Title Page

  • Site conducted

  • Company Name:

  • Contractor Representative (Name & Position):

  • Nature of work:

  • Location:
  • Major deficiencies (Immediate action required) 1 = Improvement Required, 2 = Satisfactory, 3 = Good

Monitoring and Control

  • 1. Relevant permits in place?

  • 2. Other relevant documentation / authorisation in place?

  • 3. Risk assessment / method statement specific to the work in place?

  • 4. Controls identified by the risk assessment in place?

  • 5. Method statement being followed?

  • 6. Site visitors log being used?

  • 7. Lone worker system in place and being used?

  • 8. Contractors aware of the site / their own emergency arrangements?

  • 9. Point of use risk assessments? (Identifying and controlling major hazards)

Training and Competence

  • 10. Evidence of contractor induction?

  • 11. Contractors have the required competencies for the task?

  • 12. Relevant training certificates available?

Working Area / Housekeeping

  • 13. Staff access and egress to the work area?

  • 14. Work area suitably barriered off and the other protected?

  • 15. Adequate signage?

  • 16. Work area generally tidy / materials and substances stored properly?

  • 17. Potential tripping hazards removed?

Hygiene and Welfare

  • 18. Suitable first aid arrangements in place?

  • 19. Suitable washing & toilet facilities available?

  • 20. Procedures for dealing with contact with sewage?

  • 21. Availability of sharps containers?

Safety and Personal Protective Equipment (PPE)

  • 22. PPE appropriate for the task being worn and consistent with RAMS?

  • 23. Fit for purpose - clean, well maintained, etc?

  • 24. Required safety equipment in use suitable and in good condition?

  • 25. Evidence of relevant calibration / test available?

Plant, Equipment, Materials and Environment

  • 26. Correct tools being used for the task?

  • 27. Tools maintained and fir for purpose?

  • 28. Relevant test / inspection records available? (i.e PAT Testing)

  • 29. Dangerous moving parts adequately guarded?

  • 30. Hazardous substances stored and labelled appropriately?

  • 31. Suitable chemical assessments and data sheets available?

  • 32. Suitable arrangements in place to prevent pollution?

  • 33. Arrangements in place to protect themselves and other against noice, dust, vibration etc. ?

  • Other
  • (The following section can be tailored to suit the contractor / type of work. If not used ensure NA is entered in the score section.)

Sign-Off

  • Inspection competed by:

  • Date & Time:

  • Sign:

  • Distribution:

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.