Title Page
-
Conducted on
-
Prepared by
-
Location
-
This checklist is to be completed by a Cushman & Wakefield Facilities Management, or suitably authorised person, in consultation with contractors or Cushman & Wakefield technicians who have completed or are in the process of performing works onsite
-
Any significant issues identified should be addressed immediately in consultation with the appropriate site/account director, or escalated to the senior account team for resolution. In these situations, works should not continue until items are adequately addressed and the IR/NCR – Corrective Action Procedure must be applied
-
Completed forms are to be retained in the pre-determined location for site records
TECHNICIAN DETAILS
-
Employee
-
Contractor
-
Client
-
Site Location
-
Date
-
Technician Name
-
Company
-
Work Order No
-
Description of works being undertaken:
-
Electrical
-
Mechanical
-
Plumbing
-
Building
-
Refrigeration
-
Fuel
-
HVAC
-
Carpentry
-
Asbestos
-
Other
Spot Check
-
Does the technician have current photo ID?
-
Record Details
-
Does the technician hold a current trade licence?
-
Record Licence details:
-
Has the technician completed an induction?
-
Site-specific induction?
-
Cushman & Wakefield Induction
-
Has the technician completed the site attendance book or client-specific sign in?
Does the technician have the following paperwork
-
Cushman & Wakefield Work Order?
-
Is appropriate safety documentation available and being followed? E.g. SWMS, JSA etc?
SWMS / JSA Check – if in use, verify the following
-
Details displayed, including: contractor name, task description, site/location, date applicable to works?
-
Steps within SWMS clearly outlined and applicable to scope of works?
-
Appropriate signatures available? (participants, manager)
Are the technician’s tools and equipment:
-
Fit for purpose? E.g. calibrated
-
Tested and Tagged? (List date) Including RCD units in use.
-
Is the required PPE being worn for the task at hand as per the SWMS/JSA/JHA?
-
Is the technician undertaking High Risk Work? (Specify)
-
When required has the technician completed appropriate permit?
Housekeeping & General Requirements
-
Are SDS's available for all substances being used and <5 years old?
-
#Record date of issue:
-
Do all chemicals conform to GHS labelling requirements?
-
Are spill kits available and persons trained on how to use them?
-
Is the area being worked on free of slip, trip and fall hazards?
-
Are barriers used / is traffic managed / signage erected?
-
Notes:
Sign Off
-
We acknowledge that any issues identified have been discussed and actions taken to initiate resolution
-
C&W Signature: C&W Name:
-
Technician Signature: