Title Page

  • Conducted on

  • Prepared by

  • Location


  • SYMPTOM SCREENING- Are there practices in place to check and ensure sick /or presumed sick individuals (public /employed) do not enter the workplace under any circumstances and what follow up or mitigated measures are in place ?

  • EMPLOYEES VIA SCREENING PROCESS- Does the employer and Employee understand the process steps to follow in the case of a suspected employee presenting COVID 19 “ ie isolation,transport arrangements,Social distancing,Self isolation etc- What section of the Audited/onsite Company Protocols references to the above requirement. Including the COVID 19 Helpline numbers.

  • COVID REPORTING- Are the defined processes detailed in the onsite /Audited Company described in their Protocols , ie : on file and present onsite during the time of audit?

  • PHYSICAL ONSITE COMPANIES AND CONTRACTORS - please insert the physical companies /contractors names operating OR Emergency Contractors names during work tasks onsite at the time of the audit .

  • HEAD COUNT - are the employees and employer ensuring the head count does not exceed the maximum allowed persons per area.

  • PPE- COVID 19 Specific requirements for high risk staff/individuals( ie: onsite security/cleaners/support staff/ reception/control rooms & site management rotational staff?) Areas are sign posted with the updated regs and protocols and validation process of instructions followed-OHS 2020 16.10.2

  • PPE- do the staff have 2 units/alternative cloth masks to alternate between days and has the washing of your cloth masks been trained/discussed and documented ?

  • SANITIZING AND SOAP- is there sufficient sanitizing(70% & above) stations or soap provided to ensure all key and risk areas ?

  • WORK CLOTHING- has the following guidelines been adhered to or provided where practical ? Including the “change rooms” Work clothes should be left at the work site and laundered in bulk using standard safety precautions during laundering.<br>If it is not feasible to leave work clothes at the work site for laundering, then advise employees to remove their work clothes at the work site and place in a plastic bag. They should wash their hands after taking off the work clothes. They should then clean the work clothes by washing it in warm water at home. <br>If it is not even feasible to change their clothes at work, then employees should remove their work clothes immediately when they get home and place them in a washing basket. They should wash their hands after removal of the work clothes.<br>Please note that clothes must not be shaken out as this can release the virus.<br>The upper part of shoes should be wiped with alcohol sanitiser.<br>The underside of the shoes should not be touched. If the underside of the shoes need to be cleaned then wear gloves and wash hands thoroughly after removing and discarding the gloves.<br>Employees would need sufficient work clothes/uniforms to allow a daily change of work clothes.

  • SOCIAL DISTANCING- Are Physical distancing expectations set and followed ie: floor markings, signage clear and understandable or any method deemed satisfactory for all levels of staff ?

  • COVID 19 PLAN- COVID 19 Management or management Company need to ensure work plans are in place which include the consideration of a phased in work approach(RTW), over 60 yrs age, pregnant or any pre-existing medical conditions (Ie: asthma, diabetes, lung disorders Reg 16.6(a)(i) sub regulation (b)

  • COVID 19 INDUCTION & TRAINING PROGRAMMES- All employees have been trained regarding COVID 19 mandatory communication relating to what is required of them in the workplace ,via electronic,paper based, toolbox talk, WhatsApp,Notice boards,Posters and awareness training methods?

  • HEALTH CHECK INNS AND NON DISCLOSURE OF NAMES- Are daily “duty of care” follow up sessions conducted and recorded of impacted employees?

  • Annual specialized medical done on file for high risk or high consequence work task( ie: drivers exceeding 3.5 tonne/forklift/chemicals contamination etc)

  • Pre- Employment medical are done for high risk persons or positions?

  • SITE SAFETY AND BUILDING COMPLIANCE RECORD KEEPING- is there a facility file onsite that presents all appointments, latest inspections, Permits,SOP, Checklists,Contact numbers , COVID 19 templates as well as all necessary policies and procedures pertaining to the management of the facility and contractors .

  • CONTRACTOR MANAGEMENT- Contractor COVID 19 additional safety deliverables /file requirements are adhered on file validated and approved prior to works commencing onsite ? Including all future contractors?

  • Appointment letter in place for COVID19 Compliance Officer as per OHS regs Act 85 of 1993 Updated (c19 OHS 2020)

  • LEGAL STRUCTURE -COVID 19 Signed Management Appointments and Safety Committee in place that meet at least quarterly ? ( ensure minutes of all meetings discussing the mitigation’s and any necessary violations to be addressed)

  • COMMUNICATION- Sample 5x persons to establish whether the described COVID PROTOCOLS are sufficient and has been cascaded to all employees - by any means of communication and documented on file?

  • PROCESS FOR + COVID 19 RTW (RETURN TO WORK)- Official clearance certificate on record of individuals supplied by an approved medical practitioner/facility ?

  • VENTILATION- HVAC and Air circulation policies and procedures are in place /last review which is aligned /mapped to the updated COVID Requirements or Best Practice .

  • CLEANING AND DE CONTAMINATION SCHEDULES- is there a policy or procedure to ensure cleaning and de contamination process is been followed in accordance of the regs and maintained ?

  • RECREATIONAL AREAS OR PAUSE AREAS- are there rooms,areas,open plan spaces where employees are making use of during tea or lunch breaks whilst at work meeting the COVID 19 requirements?

  • RECREATIONAL OR PAUSE AREAS FACILITY EQUIPMENT- has the designated area been equipped with electrical devices for food preparation processes, does the room or areas meet the social distancing and staggering procedures of employees during breaks?

  • DESIGNATED SMOKING AREAS- is there a designated smoking zone / area ,that has been adequately provided for the workers/employees during shift with all the necessary signage posted and information , including the COVID 19 smoking requirements?

  • BATHROOM FACILITIES- Does the employee have access to adequate bathroom facilities ,sign posted , hand safety protocol such soap and water or equivalent, large enough bins ,NO CLOTH TOWELS and a rotational cleaning procedure In place?

  • WASTE MANAGEMENT- Is there a waste process in place ensuring the contaminated waste is removed from site in accordance with the COVID 19 requirements? ie: double bagged /segregation etc including contractors onsite?

  • GOODS RECEIVING OR DELIVERIES - is there a policy and procedure in place to ensure the following : Drivers should remain in their vehicle as far as possible.<br>Drivers and assistants must wear a cloth mask.<br>Physical distance should be maintained when receiving goods.<br>Drivers and assistants must use hand sanitiser before handing any delivery documents or packages to employees. <br>Ensure regular hand washing/use of sanitiser.

  • COMMON AREAS AND WALKWAYS- Does the tenanted or leased areas/stores/line shops adhere or demonstrate the following requirements. Prevent congestion of employees and or customers (e.g. in shops or warehouses) by placing floor markers 1.5m apart in aisles and walkways which are typically busy.<br>Designate a direction of travel in aisles and walkways (i.e. make aisles “one-way”) by placing arrows on the floor, if possible.<br>Prevent bottlenecks in aisles by limiting restocking of shelves during trading hours or closing aisles while restocking to prevent bottlenecks.<br>Don’t block aisles and walkways with boxes or equipment.

  • GENERAL VISUAL INSPECTION- Does the area demonstrate / present instructions to visitors in the common areas relating to COVID 19 requirements?<br>

General comments

  • General comments

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.