Audit

Manual handling

1.1 Lifting / lowering

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

1.2 Pushing / pulling

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

1.3 Over extending

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

1.4 Carrying

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Personal protective equipment

2.1 Mandatory PPE

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

2.3 Condition of PPE

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Assessment / procedures

3.1 Pre/post job inspection

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

3.3 Housekeeping

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

3.7 Lighting

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Visibility

4.1 Eyes on path

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

4.2 Eyes on Hands

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Communication

5.1 Hazard communication

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

5.2 Barricades / warnings

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

5.3 Asking for assistance

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Tools / equipment

6.1 Selection

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

6.3 Use

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Vehicle Use

8.1 Checksheet completed

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.2 Use of Mobile Phone

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.3 Keeping Safe Distance

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.4 Keeping within Speed Limit

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.5 Use of indicator

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.6 Use of Seat Belt

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

8.7 Rest Breaks

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Ergonomics

9.1 Posture

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

9.2 Workstation Setup

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

9.3 Electronic Display Use

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Personal Safety

10.1 Public Transport

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

10.2 Other Transport / Walking

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

10.3 Awareness of Surroundings

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)

10.4 Induction

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Security

11.2 Visitors Escorted

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Other at risk behaviour

Info

Detail of at risk behaviour

Barrier type

Barrier

Agree at risk

Follow up

Solution

While (activity)

Was at risk of

Because (barrier)

Solution

Picture (optional)
Additional information

Please enter additional info and comments here.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.