Title Page

  • Company Name

  • Registered Address
  • Inspected by

  • Conducted on

Protecting Yourself and Others

  • Continue to follow all safe work procedures. If it is unsafe to work, talk to your supervisor, health and safety committee or representative, and/or union.

  • Practice physical distancing by working more than 2 metres (6 feet) apart from others.

  • Stay home if you are sick or might be sick. Follow the Public Health Agency of Canada’s steps for self-assessment: https://www.canada.ca/coronavirus

  • Wear gloves and do not touch your face.

  • Wash your hands at the start of your shift, before eating or drinking, after touching shared items, after using the washroom, and before leaving the site. Remove jewellery while washing.

  • Do not share communication devices, personal protective equipment, cigarettes, or vaping equipment.

  • Do not spit on-site.

  • Remove work clothes and wash them as soon as you get home.

On-site Sanitation

  • Provide access to handwashing stations (even if it is a spouted water container, catch bucket for water, soap, and paper towels) or provide hand sanitizer. If hands are visibly dirty, they must be washed with soap and water.

  • Clean offices, washrooms, lunch/break rooms and/or trailers, and other workspaces every day. Focus on commonly touched surfaces such as doorknobs, handles, handrails, tables, chairs, pens, tools, radios, vending machines, and kitchen equipment.

  • Regularly clean shared tools, phones, and other devices with alcohol or disinfectant wipes.

  • Assign one driver per vehicle, or clean shared vehicles between driver changes.

Site Management

  • Minimize the number of workers at one time on-site. Stagger trades and their work locations, meetings, breaks, tool cribs, safety toolbox talks, and orientations.

  • Ask everyone to check in. Do not allow people on-site if they are sick or might be sick.

  • Minimize contact during sign-in. Have the supervisor sign in for people (or provide separate pens), or have people text the supervisor. Clean any sign-in devices between users.

  • Submit hazard assessments and documents electronically, or wash hands after handling papers.

  • Control site movement to reduce gathering at scaffolds, hoists, washrooms and other high traffic areas.

  • Designate travel paths so workers do not have to pass each other closely (e.g., one set of stairs for up, another for down) or have workers call out before entering a shared space.

  • Hold meetings in an outside or large space to allow for physical distancing of at least 2 metres (6 feet) between people.

  • Hold verbal orientations to avoid touching papers.

Crew Management

  • Maintain physical distancing, unless otherwise unsafe to do so (3-4 workers per 1000 square feet, or 10 workers per 10,000 square feet, and keep large job shacks to 5 people, and small shacks to 3)

  • Keep crews together so that they are comfortable working in closer proximity when absolutely necessary.

  • Wear personal protective equipment (PPE) such as a respirator, face shield, gloves, and long-sleeved shirts, if appropriate and available. Train workers on how to work with and care for PPE, and to understand its limitations.

  • Discuss with crews how to perform work safely while maintaining distance. Modify production schedules if necessary.

  • Make sure workers are trained to work safely before replacing the duties of others.

  • Consider multiple shifts to help keep distance between workers and to accommodate those with caregiving needs.

  • Make sure workers on-site have the necessary skills and training to operate equipment, perform first aid, supervise, etc.

Completion

  • Additional Observations

  • Inspector Name & Signature

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.