Information

  • Document No.

  • Project Name

  • Auditor

  • Location
  • Conducted on

  • Contractors

Administrative Job Site Requirements

  • Active construction area clearly barricaded or identified in field?

  • Emergency contact information, egress routes and evacuation muster points posted and identified?

  • Area urgent and emergency healthcare facilities posted?

  • Standard Cyma construction area warning signage posted at project entry points?

  • Client or facility-specific construction signage or notifications posted?

  • Project-specific Safe Work Plans (SWP), Health and Safety Plans (HASP), etc. in place and properly implemented?

JSA COMPLIANCE

  • JSAs readily accessible in the field?

  • Are all JSAs reviewed and approved by Cyma EHS?

Onsite Contractor JSA Audit Review; audit at least one JSA per active contractor.

  • Name of Contractor?

  • Name of JSA?

  • Does the JSA adequately capture the scope of work?

  • What is missing from JSA or what needs expanded in JSA?

  • Is the JSA signed by the contractors working on the job?

Onsite Contractor JSA Audit Review; audit at least one JSA per active contractor.

  • Name of Contractor?

  • Name of JSA?

  • Does the JSA adequately capture the scope of work?

  • What is missing from JSA or what needs expanded in JSA?

  • Is the JSA signed by the contractors working on the job?

Onsite Contractor JSA Audit Review; audit at least one active JSA per active contractor.

  • Name of Contractor?

  • Name of JSA?

  • Does the JSA adequately capture the scope of work?

  • What is missing from JSA or what needs expanded in JSA?

  • Is the JSA signed by the contractors working on the job?

Training and Competency

  • Client site safety orientation process in place?

  • Cyma contractor safety orientation process implemented?

  • Contractor Foreman/ Competent Persons OSHA 10-Hour Construction Safety Trained?

  • Competent Persons identified in writing by contractors?

Daily Safe Plan of Action (SPA); audit minimum of one SPA per active contractor.

  • Daily SPA accurately reflects work, means/ methods, and precautions?

  • Daily SPA reviewed and signed by Superintendent or representative?

  • Daily SPA readily accessible in the field?

  • Daily SPA completed and signed by contractor Competent Person and contractors performing the work?

  • Daily SPAs are closed and end of day affirmation signed?

  • Identified changes to means/ methods/ precautions on SPA reviewed and approved by Cyma representative?

COVID-19 Mitigation

  • COVID-19 Management Plan for project/ site approved and current?

  • Client COVID-19 screening process implemented for contractors?

  • Cyma Daily Pandemic Self-Assessment completed by all contractors and visitors?

  • COVID-19 signage posted clearly?

  • Sanitation facilities and hand washing facilities available and stocked?

  • Routine (3-4 times daily) touchpoint sanitization being conducted?

  • All workers and visitors wearing fabric or surgical mask face-covering? Bandanas and neck gaiters prohibited.

  • All workers maintaining 6' distance at all times?

  • Proximity Work Guidance being implemented for work requiring workers to be within 6' of others?

  • Do workers have a COVID-19 Pre-Task Safety Planning in place for activities which are infeasible to complete while maintaining 6' of distancing at all times?

  • Break and lunch accommodations made to maintain 6' distance?

  • Tools not being shared or being sanitized between users?

Housekeeping

  • Are materials stored properly?

  • Is trash being centered piled and collected routinely throughout work day?

  • Has construction dumpster been designated and located for the project?

  • Is the dumpster appropriately sized and properly managed for pick ups?

  • Is the dumpster safely accessible with secure ramps in place?

  • Is dumpster door secured open if workers must access dumspter?

  • Dumpsters are covered each night or when not in use?

  • Are the walking and working surfaces clear, clean, trip hazards eliminated?

PPE

  • ANSI Z87 compliant safety glasses, or equivalent, in use by everyone on the project?

  • ANSI Z41 compliant safety toe footwear in use by everyone on the project?

  • Cut resistant gloves meeting ANSI Cut Level 3 or highre in use by everyone on the project?

  • Hard hats in use by everyone on the project?

  • Multi-directional impact rated hard at with chin-strap in use during PFAS use where required?

  • ANSI Class 2 high visibility outerwear in use when required: around mobile equipment, in active lots and roads and in low light situations?

  • Additional PPE identified in JSA or SPA in use? i.e. hearing protection

  • All PPE is in safe working condition and fit for use?

  • PPE available for visitors to active construction site?

  • Is respiratory protection in use? (voluntarily or required)

  • Is Medical Clearance and Fit testing verified for tight fitting cartridge respirator users?

  • Respiratory users clean shaving?

  • Lack of airborne hazard verified by Cyma EHS prior to implementation of voluntary use respirators?

  • Voluntary users of respirators provided with 1910.134, Appendix D, Information for Employees using Respirators When Not Required?

Fall Protection

  • NOT including LADDERS/MEWPs. Is elevated work 6' or more above a lower level detailed in a Fall Protection Work Plan approved by Cyma EHS?

  • Post fall-event response identified and documented in Fall Protection Work Plan?

  • Working at Height/ Elevated Work Permit in place and properly excuted?

  • Adequate fall height clearance and swing fall clearance confirmed?

  • Personal Fall Arrest Systems use is compliant with approved Fall Protection Work Plan and applicabl permits?

  • PFAS components are compatible, inspected and in safe working order?

  • PFAS anchorage points are properly rated and are either engineered or evaluated by a Qualified Person?

  • Suspension trauma straps are in use when PFAS is used?

  • Leading edges, hole openings, excavation, etc. greater than 6' from a lower level protected by compliant guardrail, warning line system or covered and identified as required?

  • Guardrail meet 1926.502(b) and rails are capable of withstanding 200lbs at the top rail with top rail at 42" (+/-3") and middle railing at 21" or midway between surface and top rail?

  • Warning Lines meet 1926.502(f)(2) with flags every 6' at a height 34-39" and a breaking strength of 500LBS.

  • Warning Lines are erected at 15' (6' for roofing activity) from unprotected edge and access routes within 15' (6' for roofing activity) of unprotected edge are protected by guardrail?

  • Where applicable, Leading Edge rated PFAS equipment is in use?

  • Holes or openings in walking and working surfaces are covered with covers secured in place, marked 'HOLE' or 'COVER' and meeting or exceeding Cyma's additional requirements?

  • Overhead hazards have been identified, secured, removed or protected (debris nets, toe boards, etc.) have been implemented?

Fire Safety and Hot Work

  • 10LBS ABC fire extinguishers available with in 50 feet of work with one extinguisher for every 3000 square feet of project area?

  • Are all fire extinguishers currently inspected, tagged and located prominently in work area?

  • Are contractors trained in proper fire extinguisher use?

  • Is hot work being performed?

  • Is all work involving flame/sparks detailed on the daily Hot Work Permit for each contractor performing hot work activities?

  • All precautions detailed on Hot Work Permit are in place and permit is properly excecuted?

  • Combustibles including paper, plastic, wood, drywall, cardboard, etc. are moved at least 35' from hot work or protected with fire blankets?

  • Hot work equipment in safe working order with cylinders secured upright, functional gauges, flash back arrestors in place, etc.

  • Compressed gas cylinders are secured upright, fuel separated from oxygen by 25' or fire rated divider, regulators removed and valve protector caps installed when in storage?

  • Welding equipment is in safe working order with intact leads, local disconnect, secure electrical connections, etc.?

  • Dedicated and trained fire watch on duty during and for one hour after Hot Work?

  • Periodic fire watch on duty for required duration after dedicated fire watch?

  • Are the sprinkler heads and fire protection systems unobstructed ( sprinkler heads clear by 18'' or greater)?

  • Fire system (fire/ smoke detection, horns/ strobes) impairments are managed with Fire System Impairment Permit?

  • Egress routes and stairwells clear of combustible or flammable materials?

  • Are flammable and combustible materials stored properly?

General Safety

  • Have findings from the previous weeks audit been corrected or addressed?

  • List any outstanding safety violations from previous audits:

  • Is work area properly illuminated?

  • Temporary light properly installed with guards/ cages in place, if applicable?

  • Is equipment guarding in place as per manufacturers instructions?

  • Are tools and equipment inspected and in good condition prior to use?

Ladders/ Stairs/ Scaffolds.

  • Are stairs provided where there is a change in elevation >19'' ( EU >0.5m), and secured?

  • Are stairs greater than 4 risers all equipped with a hand rail?

  • Is any scaffolding in use?

  • Is scaffolding built by a qualified competent erector, built correctly, secured, tagged correctly? (check mudsills or locked wheels)

  • Does the scaffolding have safe access and egress for workers?

  • Are all scaffold inspected daily by a Competent Person?

  • Are system or supported scaffolds Green Tagged?

  • Are mobile/ rolling scaffold wheels locked?

  • Are Holes/penetrations protected with secured covers labeled "HOLE" or barricaded?

  • Cyma-specific hole and cover guidelines adhered to?

  • Is the scaffolding protected for use by unauthorized persons, is there a swing gate which can be locked when no one is working?

  • Are ladders in use?

  • Are ladders in good condition? Labels, rings, feet...

  • Are all ladders fiberglass and rated minimum Type 1A?

  • Are all ladder labels and warnings present and legible?

  • Are ladders being stored correctly?

  • Are ladders in use being used safely and as intended?

  • Are ladders setup on solid ground with braces fully engaged and locked with all four feet supported on flat floor?

  • Ladders are NOT placed in front of doorway, emergency exit route or in the way of any other construction equipment.

  • The waist of the ladder user is NOT above the top step and workers are not twisting body excessively reaching to work while on ladder?

  • Are extension ladders being used safely with proper pitch, ladder secured and a 36 inch overhang?

  • Are platforms protected by handrail, midrail and toe board?

Crane Lifting / Rigging.

  • Is there a scheduled Lift today?

  • Has the lift plan and permit been completed and reviewed with all affected personnel?

  • Are there trained signalperson in "line of sight" of operator or other means of communication with operator?

  • Has the qualified rigger inspected all lifting equipment prior to use?

  • All rigging (standard and specialty or custom) is in safe working order, tagged, compatible and properly rated?

  • Has the crane set up area been properly barricaded?

  • Has the crane erection area been surveyed for subsurface utilities or installations?

  • Is crane equipped with Load Management Information System (LMIS)?

  • Is crane equipped with wind speed monitor (anemometer) or is wind speed being monitored in real time?

  • Anti-two block safety device present and functional?

  • Have all the areas within the swing radius been evacuated and notified, with proper signage , barricaded with danger tape and evacuated?

  • Are tag lines being used to control the load?

  • Spill containment deployed or kit available?

  • Is crane erected level with proper outrigger cribbing?

  • Outrigger safety pins present?

  • Has the crane inspections been completed and documented?

Excavation and Trenching

  • Is there an active Excavation on site during audit?

  • Has Excavation Competent Person been identified and documented?

  • Has Competent Person classified the soil?

  • Has utility One Call/ Miss Utility notification been made by excavator? (Verify)

  • Utility mark out is clear with field marks being properly maintained?

  • Is the excavation laid out in white paint?

  • Has the excavation permit been reviewed and completed?

  • Has utility location taken place? 25 feet outside the perimeter of the excavation? Verify report

  • Are the trenches/ excavations sloped properly or shored and barricaded?

  • Is shoring and shielding properly selected, compatible, inspected and installed?

  • Tabulated data onsite?

  • Structural stability of adjacent structures maintained?

  • Spoils and heavy materials not stored within 24" of excavation?

  • Is trench/ excavation greater than 4ft?

  • Are there proper egress in place, ladders no more than 25' apart?

  • Is this a HAZWOPER site and if yes is training verified?

  • Has a weather event occurred since initial evaluation from a Competent Person?

Confined Space

  • Are all confined spaces on the project identified and labeled by the site and/ or Cyma?

  • Are all permit required confined spaces identified and labeled by the site and/ or Cyma?

  • Is confined space being performed and applicable for this audit?

  • Entrants, Attendants and Entry Supervisors confined space trained?

  • Are permit required confined spaces being reclassified or Alternate Procedure entries made being using Cyma documented process?

  • Confined Space Permit in place and properly executed for permit required entries?

  • Confined space Attendant maintaining Entrant log properly?

  • Confined space Attendant has radio, cell phone or other means of communicating with site security or emergency services?

  • Confined space Attendant maintaining atmospheric monitoring log properly?

  • Non-entry rescue system in place for permit required entries?

  • Entry rescue team or service confirmed available? Explain answer.

  • Pre-entry 4 gas atmospheric testing conducted at various levels/ areas in permit required confined space?

  • 4 gas atmospheric testing conducted before and continuously during entry?

  • Atmospheric monitor calibrated and bump tested properly?

  • Proper forced air ventilation in place before and continuously throughout entry?

  • Ventilation intake well away from space exhaust or other sources of contamination?

  • Confined spaces are locked and tagged out, drained/ purged, pumped out, cleaned, etc. prior to entry?

Material Handling and Heavy Equipment

  • Is there motorized heavy equipment being used?

  • Has the proper pre-operational inspection been performed and documented?

  • Pre-mobilization equipment inspection documentation provided?

  • Spill kit onsite and available in equipment operation area?

  • Do the operators have the proper training for the equipment being used?

  • Are seat belts used by all operators?

  • Do the motorized vehicles have proper back up alarm?

  • Equipment has visible or audible operational travel indictor?

  • Are flaggers in place where needed?

  • Equipment operation area barricaded?

  • Is the rollover protection system (ROPS) in place and maintained?

  • No field or owner made modifications made to equipment or attachments?

  • Forklift/ telehandler attachments are approved in writing by forklift/ telehandler manufacturer?

  • Equipment capacity rating recalculated with attachment use?

  • Equipment capacity is adequate for intended loads?

  • Is the equipment operated more than 20' away from power lines?

  • Equipment tuned off and keys removed when unattended?

  • Fueling of equipment detailed in approved JSA?

  • No onsite repair or maintenance of equipment?

Mobile Elevated Work Platforms (MEWPs)

  • Is Mobile Elevated Work Platforms(MEWPs) in use?

  • Has the proper pre-use inspection and functional tests been performed and documented?

  • Does the operator have the proper training for the equipment being used?

  • Is the operator using the proper harness and tie-off points? (i.e. approved engineer anchor points)

  • MEWPs being used safely? Feet on surface, not using mid rail or toe board to stand on, not leaning outside lift?

  • Do MEWPs have proper travel alarms or indicators?

  • MEWPs path is clear and free of clutter, holes, etc.?

  • MEWPs operational area is level?

  • Is the chain or gate closed on MEWPs?

  • Is the equipment operated more than 20' away from power lines?

  • Are the materials being carried or stored on MEWP within the confinement of the platform?

  • Barricades or spotter in place when needed?

Electrical Safety.

  • Electrical tools and equipment left in a safe state if unattended?

  • Temporary power provided and inspected by Qualified Person?

  • Extension/ power cords routed to avoid creating a trip hazard?

  • Are cords in good condition, no cuts or repairs?

  • Is there a 3ft clear distance around electrical panel?

  • Are GFCI's being used and closest to the power source?

  • All electrical tools are Double Insulated or third-prong grounded?

  • Extension cords not plugged in to extension cords?

Control of Hazardous Energy/ LOTO

  • Are sources of hazardous energy locked and tagged out?

  • All employees involved in LOTO are properly trained in hazardous energy control?

  • Employees exposed to hazardous energy each have their own tag and lock and with separate key on energy control points?

  • LOTO permit or plan implemented to document control of hazardous energy?

  • Cyma Superintendent participating in LOTO with locks and tags at energy control points?

  • Are tags legible with name, company and contact information listed?

  • Has all residual or potential energy been released or secured?

Hazard Communication/ GHS

  • Are SDSs submitted and reviewed with JSA?

  • Are SDSs available for review onsite?

  • Are all chemicals properly labeled?

  • Chemicals properly stored?

  • Chemical quantities onsite acceptable?

  • Chemical stored in secondary containment?

  • Are personnel trained in the chemicals they are handling?

  • Spill kit stocked and present?

Environmental/ Waste Stream

  • Have all proper barricades been put in place to minimize cross contamination?

  • Concrete washout containment available and serviced regularly?

  • Are the concrete truck washout procedures being followed?

  • Is the waste handling and disposal of hazardous waste being executed properly?

  • Is secondary containment in place where needed?

  • Is threading machine catch box in place?

  • Are storm sewers and drains protected?

  • Contaminated areas identified and assessed?

  • Residual waste properly labeled and stored?

Corrective actions and supplemental comments.

  • Safety and health observations were reviewed in the field with appropriate contractors when possible?

  • General Comments

Stakeholders

  • Project Superintendent

  • Project Superintendent Optional Comments:

  • Auditor

  • Auditor Optional 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.