Clearvision Site Safety Interaction V2

• simPRO Job No.

• Location
  Address

• Prepared by

• Vehicle Rego

• Lead Tech

• Assistant Tech

• Conducted on

  Date

• Site Status - (pass or Fail)

Site Observations

• Would you like to complete a Full Health & Safety Site Observation

  Yes

  No

  N/A

• Is the site meeting safety expectations?

  Yes

  No

  N/A

• Was the Induction helpful or not?

  Yes

  No

  N/A

• Why was the induction not helpful?

• Have they identified and controlled all of the significant hazards such as utility services?

  Yes

  No

  N/A

• What was the unidentified and uncontrolled significant hazards and how can they be identified easier by the crews next time?

• Are there any new hazards to consider?

  Yes

  No

  N/A

• Enumerate all the new hazards and add to the job pre-start and hazard register.

• Was the site tidy or presented well?

  Tidy

  Untidy

• What could be done to keep the site tidy?

• Are the techs confident to do the job safely?

  Yes

  No

  N/A

• Why are the techs not confident to do the job safely, and what can be done immediately at site to help them?

• Complete PPE (As per task requirements)?

  Yes

  No

  N/A

• What PPE was missing and why was this missing?

• Has the crew explained the task and it's hazards and had control the risks as properly?

  Yes

  No

  N/A

• Was the crew coached and taught to explain the task and it's hazards and had control the risks as properly?

  Yes

  No

• Has the job pre-start captured these controls?

  Yes

  No

  N/A

• Did the techs consider other people (public, workers, home owners) when they do their risk assessment?

  Yes

  No

  N/A

• Why did the crew fail to

• What are the techs considering, for from a safety perspective, when they start the task?

• Is the vehicle, generator, power tools, hand tools & equipment in safe, tidy and good condition?

  Yes

  No

  N/A

Site Safety Interaction snap shot

• Please list the Good Safety Behaviors?

• Add Good Safety Behaviors photos

  Media

• Unsatisfactory Behaviors (e.g. hazards, controls and at-risk behavior)

• add Unsatisfactory Behaviors (e.g. hazards, controls and at-risk behavior) photos

  Media

• Safety Discussion and Immediate Actions required?

• Photos of rectifications

  Media

• Future Improvements/ Training done on site?

Quality Assurance

• Would you like to complete a Full Site Quality Assurance Check?

  Yes

  No

  N/A

• Are there any Civil Works involved?

  Yes

  No

  None

• Outside Boundary & Boundary reinstatement standard

  Yes

  No

  Not Completed

• What needs to be remediated?

• Fence line / surface mounting straight & standard?

  Yes

  No

  None

• What needs to be remediated?

• Shallow trenching straight, correct depth & reinstatement standard?

  Yes

  No

  Not Completed

• What needs to be remediated and completed?

• Slot-Cut depth, bends, straight & reinstatement are standard?

  Yes

  No

  None

• What needs to be remediated and completed?

• Slot-Cuts are all inside boundary?

  Yes

  No

  None

• Remove all slot-Cuts and move to 300mm inside boundary

• Is there a Pedestal installation?

  Yes

  No

  None

• Was the Pedestal installation standard?

  Yes

  No

  None

• What needs to be remediated?

• All reinstatement completed?

  Yes

  No

  Not Completed

• Complete all reinstatement before leaving site. If weather dependent, send photos and e,ail to your department and field manager.

• Are there any provisioning tasks on site?

  Yes

  No

  None

• Are the FTP & conduit/s installation standard?

  Yes

  No

• What needs to be remediated?

• Gas block/s installed correctly?

  Yes

  No

  None

• Install correct type of gas block/s

• FTP & ITP fibre management standard and had followed correct bend radius?

  Yes

  No

• Re-manage fibre and ensure that the correct bend radius is followed

• Spacing of clips at 300mm & saddles at 600mm maximum?

  Yes

  No

• ensure spacing of clips at 300mm & saddles at 600mm maximum

• Capping / Mini Trunking Used?

  Yes

  No

  None

• If yes, why is back to back or cavity drop (using existing phone wiring inside the wall as draw) possible?

• Correct materials used?

  Yes

  No

• remove all non-approved and incorrect materials then, replace with correct and approved materials.

• All other reinstatement (anything that requires reinstatement, even build work) completed?

  Yes

  No

  Not Completed

• take photos of uncompleted reinstatement and reinstate, then take photos and send to your department manager and field manager.

• Are the depth/s of Peg/s Marker/s Correct?

  Yes

  No

  None

• Install Peg/s Marker/s in the correct depth (ground line on peg).

• Is there a Enable tile marker?

  Yes

  No

• Is the tile marker at level with the surrounding ground?

  Yes

  No

• Reinstall the Enable tile marker to the correct level with the surrounding ground.

• Any there any tasks waste or rubbish left on site?

  Yes

  No

• Ensure all tasks waste on site are removed before leaving site.

• Any Feedback from the End-customer?

  Yes

  No

  N/A

• Please list the feedback, and request if the customer can send the feed back to cvfibre@gmail.com

Quality Assurance Snap Shot

• Please list good quality workmanship

• Please add good quality workmanship photos

  Media

• Please list bad quality and non-compliant workmanship.

• Please add bad quality and non-compliant workmanship photos

  Media

• Discussion and immediate rectification/s required?

• Add photos of rectification

  Media

• Future Improvements / Training done on site?

Acknowledgement

• Manager/Auditor Name

• Add signature

  Sign
Technician

• Name

• Add signature

  Sign