DAILY AREA SAFETY AUDIT

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

RISK OBSERVATIONS

• Are MTA conducted and documented

  YES

  NO

  N/A

• JSA

  YES

  NO

  N/A

• STOP WORKING AND PERFORM YOUR JHA

• Permit

  YES

  NO

  N/A

• STOP WORKING AND GET YOUR PERMIT

• Lockout / Tagout

  Safe

  Unsafe

  At Risk Behavior

  At Risk Site Condition

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• STOP WORKING AND PREFORM TAGOUT / LOCKOUT PROCEDURE

• DATE AND TIME OF CORRECTION

  Date

• DATE AND TIME OF CORRECTION

  Date

• Confined Space Entry

  Safe

  Unsafe

  At Risk Behavior

  At Risk Site Condition

  N/A

• DATE AND TIME OF CORRECTION

  Date

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• DATE AND TIME OF CORRECTION

  Date

• Scaffolds

  Safe

  Unsafe

  At Risk Behavior

  At Risk Site Condition

  N/A

• DATE AND TIME OF CORRECTION

  Date

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• DATE AND TIME OF CORRECTION

  Date

BODDY POSITION

• Awkward Position / Static Postures

  YES

  NO

  N/A

• Safe pace not Rushing

  YES

  NO

  N/A

• STOP WORK AND PERFORM A TOOL BOX TALK

• Stable Working Surface

  YES

  NO

  N/A

• DATE AND TIME OF CORRECTION

  Date

• Recognize Need for Help

  YES

  NO

  N/A

• STOP WORK AND PERFORM TOOL BOX TALK

PERSONAL PROTECTIVE EQUIPMENT

• Are hard hat worn for all coworkers?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are all coworkers wearing face and eye protection?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are coworkers wearing ears protection when needed?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are coworkers wearing respiratory protection when needed?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are coworkers wearing hand and arm protection?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are coworkers wearing legs and feet protection?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Are coworkers using Fall Protection when needed?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

EQUIPMENTS / TOOLS

• Are coworkers using the wright tool for the task on hand?

  Safe

  Unsafe

  At Risk Behavior

  At Risk Site Condition

  N/A

• DATE AND TIME THAT THE WRIGHT TOOL WERE ISUED TO THE COWORKER

  Date

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• DATE AND TIME OF CORRECTION

  Date

• Is the tool used as designed?

  YES

  NO

  N/A

• STOP WORK AND TRAIN COWORKERS ON HOW TO USE THE TOOLS

• Inspected / safe condition?

  YES

  NO

  N/A

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• Has the tool proper guards?

  YES

  NO

  N/A

• LOCKOUT / TAGOUT THE TOOL UNTIL PROPER GUARD IS IN PLACE

• Are ladders secured top and bottom?

  YES

  NO

  N/A

• DATE AND TIME OF CORRECTION

  Date

• Proper material handling

  YES

  NO

  N/A

• STOP WORK AND TRAIN COWORKERS ON MATERIAL HANDLING PROCEDURE

• Material placement and storage

  Safe

  Unsafe

  At Risk Behavior

  At Risk Site Condition

  N/A

• DATE AND TIME OF CORRECTION

  Date

• CORRECTIVE ACTION

  Verbal Warning

  Written Warning

  Suspended

  Terminated

• STOP WORK AND FIXT THE AREA add CORRECTIVE PICTURES

• Are barricades in place?

  YES

  NO

  N/A

• DATE AND TIME OF CORRECTION

  Date

WORK ENVIROMENT

• Is a good housekeeping observed?

  YES

  NO

  N/A

• DATE AND TIME OF CORRECTION

  Date

• Are the excavations and protective system inspected?

  YES

  NO

  N/A

• REMOVE EVERY COWORKER FROM EXCAVATION AND HAVE THE INSPECTION DONE

• CORRECTION CORRECTIVE ACTION

  Select Verbal Warning Written Warning Suspended Terminated

  • Verbal Warning
  • Written Warning
  • Suspended
  • Terminated

• There is air contaminants in the area?

  NO

  YES

  N/A

• EVACUE THE AREA AND CALL IHI SAFETY

• Are power lines secured and off the ground?

  YES

  NO

  N/A

• HAVE SOMEONE TO FIX IT

TRAINING

• New hire

  YES

  NO

  N/A

• Site orientation

  YES

  NO

  N/A

• Crane Operator

  YES

  NO

  N/A

• Rigger

  YES

  NO

  N/A

• Competent Person

  YES

  NO

  N/A

• Truck operator

  YES

  NO

  N/A