Safety Work Contact and JSA Audit
Number of people in Observation team
Number of people contacted:
Head, Foot, Eye / Face, Body
Mandatory PPE is worn by work group
Hand - Available and used as required by JSA
Respiratory - Available and used as required by JSA
Hearing - Available and used where mandatory
Tag / Lock / Isolation - Personal Danger Tag is attached correctly
Secure Work - Crew agrees with Contents of SWI & JSA
Job Prep Hazard - SWI & JSA available and being used
Chemical Usage - MSDS readily available
Housekeeping / Storage - Work area free of housekeeping hazards
Barricades / Exclusion Zones - Reason for installation is on attached tag
Facility condition / Working conditions - Aware of housekeeping responsibilities
Selection - Adequate and suitable for task being performed
Condition - In good order and checked prior to use
Use - Able to explain safety features / controls
Line of Fire - Defensive working positions adopted
Pinch Points - Mechanical aids available and used
Lifting / Pushing / Pulling / Carrying - Able to explain correct lifting techniques
Walking / Climbing - Aware of hazards on floors, stairs and wet surfaces
Stable/Secure/Extended - Correct body position during task performance
Condition - Pre-Start Checks completed daily
Enter / Exit - Three points of contact used
Pedestrian Segregation - 50m Rule, radio or eye contact used
Is the JSA readily available at the workface for any persons entering the work area?
Has the JSA been reviewed/updated and signed onto today?
Have all personnel engaged in the task signed onto the JSA?
Has the JSA been reviewed and signed by the CHC Supervisor?
Has the JSA been signed off by the client representative?
Does the workgroup have a clear understanding of the task and associated hazards?
Does the JSA identify ‘Permit To Work’ requirements associated with the task?
Is an exclusion zone erected as per site requirements and are all entry points signed posted?
Does the JSA adequately reflect the task being performed?
Has the task been appropriately Risk Assessed?
Are the JSA task steps being followed by the work group?
Have all potential hazards been identified (detail major hazards that have not been accounted for)?
Is the workgroup wearing all the required PPE for the task?
Have STOP points been identified in the JSA?
Is the workgroup working with the correct ergonomics techniques in place?
Have the critical controls been documented and implemented?
Did you need to STOP the task or implement any corrective actions? YES / NO (detail actions above)
Are there any follow-up actions required? YES / NO Details:-