

  • Other issues

Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)

  • Comments / Recommendations / Corrective action

  • Corrective action completed details

  • Name and signature of person responsible for implementing corrective action

  • Comments / Recommendations / Corrective action

48. Asbestos

48. Asbestos

  • 1. Asbestos removalist has applicable license (Class A Friable or Class B Non-Friable less than 10 Square metres)?

  • 2. Asbestos management plan available at the worksite (SWMS acceptable provided compliant)?

  • 3. Is a licensed asbestos removalist on location?

  • 4. Are workers wearing the correct PPE when handling asbestos?

  • 5. Are all workers trained in the handling and removal work (Provide evidence)?

  • 6. Are suitable suppression of asbestos equipment of processes being used?

  • 7. Is adequate signage and fencing in place for asbestos contaminated locations?

  • 8. Are there adequate decontamination facilities for workers?

  • Other issues

Comments, Corrective Actions and Persons Responsible

  • Comments / Recommendations / Corrective Action

  • Corrective action completed details

  • Name, signature and person responsible for implementing corrective action

  • Comments / Recommendations / Corrective Action

Compliance Officer Summary Comments and Officer Details

Compliance WHS Officer(s) (Comments)

  • 1. Name, title and signature of person conducting compliance audit

  • Comments

  • 2. Name, title and signature of person conducting compliance audit

  • Comments

Site Supervisor (Person in charge) Details

Site Supervisor (Person in charge) Details

  • Name, title and signature of person in charge (Supervisor)

  • Comments

  • Name, title and signature of person in charge (Team Leader)

  • Comments

Worker Names, Titles and Signature

Workers On-site, Names, Titles and Signature

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

  • Name of worker and signature (Add title if required)

Sketch Details

  • Details:

  • Select date

  • Add location
  • Add drawing

  • Add media

  • Add drawing

  • Add media

  • Add drawing

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.