Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Section I: General Workspace
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Building cleanliness (Trash removed, equipment and floor clean, items stored neatly)
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Signage (caution, warning, no smoking, exit signs, properly affixed to identify hazards)
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Egress (clear of obstructions, free access, doors operate freely)
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Equipment/Machinery (Secure/Safe to use, machine guards/panels securely in place)
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Tools (Properly cleaned/ stored, free of defects, safety features working/ labeled CBRE)
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Safety Station (Proper PPE available, good condition, supplies are stocked and inventoried)
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Ladders (Good condition/ non-conductive, properly stored/secured, inspected monthly or prior to use/log available,<br> labeled CBRE
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Oil Rag Can (Accessible, used only for rags with oil or flammable properties, void of excess rags, laundered weekly)
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Confined Space (Plan available, locations identified, signage of locations)
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Compressed Gasses (Proper storage location, properly secured, caps on and tight)
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Fall Protection (Proper and adequate PPE, inspected monthly or prior to use/log available)
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Areas of High Noise (Signage posted, Proper and adequate PPE available)
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Overall Average Score for General Workspace:
Section II: Safety Training
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Safety Training Current for all Staff (attached CBRE Foundation Training Report)
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First Aid Training (100% Staff is exct and 70% is Poor)
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Safety Bulletin Boards (Available, current postings, current newsletter posted)
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Monthly Safety Meetings (Verify Minutes are maintained, signed)
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Bloodborne Pathogen Training (Annual training, signed acknowledgements)
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Storm water Management (Annual Training, signed Acknowledgement)
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Spill Containment (Annual training, signed acknowledgements)
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Universal Waste Disposal (Annual training, signed acknowledgements)
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HazCom (Annual training, signed acknowledgements)
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Hot Work (Annual training signed acknowledgements)
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Illness/ Injury Reporting (Annual training, signed acknowledgements)
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Compressed Gas Mgmt (Annual training, signed acknowledgements)
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Confined Spaces (Annual Training, signed acknowledgements)
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Fall Protection (Annual training, signed acknowledgements)
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Lockout/ Tagout (Annual training, signed acknowledgments)
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EHS Plan (Schedule of EHS Plan review available, signed acknowledgements are current)
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Overall Average Score for Safety Training:
Section III: Documentation
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EHS Policies (IF PRINTED: copies must be current, complete, organized in a book, accessible with signed acknowledgements. IF ELECTRONIC: Staff must be able to locate the newest version on HSE Share Point site, print policies if asked by a regulatory agency or auditor and retain signed acknowledgements
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CBRE HSE Handbook (IF PRINTED: copies available to all staff. IF ELECTRONIC: Staff must be able to locate the Handbook on the HSE Share Point site, and print if asked by staff/regulatory agency/ auditor)
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Licenses (All licenses properly displayed, copies on file, easily accessible)
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Permits (Verify all required permits are posted and compliant)
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Hot Work Permits (Properly filled out, completed, filed in an organized manner)
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MSDS (Master Chemical List/MSDSs current, complete & organized, easily accessible, archived MSDSs kept 25 years)
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Emergency Evacuation Plan (Current, posted, easily accessible, staff knows evacuation accumulation area and their duties during an evacuation)
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Injury Reporting Plan (Site-specific plan available to all staff, adequate forms available)
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Emergency Response Plan (Site-specific plan available to all staff)
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OSHA 300A (Posted Feb 1st thru April 30th, signed copy retained for 5 years)
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Spill Reporting Plan (Plan available, accurate, acknowledged)
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SOP: Generator Exercise (Plan available, accurate, acknowledged)
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SOP: Fire Pump Exercise (Plan available, accurate, acknowledged)
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Overall Average Score for Documentation:
Section IV: Electrical
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Electrical Rooms (Clean, organized, no flammables stored in room or within 25' of any electrical panel)
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Electrical Distribution (Panel covers installed, 36" clearance in front of each Panel)
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Arc Flash (Arc Flash survey complete, proper labels attached to all distribution equipment)
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Arc Flash Kit (Adequate amount of arc flash PPE on hand, good condition, properly stored)
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Electrical Gloves (Adequate amount of gloves, current test, free of defects)
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Extension and portable electrical equipment cords are inspected for torn insulation and missing grounding conductors
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Overall Average Score for Electrical:
Section V: Refrigerant Management
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Site Refrigerant Program Manager:
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CBRE Chief Engineer Monthly Audit (Records complete and current)
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CBRE Major Ref. Equip. Form (Records complete and current)
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CBRE Major Equip. Ref. Usage Log (Records complete and current)
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CBRE Ref. Cylinder Inventory Log (Records complete and current)
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CBRE Monthly Refrigerant Report (Records complete and current)
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CBRE EPA Section 608 Tech. Roster (Records complete and current)
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CBRE Energy Manager Ref. Program Compliance Grade:
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Overall Average Score for Refrigerant Management Program:
Section VI: Diesel Fuel Management
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Diesel Fuel Reporting (Fuel receipts are distributed to CBRE Senior Energy Manager on a monthly basis, receipts are organized and filed at the site)
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Diesel Fuel Management (Three years of records showing purchase, quantity, amount per piece of equipment)
Section VII: Fire & Life Safety
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Fire Extinguisher Annual Training (Proof of current training for all staff)
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Standpipe Inspection (Inspection tags current, marked with MM/DD/YY and initials format)
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Fire Extinguishers (Inspection tags current, marked with MM/DD/YY and initials format)
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Generator Testing (Copies of monthly, semi-annual and annual tests, retain 2 years)
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Fire Pump Testing ( Copies of weekly/monthly and annual flow test, retain 2 years)
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Fire Doors (Copies of annual report, retain 5 years)
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Sprinkler & Smoke Detection Testing (Copies of all annual reports, signed, retain 5 years)
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Fume Hood (Copies of all testing reports, signed, retain 2 years, training)
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Kitchen Hood Testing/ Cleaning (Copies of all testing reports, retain 2 years, training)
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Overall Average Score for Fire & Life Safety:
Section VIII: Chemical Management
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HP Prohibited Chemicals (List located in all MSDS books)
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Chemical Labeling (Verify all chemical containers are properly labeled)
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Chemical Disposal (Review site-specific plan, verify we are in compliance)
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Flammable Cabinet (Accessible, proper cabinet, flammables properly stored)
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Corrosives Cabinet (Accessible, proper cabinet, corrosives properly stored)
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Spill Kits (In close proximity to all chemical storage, sized properly for spill)
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Overall Average Score for Chemical Management:
Section IX: First Aid
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First Aid Kit (Adequate quantity, properly stocked, ready available to all staff)
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Eyewash Stations (Located properly, adequate signage, current PM, signed tag)
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Hazard assessments (on file for where PPE must be worn and the types that must be worn)
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Overall Average Score for First Aid:
Section X: LOTO
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Assigned Locks & Tags (Each staff has at least one lock/tag, identifiable and all keys)
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Communal Locks (Available, complete, one key per lock only)
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Lockout Devices (Adequate supply of various devices used for lockout, per facility req.)
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Overall Average Score for LOTO:
Section XI: Employee Interview
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Elevator Entrapment (Explain your role in the event of an elevator entrapment)
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MSDS (Randomly choose a site chemical, employee must locate MSDS)
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Lockout (Employee presents lock and key and explains when to use Lockout and Tagout)
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Injury Reporting (Employee describes injury reporting plan and where to locate forms)
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Safety Plan Documentation (Employee shows inspector where all documentation is located)
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PPE (Employee describes PPE available to them and when they use it)
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Safety Plans (Random) (Ask employee to explain two randomly selected written plans)
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Lifting (Employee demonstrates proper way to lift a box from the floor)
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Spill Kit (Employee shows where the spill kit, identifies content, and describes when to use it)
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Overall Average Score for Employee Intervies:
Section XII: Scorecard Averages
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Section I: General Workplace
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Section II: Safety Training
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Section III: Documentation
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Section IV: Electrical
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Section V: Refrigerant Management
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Section VI: Diesel Fuel Management
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Section VII: Fire & Life Safety
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Section VIII: Chemical Management
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Section IX: First Aid
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Section X: LOTO
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Section XI: Employee Interview
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Overall Average Site Score:
Inspection Verfication
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