Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
Personal Protective Equipment
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Are all employees wearing F.R. (Fire Resistant) clothing?
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Are all employees wearing hard hats?
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Are all employees wearing steel toe boots?
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If working in an environment where H2S gas may be present, are all employees wearing a gas clip and have it properly placed?
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Are all employees wearing protective eye wear?
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Are gloves, ear plugs, face shields, face masks, respirators, etc., being used when appropriate?
Procedures
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Has a Job Safety Analysis (JSA) been completed and signed by all personnel?
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Are the tasks/jobs that are being observed written in the JSA with hazards and mitigation and elimination strategies noted?
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Are any permits (excavation, confined space, line finding, etc.) required? If so, have they been approved?
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Are proper procedures for tasks being followed?
Work Environment
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Is the work environment clean and orderly?
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Are walking and working surfaces free of tripping hazards?
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Is there a water log kept to monitor water intake for each employee?
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Are there any overhead hazards that can potentially fall?
Position of People
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Crush Points
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Falls, Slips, and Trips
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Contacting Extreme Temperatures
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Contacting Electrical Current
Focus Behaviors
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Are employees in the line of fire?
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Is the proper technique used with suspended loads?
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Are employees using proper harnesses and lanyards as well as 100% tie offs when utilizing aerial platforms?
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Are forklift, aerial platform, backhoe, and other heavy machinery operators working safely in all work areas (using back-up alarms, spotters, taglines, appropriate straps and chokers, etc.)
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Is any excavation being performed and has line finding been performed with proper documentation?
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Are employees using proper lifting techniques?
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Are hands and fingers in the proper position?
Tools and Equipment
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Employees using the right tools for the job?
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Employees using tools correctly?
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Are tools in safe condition?
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Are barricades, fencing, and other forms of warning used when appropriate?
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Are hand and power tool guards and handles in place and are cords in safe operating conditions?
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Are forklift, aerial platform, and backhoe operators certified?
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Are there any electrical hazards or concerns?