Title Page

  • Conducted on

  • Prepared by

  • Project/Location

Site Set Up/Recordkeeping

  • Are there COVID-19 Postings at entrance?

  • Is there a COVID-19 Response Plan on site?

  • Is there a specific induction process at entrance?

  • Is there evidence of a register of workers and visitors providing health declaration?

  • Is there evidence of a daily register of workers and visitors with contact detail entering and leaving the site?

  • Is temperature monitoring required for this site?

On Site Audit

  • Is there evidence of sanitation facilities available including hand washing stations or provision of additional sanitizer/disinfectant?

  • Adequate number of trash bins?

  • Are workers practicing the social distancing protocol of 6 feet?

  • Are workers wearing the required PPE correctly?

  • Has additional PPE being required since last site audit?

Audit Certification

  • Add 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.