Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. Job Information

  • 1.1. Phone number for the nearest medical center posted?

  • 1.2. Weekly safety meetings up to date?

  • 1.3. Is JHA being done and reviewed with crew?

  • 1.4. Work areas properly signed and barricaded?

  • 1.5. Is each employee instructed in the recognition and avoidance of unsafe conditions?

  • 1.6. Are first aid supplies readily accessible?

  • 1.7. Is facility for treatment of injured employees located within 15 minutes of the jobsite? If not, is there an employee trained in first aid?

  • 1.8. Are telephone numbers, physicians, hospitals posted?

  • 1.9. Are potable drinking and toilet facilities available at the jobsite?

  • 1.10. Is there protection for blood borne pathogens?

2. Housekeeping

  • 2.1. General neatness of work area?

  • 2.2. Projecting nails removed or bent over?

  • 2.3. Waste containers provided and used?

  • 2.4. Passageways and walkways clear?

3. Fire prevention

  • 3.1. Adequate fire extinguishers, checked and accessible?

  • 3.2. Phone number of fire department posted?

  • 3.3. "No smoking" posted and enforced near flammables?

4. Electrical

  • 4.1. Extension cords or attachment cords with bare wires, missing ground prongs or damaged are taken out of service?

  • 4.2. Ground fault circuit interrupters being used?

  • 4.3. Terminal boxes equipped with required boxes?

  • 4.4. Are flexible cords and cables protected from damage?

  • 4.5. Are unused openings in cabinet boxes and fittings closed?

  • 4.6. Are all cabinets, panels and switches located in wet locations enclosed in weather proof enclosures?

5. Hand, power and powder actuated tools

  • 5.1. Hand tools inspected regularly?

  • 5.2. Guards in place on machine, such as saws?

  • 5.3. Right tool being used for the job at hand?

  • 5.4. Operators of powder actuated tools are licensed?

6. Fall protection

  • 6.1. Safety rails and cables are secured properly?

  • 6.2. Employees exposed to fall hazards are tied off?

  • 6.3. Employees below are protected from falling objects?

  • 6.4. Employees using body belts for positioning devices only?

  • 6.6. Are employees working 4' above a lower level protected by guard rails, safety nets, personal fall arrest system?

7. Ladders

  • 7.1. Ladders extend at least 36" above the landing?

  • 7.2. Ladders are secured to prevent slipping, sliding, or falling?

  • 7.3. Ladders with split or missing rungs are taken out of service?

  • 7.4. Step ladders are used in fully open position?

  • 7.5. No step at top two rungs of step ladder?

8. Scaffolding

  • 8.1. Is all scaffolding inspected daily?

  • 8.2. Erected in sound rigid footing?

  • 8.3. Tied to structure as required?

  • 8.4. Guard rails, intermediate rails, toe boards and screens in place?

  • 8.5. Planking is sound and sturdy?

  • 8.6. Proper access provided?

  • 8.7. Employees below are protected from falling objects?

9. Floor and wall openings

  • 9.1. All floor or deck openings are planked over or barricaded?

  • 9.2. Perimeter protection is in place?

  • 9.3. Deck planks are secured?

  • 9.4. Materials are stored away from edge?

10. Trenching, Excavation and shoring

  • 10.1. Competent person on hand inspecting daily?

  • 10.2. Excavations over 5'in depth are shored or sloped back?

  • 10.3. Materials are stored at least 2' away from trench?

  • 10.4. Equipment is a safe distance way from edge of trench or excavation?

  • 10.5. Ladders provided every 25' in trench more than 4' deep?

  • 10.6. Have underground utility installations been located?

  • 10.7. Are employees exposed to vehicular traffic wearing warning vests of reflectorized or highly visible material

11. Material Handling

  • 11.1. Materials are properly stored or stacked?

  • 11.2. Employees are proper lifting methods?

  • 11.3. Taglines are used to guide loads?

  • 11.4. Proper number of workers for each operation?

12. Welding and Burning

  • 12.1. Gas cylinders stored upright and secured?

  • 12.2. proper separating distance between fuels and oxygen? min 20?

  • 12.3. Burning/Welding goggles or shields are used?

  • 12.4. Fire extinguishers are nearby?

  • 12.5. Hoses and regulators are in good conditions?

13. Cranes

  • 13.1. Outriggers are extended and swing radius barricaded?

  • 13.2. Operator is familiar with load charts?

  • 13.3. Crane operator logs are up to date?

  • 13.4. Employees kept from under suspended loads?

  • 13.5. Chains and slings inspected and tagged as required?

  • 13.6. Hand signal charts are on crane?

14. Concrete construction

  • 14.1. Employees are protected from cement dust?

  • 14.2. Exposed skin covered?

  • 14.3. Runways are adequate?

  • 14.4. Walls over 8' are supported?

  • 14.5. Are all protruding reinforcing rods covered?

  • 14.6. Is lock-out/tag-out procedure in use on any machinery where inadvertent operation could cause injury?

15. Personal protective equipment (PPE)

  • 15.1. Hardhats are being worn?

  • 15.2. Safety glasses are being worn?

  • 15.3. Respirators are used when required?

  • 15.4. Hearing protection worn when required?

  • 15.5. Traffic vests being worn?

16. Vehicles

  • 16.1. Do vehicles, earth moving or compacting equipment with an obstructed view to the rear have a back up alarm or used with an observer?

  • 16.2. Do vehicles and earth moving equipment have seat belts and are they used?

  • 16.3. Are flag men wearing reflectorized garments and using flags, sign paddles or lights?

17 Stairs

  • 17.1. Are flights of stairs with 4 or more raisers equipped with standard stair railings or handrails?

18. Miscellaneous

  • 18.1. Is a written Hazard Communication Program on site including MSDS, Material list, Container labeling, employee training?

  • 18.2. Is exposure to lead or lead base paint, such as paint removal controlled?

  • 18.3. Is exposure to silica, such as sand blasting, using sand or cutting brick or cinder-block controlled?

  • 18.4. Is exposure to asbestos controlled?

Corrective Actions

  • Enter any corrective actions that will be undertaken

Sign Off

  • On site representative

  • Auditor's 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.