C&W SERVICES STARR - Safety Training and Risk Recognition 20151030

STARR Audit

• Client / Site

• Add location
  Address

• Select date

  Date

• Audit Title

• Personnel

• Document No.

• Prepared by

ACTIONS OF PEOPLE

• Adjusted PPE?

  Safe

  At Risk

  N/A

• Changing positions?

  Safe

  At Risk

  N/A

• Rearranging job?

  Safe

  At Risk

  N/A

• Stopping Job?

  Safe

  At Risk

  N/A

PERSONAL PROTECTiVE EQUIPMENT

• Head?

  Safe

  At Risk

  N/A

• Eyes?

  Safe

  At Risk

  N/A

• Ears?

  Safe

  At Risk

  N/A

• Respiratory systems?

  Safe

  At Risk

  N/A

• Arms and hands?

  Safe

  At Risk

  N/A

• Trunk?

  Safe

  At Risk

  N/A

• Legs and feet

  Safe

  At Risk

  N/A

• Equipment Use

  Safe

  At Risk

• Body Position and Use

  Safe

  At Risk

• Adherence to Procedures

  Safe

  At Risk

EQUIPMENT USE

• Wrong for the job?

  Safe

  At Risk

  N/A

• Used incorrectly?

  Safe

  At Risk

  N/A

• In an unsafe condition?

  Safe

  At Risk

  N/A

BODY POSITION AND USE (looking for possible outcomes)

• Struck by objects?

  Safe

  At Risk

  N/A

• Striking against objects?

  Safe

  At Risk

  N/A

• Caught in, on or in between objects?

  Safe

  At Risk

  N/A

• Awkward position / static posture?

  Yes

  No

  N/A

• Over exertion?

  Safe

  At Risk

  N/A

• Falling or tripping?

  Safe

  At Risk

  N/A

• Contacting electrical current?

  Safe

  At Risk

  N/A

• Contacting temperature extremes?

  Safe

  At Risk

  N/A

• Inhaling hazardous substance?

  Safe

  At Risk

  N/A

• Swallowing hazardous substance?

  Safe

  At Risk

  N/A

• Absorbing hazardous substance?

  Safe

  At Risk

  N/A

• Repetitive motion?

  Safe

  At Risk

  N/A

ADHERENCE TO PROCEDURES (JHA Requirements)

• Work procedure and JHA adequate?

  Yes

  No

  N/A

• Work procedure and JHA being followed?

  Yes

  No

  N/A

• Work procedures and JHA understood by all personnel?

  Yes

  No

  N/A

• Housekeeping / 5's standards adequate?

  Yes

  No

  N/A

• Housekeeping / 5's standards understood by all personnel?

  Yes

  No

  N/A

• Working conditions?

  Safe

  At Risk

  N/A

• Was UTake 5 performed?

  Yes

  No

  N/A

SAFE ACTS OBSERVED (SAFE)

• Additional actions taken to encourage continued safe performance.

ADDITIONAL UNSAFE ACTS OBSERVED (AT RISK)

• All corrective actions must be allocated to the person observed or immediate supervisor with a completion date.