Clayton's installer Audit Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

INDUSTRY INDUCTION LICENSES

• Photo of installer

  Media

• Is the installer carrying industry induction card?

  Yes

  No

  Other (list comments at bottom)

• please enter industry induction card number

PPE

• Hearing protection

  Yes (sufficient)

  yes (insufficient)

  NO

• Eye protection

  Yes (sufficient)

  yes (insufficient)

  NO

• First aid kit

  Yes (sufficient)

  Yes (insufficient)

  NO

• Safety vest or high vis polo

  Yes

  No

• Safety footwear

  Steel toe

  no steel toe

  no safety footwear

• Dust mask for MDF cutting

  Yes

  No

• Hard hat

  Yes

  No

ESSENTIAL EQUIPMENT

• MDF cutting warning sign

  Yes (displayed while cutting)

  Yes (not displayed)

  Does not have sign with

  Does not have sign at all

• Handle jigs

  Yes (in good condition)

  Yes (in worn condition)

  Yes (in bad condition) comment below

  No (not with installer)

  No (does not own)

• Industrial rated ladder, minimum 120kg

  Yes

  No

  industrial rated but less than 120kg

  not industrial rated

• Tool tagging date on tools (test date)

  Date

• Licensed test and tag certificate number (located on log sheet)

• Take a photo of a tag

  Media

• Safety guards in place on all tools

  Yes (in good order)

  Yes (requiring attention)

  No (faulty-broken-missing) comment below

• NO double adapters in use

  Yes (none in use)

  No (non compliant double adapter in use)

• Table rip saw, or approved plunge saw with guides, on site and In use

  Yes

  No

• Photo of table rip saw

  Media

• List make and model of table rip saw, or plunge saw, and any other relevant information

• Tagged power box (RCD) and extension leads

  Yes

  No

SAFETY DOCUMENTS AND REGISTERS

• Is installers folder, including safety management documents, MSDS, tool tag registers, incident forms etc in work vehicle

  Yes

  No

• How many builders audits have been conducted in the last 3 months

  None

  One

  Two

  Three

  More

• I declare the information listed above has been supplied and sited as current and complies with Clayton's safety standards

  Yes

  No

• Auditors signature

  Sign

• Installers signature

  Sign

• Please list all relevant information on items installer is to rectify, including dates to be completed by.

• Please list any other relevant information, requests, or comments