Control Self Assessment 2014

• Audit Title

• Introduction.

• Scope.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Risk 1.

• Area of risk.

  Yes

  No

  N/A

• List current controls.<br>

  Yes

  No

  N/A

• Are current controls in place and working efficiently.<br>

  Yes

  No

  N/A

• New controls identified during audit.

  Yes

  No

  N/A

• Action plan.

  Yes

  No

  N/A

• Recommendations:

  Yes

  No

  N/A

Risk 2.

• Area of risk.

  Yes

  No

  N/A

• List current controls.

  Yes

  No

  N/A

• Are current controls in place and working efficiently?

  Yes

  No

  N/A

• New controls identified during the audit.

  Yes

  No

  N/A

• Action plan.

  Scope

• Recommendations:

  Yes

  No

  N/A

Risk 3.

• Area of risk.

  Yes

  No

  N/A

• List current controls.

  Yes

  No

  N/A

• Are the controls in place and working efficiently?

  Yes

  No

  N/A

• New controls identified during audit.

  Yes

  No

  N/A

• Action plan.

  Yes

  No

  N/A

• Recommendations:

  Yes

  No

  N/A

• Progress on action plan and or recommendations.

• Comments.

• Auditor: Print name and sign. Date.

  Sign

• Auditee: print name and sign. Date.

  Sign

• Group manager: Print name and sign. Date.

  Sign