Compass - Interiors

• Client

  IU Health

  Community Health

  Hendricks Regional

• Project

  IU Health - Floor 8 Renovation

  Metro 8

  Metro 6

  Lincoln Square

• Conducted on

  Date

• Prepared by

• Location
  Address

General Safety

• Are personnel active on the project?

  Yes

  No

  N/A

• All personnel are wearing hard hats

  Safe

  At Risk

  N/A

• All personnel are wearing safety glasses

  Safe

  At Risk

  N/A

• All personnel are wearing high visibility clothing

  Safe

  At Risk

  N/A

• All personnel onsite have successfully completed orientation

  Safe

  At Risk

  N/A

• All personnel are conducting daily planning activities (Task Hazard Analysis)

  Safe

  At Risk

  N/A

• Workarea is clean and materials organized

  Safe

  At Risk

  N/A

• Lighting in all work areas is adequate

  Safe

  At Risk

  N/A

• Fire extinguishers are available, inspected, and in good working order

  Yes

  No

  N/A

• Emergency Action Plan and escape routes are complete and readily available

  Safe

  At Risk

  N/A

• Ventilation in work area is effective

  Safe

  At Risk

  N/A

Interior Demolition

• Are demolition activities being conducted?

  Yes

  No

  N/A

• Utilities (i.e. electrical, steam, water, gas, fire protection) are isolated, locked out, and tagged

  Safe

  At Risk

  N/A

• Material, equipment, debris/trash, and the work area is organized and tidy

  Safe

  At Risk

  N/A

• Personnel are wearing protective clothing (i.e. gloves, kevlar sleeves) necessary for task

  Safe

  At Risk

  N/A

• Penetrations in the deck >2 inches are securely covered and identified as "HOLE"

  Safe

  At Risk

  N/A

Ladders

• Are ladders being used?

  Yes

  No

  N/A

• Ladders are free of damage and defects

  Safe

  At Risk

  N/A

• Ladders are set up and secured

  Safe

  At Risk

  N/A

• Personnel using ladder is maintaining three points of contact

  Safe

  At Risk

  N/A

Lifts

• Are scissors lifts being used?

  Yes

  No

  N/A

• Scissors lift has been inspected

  Safe

  At Risk

  N/A

• Scissors lift is being operated on a level surface

  Safe

  At Risk

  N/A

• Personnel have feet on deck of scissors lift

  Safe

  At Risk

  N/A

• Chain on scissors lift is attached

  Safe

  At Risk

  N/A

Public Protection

• Does the work potentially interact with public and/or staff?

  Yes

  No

  N/A

• The perimeter of the work area identified and protected

  Safe

  At Risk

  N/A

• Signage is present identifying work areas as "Construction Zone"

  Safe

  At Risk

  N/A

ILSM/ICRA

• Are infectious control measures (ILSM/ICRA) needed for the work?

  Yes

  No

  N/A

• Temporary walls are complete and identified with signage

  Safe

  At Risk

  N/A

• All penetrations and doors are secured and sealed

  Safe

  At Risk

  N/A

• Access and exit routes are clear

  Safe

  At Risk

  N/A

• ILSM/ICRA documentation is current and posted

  Safe

  At Risk

  N/A

• Negative air pressure is maintained at all times

  Safe

  At Risk

  N/A

• Walk off mats are present and maintained

  Yes

  No

  N/A

• Debris carts are clean and covered when in occupied hospital space

  Safe

  At Risk

  N/A

Fall Protection

• Are personnel working with their feet at/or above 6 feet?

  Yes

  No

  N/A

• Are guardrails present

  Yes

  No

  N/A

• Top rail, mid-rail, and toe board present in all areas

  Safe

  At Risk

  N/A

• Toprail, mid-rail, and toe board sturdy (200 pounds of force) and in good condition

  Safe

  At Risk

  N/A

• Is a harness, lanyard, and anchor point being used?

  Yes

  No

  N/A

• Anchor point is secure and can withstand 5,000 pounds

  Safe

  At Risk

  N/A

• Lanyard is securely affixed to anchor point and harness

  Safe

  At Risk

  N/A

• Lanyard is in good condition and the correct type of lanyard is utilized for working environment

  Safe

  At Risk

  N/A

• Harness fits well and is in good condition

  Yes

  No

  N/A

• Are covers being utilized to protect floor penetrations greater than 2 inches in diameter?

  Yes

  No

  N/A

• Covers are secured and labeled as "HOLE

  Safe

  At Risk

  N/A

• Material used for floor penetration protection has sufficient load capacity for activity in work area

  Safe

  At Risk

  N/A

Electrical

• Is electrical power for tools, equipment, lighting, etc. being used?

  Yes

  No

  N/A

• Electrical panels and/or cabinets are identified and secured

  Safe

  At Risk

  N/A

• Electrical cords, pugs, and/or outlets are in good working condition

  Safe

  At Risk

  N/A

• Ground Fault Circuit Interrupter (GFCI) are used with all electrical tools and equipment

  Yes

  No

  N/A

• Electrical cords are out of walkways

  Safe

  At Risk

  N/A

Fire Protection

• Are flammable and/or combustable materials being stored on the project?

  Yes

  No

  N/A

• All flammable and combustable materials are stored in a safe location

  Safe

  At Risk

  N/A

• Location of stored flammable and combustable materials are identified with signage and secure

  Safe

  At Risk

  N/A

• Compressed gas cylinders are secured, upright, and are capped

  Safe

  At Risk

  N/A

• Are grinding, cutting, welding or any other spark producing activities being conducted?

  Yes

  No

  N/A

• If required, are Hot Work Permits completed, reviewed, and approved?

  Safe

  At Risk

  N/A

• A fire extinguisher available for the activity being conducted

  Safe

  At Risk

  N/A

• All flames, sparks and/or slag is contained from spreading (i.e. floor penetrations, stairways, etc.)

  Safe

  At Risk

  N/A

• Gauges, hoses, cables, and welding leads in good working condition

  Safe

  At Risk

  N/A

• Flash arrest protection is present with torches

  Yes

  No

  N/A

• When welding, flash protection is used

  Yes

  No

  N/A