Title Page
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Client / Site Location
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ROW, SDU, MDU or Other
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What type of work was completed?
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Prepared by
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Conducted on
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Pass or Fail
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Lead Tech
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Assistant Tech
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Type of Audit
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Please provide brief description of the training
- Health and Safety Standards Compliance
- Traffic Management
- Traffic Management Vehicle Competancy Technical Plant/Equipment Leadership Systems/IT Process/Procedure Field Induction
- Vehicle Competency
- Technical
- Plant/Equipment
- Leadership
- Systems / IT
- Process and Procedure
- Field Induction
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Is the What Job Pre-Start / Risk Assessment Completed and practiced on site?
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Stop works and find out why was there no Is the What Job Pre-Start / Risk Assessment Completed or not practiced?
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What was the immediate action to address the situation?
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Is the site and crews compliant with current Health, Safety & Environmental procedures & policies?
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What are the non-compliance with Health, Safety & the Environment?
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Attach Health, Safety & Environmental non-compliance photos
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Was the personnel shown and instructed to correct the non-compliance with Health, Safety & the Environment?
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Enumerate all corrective actions and coaching performed on site
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Was all the Hazards Identified?
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Enumerate / List down what hazards where not identified and next to them are the action points
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Where you (the auditor) inducted properly before entering the site in the following informations?<br>1. Tasks to be performed & the hazards associated with it.<br>2. Checked your PPE if complete<br>3. First aiders on site, firt aid kit and fire extinguisher location (rego if in vehicle).<br>4. Exact location of evacuation point, nearest emergency center address.<br>5. Responsible department manager, field manager and NSM (network delivery specialist).
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Was crews taught how to induct properly?
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Enumerate all that has be taught
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What are the good safety behaviors?
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Attach good Health, Safety & Environmental photos
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Comments for further improvent
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Do you deem the site to be safe, at risk or significant at risk?
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Stop Works reassess the hazard & their risks with the crew.
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Is the site now made safe?
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Crew has Complete PPE (fit for purpose)?
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Enumerate what are are the missing PPE?
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Proper use of PPE?
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Was the crew/s shown how to use the PPE?
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What are the PPE shown to be used?
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Any PPE requests?
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Site Set-up (OSB according to CoPTTM, ISB work site isolated)
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Enumerate all rectifications made
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First Aid Kit
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Fire Extinguishers
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Any ground disturbance (all types of trenching, concrete cutting and drilling)
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Are the service plans (OSB) onsite?
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Stop works, call department manager and get the services plans on site.
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Has the power and telecom cable located & marked?<br>Has the water & storm water been located & exposed in potholes?
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Stop Works and ask the crew to locate services, with the intention of not striking them.
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Does the Vehicle have a CV Field pack?
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Stop Works and ask one of the crew to pick one from the office
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Does the vehicle have a Hazardous Chemical Container?
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Is there a Hazardous Chemical Register?
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Does the crew/van have the corresponding Safety Data Sheet (SDS)?
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Actions on Hazardous Chemicals:
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Fibre and Sharps container
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Ask Crew to get one from the office or label a sealed bottle as a sharps container
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Is the Vehicle in a tidy, safe and working condition?
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Enumerate the vehicle issues
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Site Final Assessment on Health and Safety
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List all the learning that was gathered on this live audit
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Would you like to complete a live Quality Assessment
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FTP Installation & Fibre Management
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Take Photos
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Fibre / mini trunking / conduit run
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Take Photos
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ITP Installation & Fibre Management
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Take Photos
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ONT Installation & cable management
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Take Photos
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Was the phone line integrated to the VoIP?
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Take Photos
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Fence line / Surface Mounting
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Take Photos
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Slot-cut (micro-cutting) straight?
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Take Photos
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Slot-cut (micro-cutting) reinstated?
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Take Photos
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Boundary Reinstatement
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Take Photos
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Trenching Reinstatement (Soft, gravel, seal, concrete)
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Take Photos
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Is the Site Tidy during the inspection?
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Take Photos of the site
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Was the job completed according to the Quality Assurance standards of both client & Clearvision?
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Attach the good quality workmanship photos
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Comments for further improvement
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Enumerate the non-compliance to the Quality Standards?
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FTP Installation & Fibre Management
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Take Photos
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Fibre / mini trunking / conduit run
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Take Photos
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ITP Installation & Fibre Management
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Take Photos
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ONT Installation & cable management
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Take Photos
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Was the phone line integrated to the VoIP?
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Take Photos
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Fence line / Surface Mounting
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Take Photos
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Slot-cut (micro-cutting) straight?
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Take Photos
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Slot-cut (micro-cutting) reinstated?
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Take Photos
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Boundary Reinstatement
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Take Photos
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Trenching Reinstatement (Soft, gravel, seal, concrete)
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Take Photos
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Is the Site Tidy during the inspection?
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Take Photos
Personnel
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Personnel
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Audited By:
