Co-op FM Contractor Safety Check v1.0

• Client / Site

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

Contractor and Job Information

• Contractor Information

Enter Contractor Information

• Enter Contractor Name:

• Enter Operatives Name:

• Enter Work Order Number

• Enter details of work being carried out

Health & Safety Questions

• Did all operatives sign in and make themselves known to the Duty Manager?

  Yes

  No

• The operative must have signed the store sign-in book and made himself known to the duty manager before starting work.

• Did all operatives check and sign the asbestos register?

  Yes

  No

• If there is no asbestos register because the building was constructed post 2000, then answer Yes. Otherwise, evidence must be shown that the contractor has checked and signed the register prior to starting work.

• Does the contractor have a job specific Construction Phase Plan or Dynamic Risk Assessment?

  Yes

  No

• The operative must have available their specific RAMS, construction phase plan or dynamic risk assessment. If they cannot produce this, then the question is a fail.

• Is this a PFS site and is work on the forecourt? If so doe the operative hold a valid SPA card?

  Yes

  No

  N/A

• All operatives carrying our work on our PFS forecourts should have a valid SPA passport card.

• Are all operatives wearing the appropriate PPE?

  Yes

  No

• The operative must be wearing appropriate PPE as detailed in their risk assessment.

• Is the work area suitably Barriered off to prevent unauthorised access?

  Yes

  No

• The work area should be barriered off to prevent unauthorised access by colleagues or customers and create a suitable safe area to prevent injury.

• Are Hot Works involved, and if so is the Operative following the correct procedure? i.e. Permit completed and signed, fire-fighting equipment etc.

  Yes

  No

  N/A

• If hot works are not involved answer N/A.

• Are power tools being used? If so are they 110V or battery powered? If battery powered and a charger is present, is it PAT tested?

  Yes

  No

  N/A

• If no power tools are being used then answer N/A. If they are being used then all parts of the question must be satisfied, otherwise it is a fail.

• Are ladders being used? If so are the being used in a safe manner? i.e. Are they the contractor's own ladders? Are they being used correctly and appropriately secured; and do they have appropriate tags/evidence of inspection?

  Yes

  No

  N/A

• If ladders are not being used, answer N/A. If they are being used all parts of the question must be satisfied, otherwise it is a fail.

Sign-off

• Signature of Regional Facilities Manager

• RFM Signature

  Sign

• Signature of Store Representative

• Store Representative Signature

  Sign