Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Health and Safety Policy Statement

  • Is policy statement in place, signed by the senior manager responsible for Health and Safety?

  • Is it prominentaly displayed or available for all to see?

Employers Health & Safety Responsibilities

  • Are employers trained in legislated requirements?

  • Are performance evaluations for managers completed?

Managers/Supervisors Health & Safety Responsibilities

  • Are managers/supervisors trained in legislated requirements?

  • Are job descriptions which include health and safety responsibilities created for all management positions?

  • Do managers complete performance evaluations for supervisors?

Employees Health & Safety Responsibilities

  • Are all staff trained according to the Employee Handbook?

  • Are sign off sheets completed?

  • Are records of training kept up to date?

  • Are disciplinary measures being followed?

  • Is documentation of discipline kept?

Contractors Health & Safety Responsibilities

  • Are Clearance Certificates obtained?

  • Are Contractor Safety checklists completed?

Visitors Safety Program

  • Is the Visitors Policy available?

  • Is the Sign-in book being used?

Health & Safety Coordinator Responsibilities

  • Is the coordinator trained in legislative requirements?

  • Is the coordinator familiar with all elements of the program?

Health & Safety Posted Material

  • Is there a Harassment Policy?

  • Is there a Smoking Policy?

  • Is there a Violence Policy?

  • Is there a Health & Safety Law poster?

  • Is an accident book available?

  • Is a First Aid poster displayed?

  • Are sufficient First Aid provisions displayed?

  • Are there emergency phone numbers?

  • Is an emergency plan in place and are the team informed?

  • Are workplace inspections carried out and are failings noted?

  • Are safety committee meetings in place?

  • Are minutes of safety meetings displayed prominently?

  • Are accident investigation summaries available?

  • Is the name(s) of the Worker Safety Rep(s) available?

Job Task Analysis

  • Are job risk assessments rated for severity and frequency?

  • Are controls identified?

Operating Procedures

Response to Work Related Illness/Injury

  • Are all employees trained in their responsibilities?

Hazard Reporting

  • Are hazard reporting forms being used?

  • Are all hazard reports reviewed?

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Emergency Procedures

  • Is an emergency plan posted?

  • Are all employees trained on the emergency plan?

  • Are sign off sheets completed?

  • Are fire drills carried out bi-annually?

  • Are fire drills documented?

  • Are emergency phone numbers posted?

  • Is the emergency equipment inventory completed?

  • Is the floorplan completed and posted?

  • Are employees trained in the use of fire extinguishers?

Rights to Refuse Unsafe Work

  • Are all employees trained in their responsibilities?

  • Are work refusals documented?

Purchasing Policy

  • Are documented pre-use inspections used for new equipment?

Personal Protective Equipment

  • Is PPE available?

  • Are workers trained in use of PPE?

  • Are monthly PPE inspections carried out?

  • Do supervisors inspect PPE during daily inspections?

Welding and Hot Work Program

  • Are all affected employees trained in Welding and Hot Work requirements?

  • Is the hot work process being used?

Fall & Slip Prevention

  • Are all employees trained on their requirements?

  • Is fall arrest equipment available if applicable?

  • Is fall arrest equipment being used properly?

Manual Handling

  • Are all employees trained in manual handling?

  • Has the management identified manual handling hazards throughout the workplace?

Training Needs Review

  • Is the completed training matrix available?

  • Have all employees received training?

  • Are sign off sheets up to date?

  • Is training reviewed with staff on a regular basis? (every year, two years)

Employee Training Program

  • Are an appropriate number of employees trained in First Aid?

  • Is First Aid training current?

  • Are First Aid certificates posted?

  • Is forklift training current and documented?

  • Is crane training current and documented?

Manual Handling

  • Are all employees trained in manual handling procedures?

  • Is Manual Handling training documented?

Employee Health & Safety Training Programs

  • Have all employees received training?

  • Are all employees trained in emergency procedures?

  • Have employees been trained and signed off on the operating procedures for their jobs?

  • Are supervisors/managers trained in their responsibilities when promoted?

  • Have supervisors/managers taken supervisor, health, safety and law course? (or equivalent)

  • Have Committee members received training in their duties?

  • Is fire extinguisher training current and documented?

  • Is fire drill training current and documented?

  • Is lockout training current and documented?

  • Is PPE training current and documented?

  • Is COSHH training current and documented?

  • Is Spill Response training current and documented?

  • Is Hot Work training current and documented?

  • Is Pedestrian Forklift Strategy training current and documented?

  • Have all employees completed the training sign off sheets for any training they have received?

First Aid Program

  • Are all employees trained in First Aid reporting requirements?

  • Is the First Aid log book available at First Aid station?

  • Is the appropriate First Aid kit available for the facility? (stocked)

  • Are First Aid reports being filled out?

  • Are first aid reports being forwarded to the management for review?

  • Are First Aid kits inspected at least once every three months?

  • Is Inspection form available at First Aid kit?

Workplace Inspection Program

  • Is the inspection schedule available for all inspections to be carried out within the next year?

  • Does the employer perform workplace inspections at least twice a year?

  • Are employers inspections documented?

  • Do manangers perform workplace inspections at least once a month?

  • Are managers inspections documented?

  • Do supervisors perform daily inspections of their work areas?

  • Are supervisor's inspections documented?

  • Are all workplace inspection reports forwarded to the management for review?

Pre-use Inspection Program, Forklift Strategy Program and Crane Safety Program

  • Are company vehicles inspected at the beginning of every shift before use?

  • Are inspections documented?

  • Are forklift operators trained in safe forklift operation, inspection and fuel exchange?

  • Is forklift training current within 3 years?

  • Are forklift operators undergone a practical evaluation within the last 18 months?

  • Are forklifts inspected at the beginning of every shift before use?

  • Are crane operators trained in safe crane operation and inspection?

  • Is crane training current in 3 years?

  • Are cranes inspected at the beginning of every shift before use?

  • Are inspection reported forwarded to Management for review?

Planned Preventive Maintenance Program

  • Is an inventory of equipment requiring preventative maintenance available?

  • Does the inventory list describe what type of maintenance is required?

  • Are preventative maintenance reports are completed for all maintenance performed (internally or externally)

  • Are reports kept on file for a minimum of one year?

Accident/Incident Investigation Program

  • Have managers and supervisors received training in Accident Investigation?

  • Is documentation of training available?

  • Are accident investigations being conducted for all injuries and hear misses?

  • Are accident investigation reports being conducted for all injuries and near misses?

  • Are accident reports completed for all investigations?

Continuous Improvement Program

  • Has a Health & Safety Action Plan been created for next year?

  • Do management staff meet at least once very three months to review Health & Safety program implementation, changes and enhancements?

  • Are additional Health & Safety communications available throughout the facility?

  • Have all employees been trained in Return to Work program requirements?

Access/Egress

  • Is there a suitable branded site entrance/map sign when you enter the site?

  • Is it clear where visitors should go when they arrive on site and are there any directional signs?

  • Are parking areas easily identifiable on site?

  • Are there designated visitor parking spaces?

  • Is there enough parking provided on site to use?

  • Are parking areas safe and free from hazards and obstacles?

  • Are pedestrian routes clearly marked and separated from vehicles with line marking externally?

  • Are pedestrian routes clearly marked and separated from vehicles with line marking internally?

  • Are pedestrian routes clearly and adequately lit?

  • Are daily checks being undertaken of bins, maintenance, access security pests, and waste?

  • Are employees and visitors aware of the hazards that may be encountered on site?

Other Points of Note

  • Detail other items of concern

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.