Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Entrance
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1. Is the Occupancy Permit located in entry?
Contractor Management
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1. Are all restricted areas locked and signage clearly displayed?
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2. Is the contractor box locked and all relevant forms stocked?
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Restricted Access permit
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Roof Access Permit
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Hot Works permit
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Fire Systems isolation/impairment form
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Insurers impairment notification form
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Incident report form
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Emergency Contact Details
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Asbestos/Hazardous Materials Register
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Site evacuation plan and procedures
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Confined Space permit
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Hazard Awareness Register
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3. Check that contractors are using the contractor induction box and take a photo of the sign in register
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Picture of sign in register
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4. Are all contractors inducted and reviewed within past 12 months?
Fire Protection Systems
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1. Is a Service Provider regularly testing and maintaining the following components to the relevant Service Agreement and appropriate State legislation:
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Date of last Fire Panel test
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Is the Fire Panel being regularly maintained?<br>
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A - Fire extinguishers (R)
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Photo of date stamp
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B - Fire Hose Reels (R)
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Photo of date stamp
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C - Fire Doors
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Select date
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D - Fire Interface Panel - Full Function Test
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Select date
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E - Fire Sprinkler System
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Date of monthly or weekly test
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Is there a block plan of the sprinkler system in the pump room?
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G - Early Warning Intercommunication System (EWIS)
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Date of last test
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H - Emergency Lighting & Exit Signs (R)
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Photo of date stamp from last test
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3. Are Fire Cupboards (hose reel storage etc) free from stored materials and rubbish? (R)
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Photo of fire cupboard
Hydrants
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1. Are hydrants present?
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Date of last flow test
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4. Are Portable Fire Extinguishers and Fire Hose Reels clearly signed?
Emergency Management
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1. Is the emergency evacuation plan clearly displayed in all areas?
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Photo of Evacuation plan
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2. Are ALL Fire Doors / Breakout panels operational?
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3. Are assembly areas allocated and understood?
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4. Has a practice drill occurred in the last 12 months?
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Date of last fire training
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5. Are the means of escape paths and emergency exits clear?
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Photo of a typical path
Electrical (Common area equipment only)
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1. Has electrical equipment and Residual Current Devices been tested / tagged in last 12 months?
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Date of last test
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2. Are power points being used appropriately (i.e no multiboards, double adaptors, etc)
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3. Has Distribution Board had thermal test done in last 12 months
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Date of last thermographic test
Hazardous Substances
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1. Are there any hazardous materials or dangerous goods present on site?
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4. Are Material Safety Data Sheets (MSDS) available for all dangerous goods?
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2. Is Hazmat register current?
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3. Are materials or goods stored correctly? (If this is a warehouse there should be a 1m gap from the sprinkler head)
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5. Is there asbestos on site and is the register up to date?
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6. If there is a spill kit on site is it complete? (usually on an industrial site and consists of a 240L wheelie bin with absorbents to contain a spill, gloves, masks and waste bags)
First Aid. (Applies to manned properties only)
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1. Is a first aid kit supplied? (Required on a manned site)
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2. Has the first aid kit been audited in the last year?
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3. Are all injuries reported and recorded in a book or form?
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4. When first aid equipment is used is it recorded?
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5. Is a sharps kit available?
Interior Environment
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1. Are floors and surfaces in good condition?
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Photo of typical floor
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2. Are stairways and aisles kept clear and useable?
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Photo of stairway if applicable
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3. Are lighting levels satisfactory?
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4. Is the general presentation and cleanliness satisfactory e.g. Ceilings, high glass, furniture?
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5. Are toilets clean and adequately stocked with supplies?
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6. Are the kitchen/tea rooms clean?
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7. Is air conditioning within operational limits?
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8. Is the directory board up to date?
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9. Are vacant areas clean and presentable?
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10. Are lifts clean, well lit and are the emergency phones operational? (press lift emergency button to check and advise operator that this is a test)
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11. Are public facilities and large common areas (i.e food courts, etc) well presented?
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12. Is CCTV operational?
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13. Are disabled amenities and access areas clean and free from obstruction?
Exterior Environment
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1. Are exterior walls and surfaces clean and in good repair?
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Photo of typical exterior wall
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2. Are paths and external stairs in good condition?
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Photo of clear paths or stairs if applicable
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3. Are parking areas tidy and bollards/speed humps undamaged?
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Photo of carpark if applicable
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4. Is the line marking & signage adequate in the car park area?
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Photo of condition of line marking
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5. Are driveways clear and free of hazards?
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6. Are roller doors / boom gates / dock levellers operational / undamaged?
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7. Are exterior / security lighting working?
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8. Are drains / grates clear of rubbish?
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9. Are waste bins regularly emptied and area clean / tidy?
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10. Are fences / gates undamaged?
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11. Are landscaped areas well presented & free from rubbish?
Plant & Equipment
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1. Are all access ladders and stairways in good condition?
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2. Are the lifts and escalators serviced frequently?
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Date of last service
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3. Are the Building Maintenance Units (BMU's) serviced regularly?
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Date of last BMU service
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4. Does the car park ventilation system appear to be working correctly?
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5. Are ALL plant rooms neat and tidy, free from debris and trip hazards?
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6. Is there evidence that chillers/pac units/splits are regularly serviced?
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Date of last service
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7. Are there any cooling tower present?
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Expiry of registration
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Is there a current Risk Management Plan for the cooling towers?
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8. Is water testing regularly tested and are results available?
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9. Are there any boilers with pressure vessels on site?
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If a pressure vessel is present check that a notification of plant design had been submitted at time of build or installation with Worksafe. Email licensing@worksafe.vic.gov.au Subject: Plant Design
Roof
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1. Is the roof area free from debris and trip hazards?
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2. Are gutters clear and in good condition? (R)
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Photo of gutters
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3. Are roof walkways and perimeter barriers in good condition?
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4. Are anchor points and static lines being maintained?
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Date of last test and inspection
Environmental
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1. Has the back flow device been tested?
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Date of last backflow test
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2. Is a trade waste agreement in place? Trade waste is any waste water discharged from commercial, industrial, laboratory or trade activities including coffee shops
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Date of registration of trade waste agreement
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3. Are grease traps serviced as per regulations?
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Date of last grease trap service
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4. Are sump pumps operational and regularly serviced?
Workplace safety
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1. Are there any confined spaces areas on site? if so are they labelled?
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2. Are there any trip hazards apparent?
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Please make a note of any hazards not already identified in this report.
General Comment
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Please make a note of any issues not already identified in this report.
Property Risk Audits
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1. Has a Property Risk Audit been completed in the past 12 months?
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2. Has a Plant Risk Assessment been carried out?
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3. Has a Confined Space Audit been carried out?
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Are confined spaces secured to prevent unauthorised entry?
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Are confined spaces suitably labeled?