CHOICE SERVICES INSPECTION SMALL WORKS

• Site conducted

  Select

• JOB No.

• DESCRIPTION OF WORK CARRIED OUT.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• KEY STAFF

1. SITE ESTABLISHMENT

• 1.1 EMERGENCY TELEPHONE NUMBERS AVAILABLE.

  Yes

  No

  N/A

• 1.2 SIGNED INTO REGISTER

  Yes

  No

  N/A

2.0 SITE SAFETY MANAGEMENT SYSTEM

• Has Policy Document or Induction folder been received.

  Yes

  No

  N/A

• 2.2 HEALTH AND SAFETY TRAINING

  Yes

  No

  N/A

3.0 FIRE SAFETY

• 3.1 FIRE FIGHTING EQUIPMENT AVAILABLE

  Yes

  No

  N/A

• 3.2 HAS IT BEEN MAINTAINED, IS IT IN DATE?

  Yes

  No

  N/A

• 3.3 BRACKET WITH STRAP IN VAN?

  Yes

  No

  N/A

4.0 FIRST AID

• 4.1 FIRST AID KIT STOCKED?

  Yes

  No

  N/A

• 4.2 AWARE OF LOCATION?

  Yes

  No

  N/A

5.0 ACCIDENT PROCEDURES

• 5.1 REPORTING PROCEDURE AVAILABLE?

  Yes

  No

  N/A

• 5.2 STAFF AWARE?

  Yes

  No

  N/A

6.0 POWRA-RISK ASSESSMENT /SSOW/METHOD STATEMENTS

• 6.1 PREPARED

  Yes

  No

  N/A

• 6.2 ADEQUATE?

  Yes

  No

  N/A

• 6.3 COMPLIED WITH?

  Yes

  No

  N/A

7.0 COSHH ASSESSMENT

• 7.1 ASSESSMENTS AVAILABLE.

  Yes

  No

  N/A

• 7.2 COMPLIED WITH?

  Yes

  No

  N/A

• 7.3 SPILL KIT AVAILABLE?

  Yes

  No

  N/A

8.0 MANUAL HANDLING

• 8.1 MECHANICAL OR AUTOMATED MEANS USED WERE POSSIBLE?

  Yes

  No

  N/A

• 8.2 STAFF TRAINED

  Yes

  No

  N/A

9.0 HOT WORKS

• 9.1 PERMIT TO WORK SYSTEM

  Yes

  No

  N/A

• 9.2 COMPETENT PERSONS

  Yes

  No

  N/A

• 9.3 EMERGENCY PROCEDURES IN PLACE BASED ON PERMIT?

  Yes

  No

  N/A

11.0 PPE

• 11.1 IDENTIFIED FROM RISK ASSESSMENTS/POWRA

  Yes

  No

  N/A

• 11.2 TRAINED IN USE?

  Yes

  No

  N/A

• 11.3 CONFORMING ?

  Yes

  No

  N/A

12.0 WORKPLACE

• 12.1 ACCESS /EGRESS/SEGREGATION AS NECESSARY?

  Yes

  No

  N/A

• 12.2 EMERGENCY ACCESS MAINTAINED?

  Yes

  No

  N/A

• 12.3 PREVENTION OF OBSTRUCTIONS?

  Yes

  No

  N/A

• 12.8 HOUSEKEEPING?

  Yes

  No

  N/A

13.0 WELFARE

• 13.1 TOILET /WASH FACILITIES INCLUDING HOT WATER?

  Yes

  No

  N/A

• 13.2 EATING AREA

  Yes

  No

  N/A

14.0 WORK AT HEIGHT USE OF PLATFORMS

• 14.1 FALL PROTECTION

  Yes

  No

  N/A

• 14.2 ACCESS/EGRESS

  Yes

  No

  N/A

• 14.3 EDGE PROTECTION?

  Yes

  No

  N/A

• 14.4 LEADING EDGES?

  Yes

  No

  N/A

• 14.5 TRAINING?

  Yes

  No

  N/A

15.0 LADDERS,STEPLADDERS, PODIUMS,TOWER SCAFFOLDS

• 15.2 LADDER CHECK COMPLETED?

  Yes

  No

  N/A

• 15.3 SECURITY OF LADDER ?

  Yes

  No

  N/A

• 15.4 POSITION (BASE TO HEIGHT RATIO CHECKED)

  Yes

  No

  N/A

• 15.5 PLATFORMS CHECKED BY COMPETENT OPERATOR.

  Yes

  No

  N/A

16.0 WORK EQUIPMENT

• 16.1 APPROPRIATE FOR USE

  Yes

  No

  N/A

• 16.2 CONDITION CHECKED? (Check One Item)

  Yes

  No

  N/A

• 16.3 MAINTENANCE CERTS( PAT, CERTIFICATE OF CONFORMITY ETC.)

  Yes

  No

  N/A

18.0 INSPECTIONS.

• 18.2 LIFTING EQUIPMENT - LOLER MANDATORY INSPECTIONS

  Yes

  No

  N/A

• 18.3 STATUTORY SCAFFOLD INSPECTIONS?

  Yes

  No

  N/A

19.0 ENVIRONMENT

• 19.1 WASTE MINIMISATION

  Yes

  No

  N/A

• 19.4 DISCHARGES

  Yes

  No

  N/A

20.TRANSPORT

• 20.1 VEHICLE MOVEMENT?

  Yes

  No

  N/A

• 20.2 VEHICLE TIDY INSIDE AND OUT

  Yes

  No

  N/A

21.ANY OTHER OBSERVATIONS

• 21.1SAFETY ISSUES

  Yes

  No

  N/A

• 21.2 ENVIRONMENTAL ISSUES

  Yes

  No

  N/A

• 21.3 QUALITY ISSUES -INFORMATION UPLOADS CHECKED ON CONNECT

  Yes

  No

  N/A

• 21.4CONSTRUCTION PHASE PLAN AVAILABLE FOR SMALL CONTRACTED WORKS.

  Yes

  No

  N/A

• 21.5ASBESTOS REGISTER CHECKED

  Yes

  No

  N/A

• ASSESSMENT SITE OPERATIONS

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• ASSESSMENT MANAGEMENT SYSTEMS

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• CONFIRMATION FROM THE ENGINEER THAT THEY HAVE RECEIVED THE INFORMATION & RECOMMENDATIONS IN THE REPORT.

  Sign

• CONFIRMATION THAT THE HSQE MANAGER HAS DISCUSSED ALL MATTERS ARISING WITH THE ENGINEER

  Sign

• DISTRIBUTION: PROJECT MANAGER/SUPERVISOR