Title Page

  • Conducted on

  • Prepared by

  • Location
  • Select date

  • Which area is being Audited?

  • What communication triggered this audit?

  • What is the Communication Title or Number?

  • Which Fatal Risk Applies?

  • Task Being Audited with Similar Exposure/ Fatal Risks.

  • Accompanying Supervisor Name:

  • Accompanying Employee Name:

  • Are all Critical Controls in place?

  • Explain Applicable Critical Controls

  • Photos of Critical Controls

  • Which Critical Controls are lacking, or could be improved?

  • Photo of Lacking or Insufficient Critical Controls.

  • Are Non- Critical Controls present and sufficient per the highest acceptable level on the Hierarchy of controls?

  • Explain Current Controls:

  • Photos of Current Controls

  • What improvements on current practices can be made?

  • Photo of current practices or recommendations for improvement.

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.