Information
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Document No.
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Audit Title
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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
Personal Protective Equipment
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Is PPE needed at this worksite?
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Hard hats supplied by employer?
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Hard hats worn when required?
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Boots supplied by employer?
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Boots worn when required?
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Hearing protection supplied by employer?
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Hearing protection worn when required?
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Eye protection supplied by employer?
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Eye protection worn when required?
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Respiratory protection supplied by employer?
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Respiratory protection worn when required?
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Are ladders present at the worksite?
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Are the ladders correct size for the job?
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Are the ladders fully opened and spreader bars locked?
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Is there a firm foundation for ladder feet?
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Proper climbing procedures are being practiced?
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Three-point contact rule followed?
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Are ladders free from obvious defects?
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Do workers stand below top 2 steps?
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Are scaffolds present at the worksite?
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Fall protection used if over 10 feet tall?
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Set up on level, stable footing?
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Do ladders extend more than three feet above support
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Platform is appropriate width for type of scaffold?
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Is fall protection needed at this worksite?
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Fall protection provided for heights 6 ft. or more?
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Harness is worn properly and attached to secure anchorage?
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Slide guards are installed across full width and all sides?
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Guardrails set up for openings >6’ above lower level?<br>
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Guardrails are constructed sturdily with 2 x 4s?
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Are power tools and machines used at this site?
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Workers are trained on the use of power tools?
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Workers have appropriate PPe and keep clothing away?
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Workers are trained prior to using nail guns?
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Tile and concrete are cut with wet methods?
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Is heat a major problem at this site?
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Have workers been trained on preventing and recognizing heat-related illness?
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Are workers provided with enough water and appropriate rest breaks?
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Is the site at risk for lead-contaminated dust?
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Have workers been trained on handling lead dust?
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Are electrical Hazards present at this worksite?
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Work on electrical circuits or energized equipment<br>is begun only after all power sources have been identi ed, de-energized and locked out or tagged out.
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Overhead and underground electrical power lines are located, identi ed, and avoided.
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Ladders, scaffolds, equipment or materials more than 10 feet from any electrical power lines
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Are excavations present at this worksite?
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Soil and conditions are inspected everyday
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Safe exits (ladders) for excavations greater than 4 ft. deep
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Shoring, shielding, and inclination assessed for excavations greater than 5 ft. deep
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Actions or Changes
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Talked to your organizers about health and safety concerns and possible changes/training
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Talked to co-workers about health or safety concerns
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Talked to foreman or contractor about health or safety concerns
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Suggested changes in equipment or procedures to co-workers
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Asked foreman or contractor for changes in equipment or procedures
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Asked foreman or contractor for training for self and/or co-workers
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Comments:
