Information

  • Site

  • Document No.

  • Client

  • Conducted on

  • Prepared by

  • Location
  • Personnel on site

General Work Environment

  • Are all work area clean and dry?

  • Rubbish removed daily?

  • Are aisles, walkways, doorways, and exit routes kept clear and unobstructed?

  • Are toilets and washing facilities provide, kept clean, and safe?

  • Are measures in place to protect the public / other contractors from exposure to work activities and equipment?

  • Are required postings readily available to all employees in the workplace?

  • Are monthly and weekly "tool box" safety meetings held and documented with sign in sheets? Was a copy forwarded to the safety department?

  • Is material piled, stacked, or racked in a manner to prevent it from tipping, falling, collapsing, rolling, or spreading?

  • Other issues
  • Add media

First Aid and Emergency Equipment

  • Are emergency telephone numbers posted on the job site?

  • Is there at least one person on site trained in first aid and CPR?

  • Are first aid kits easily accessible, inspected, and stocked at least monthly?

  • Are there any exit doors that open into streets or other high traffic areas? Are adequate warnings provided to alert employees of the hazard?

  • Other issues
  • Add media

Fire Protection and Prevention

  • Are there fire extinguishers present and the correct type for the work area?

  • Are fire extinguishers clearly visible and unobstructed at all times?

  • Are fire extinguishers inspected monthly for proper tags, pins, hoses not cracked or plugged, fully charged, and tags up to date?

  • Are fuel gas cylinders and oxygen cylinders secured, separated by 20 feet or have fire resistant barriers while in storage?

  • Other issues
  • Add media

Fall Protection

  • Are holes and other floor openings guarded by a grate, cover, guardrail, or equivalent on all sides (except at entrances to stairways or ladders)?

  • Do all elevated surfaces have guardrails at least 42 inches high?

  • Are all elevated surfaces equipped with a safe means of access?

  • Are fall protection harnesses and lanyards used by every employee where identified in the risk assessments?

  • Are harness, lanyards, and other fall protection equipment inspected prior to use?

  • Other issues
  • Add media

Portable Ladders

  • Are all ladders maintained in good condition and inspected before each use? Are broken and defective ladders taken out of service immediately?

  • Are ladders being used for their designed purpose only? (Step ladders/Extension ladders)

  • Are ladders being used beyond their maximum intended load?

  • Are ladder rungs/steps slip-resistant and free of dirt, grease, oil, ice, snow, etc?

  • Are employees facing the ladder when climbing up and down?

  • Are employees standing below the top 2 steps when using step ladders?

  • When ladders are used to gain access to elevated platforms, does the ladder always extend at least 3 feet above the elevated surface, and secured properly?

  • Are ladders placed on dry, stable footing, and properly secured?

  • Other issues
  • Add media

Materials - Handling, Storage, Use, and Disposal

  • Is decking store in a location away from other hazards and being stored correctly before and during use?

  • Other issues
  • Add media

Scaffolding

  • Are scaffolds set up on level, stable ground with dry footings?

  • Has the scaffold been assembled and inspected by a competent person?

  • Was the scaffold inspected prior to use and scaffold tag properly filled out?

  • Do all scaffolds higher than 4 feet have 42 inch high guardrails and mid rails halfway between the top and platform?

  • Other issues
  • Add media

Electrical

  • Are all cables-connected, electrically-operated tools and equipment double insulated or effectively grounded?

  • Are ground-fault circuit breakers provided on all temporary electrical circuits?

  • Do all extension cables have 3-prong plugs and all 3 prongs intact?

  • Are all electrical cables inspected and in good working condition (i.e. no splices, frays, or the ground prong is removed)?

  • Where electrical cables must cross roads, driveways, or walkways, are they protected by solid, weather-resistant bridges to prevent damage to the cables?

  • Are multiple plug adapters prohibited?

  • Are electrical circuits and equipment shut off, de-energized, and locked out before equipment installation, repairs, maintenance, or servicing?

  • Other issues
  • Add media

Power-Actuated Tools / Hand and Power Tools

  • Do all portable equipment have a valid certificate within the site time scales (ie PAT)

  • Are employees who operate power actuated tools properly trained and carry a valid operator's card?

  • Are power actuated tools inspected for obstructions or defects before use?

  • Are all tools maintained in safe condition?

  • Are damaged and defected tools removed from service and repaired or replaced as soon as the damage or defect is found?

  • Are grinders, saws, and other tools with moving parts, equipped with appropriate safety guards to prevent physical contact with moving parts?

  • Other issues

  • m
  • Add media

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.