Classic Homes Safety Audit Form

SAFETY AUDIT FORM

• Project

• Address
  Address

• Conducted on

  Date

• Name of Person Conducting Audit

• Trade Partner(s)

PPE

• Hard Hats

  Compliant

  Non-Compliant

  N/A

• Eye Protection

  Compliant

  Non-Compliant

  N/A

• Dust Mask or Respirator Being Used

  Compliant

  Non-Compliant

  N/A

• Hearing Protection

  Compliant

  Non-Compliant

  N/A

SCAFFOLDING

• Proper Planking

  Compliant

  Non-Compliant

  N/A

• Top Rail

  Compliant

  Non-Compliant

  N/A

• Mid Rail

  Compliant

  Non-Compliant

  N/A

• End Rails

  Compliant

  Non-Compliant

  N/A

• Mudsills

  Compliant

  Non-Compliant

  N/A

• Pump Jacks

  Compliant

  Non-Compliant

  N/A

• Access

  Compliant

  Non-Compliant

  N/A

• Competent Person Present

  Compliant

  Non-Compliant

  N/A

LADDERS

• Proper Ladder for the Job

  Compliant

  Non-Compliant

  N/A

• 1:4 Lean Ratio

  Compliant

  Non-Compliant

  N/A

• Properly Secured

  Compliant

  Non-Compliant

  N/A

• 3-Foot Extension Access

  Compliant

  Non-Compliant

  N/A

• Proper Use of Step Ladders

  Compliant

  Non-Compliant

  N/A

CONSTRUCTION ELECTRICAL POWER & POWER CORDS

• GFCI Provided at Pedistal

  Compliant

  Non-Compliant

  N/A

• Proper Electrical Junction Boxes

  Compliant

  Non-Compliant

  N/A

• Electrical Cords in Good Condition

  Compliant

  Non-Compliant

  N/A

ACCESS & HOUSEKEEPING

• Free of Excess Debris

  Compliant

  Non-Compliant

  N/A

• Passage Ways Kept Clear

  Compliant

  Non-Compliant

  N/A

• Ramps: Required - 19" or Greater with Minimum 18" Wide

  Compliant

  Non-Compliant

  N/A

• Trash Container Supplied

  Compliant

  Non-Compliant

  N/A

• Material Piling & Stacking

  Compliant

  Non-Compliant

  N/A

• Nails Bent or Removed

  Compliant

  Non-Compliant

  N/A

SITE / PUBLIC PROTECTION

• Excavations / Trenches

  Compliant

  Non-Compliant

  N/A

• Forklifts / Cranes

  Compliant

  Non-Compliant

  N/A

• Barricades

  Compliant

  Non-Compliant

  N/A

• No Trespassing Signs / OSHA Boards Posted

  Compliant

  Non-Compliant

  N/A

OPEN HOLES / UNPROTECTED SIDES & EDGES

• Open-Sided Floors/Holes (e.g., Stairwell; Doors; Window Openings) Protected by Guardrails or Covers

  Compliant

  Non-Compliant

  N/A

• Window Well Covers

  Compliant

  Non-Compliant

  N/A

• Standard Guardrail: 2'x4': Top Rail at 42"; Mid-Rail at 22"; Upright at 8' Intervals (Toe Board When Someone Below)

  Compliant

  Non-Compliant

  N/A

• Window w/Sill Below 36" Requires Guardrail at 42"

  Compliant

  Non-Compliant

  N/A

FALL PROTECTION

• PFAS Being Used

  Compliant

  Non-Compliant

  N/A

• Competent Person Present

  Compliant

  Non-Compliant

  N/A

POWER TOOLS / POWER ACTUATED TOOLS & MOTORIZED EQUIPMENT

• Guards in Place

  Compliant

  Non-Compliant

  N/A

• Being Used Properly

  Compliant

  Non-Compliant

  N/A

• Proper Electrical

  Compliant

  Non-Compliant

  N/A

• Hoses & Cords in Proper Working Condition

  Compliant

  Non-Compliant

  N/A

EXCAVATING / TRENCHING

• Proper Slope or Bench

  Compliant

  Non-Compliant

  N/A

• Spoils Set Back 2'

  Compliant

  Non-Compliant

  N/A

• Access Every 25'

  Compliant

  Non-Compliant

  N/A

• Competent Person Present

  Compliant

  Non-Compliant

  N/A

• Rebar Protection in Place

  Compliant

  Non-Compliant

  N/A