Information

  • Client / Site

  • Conducted on

  • Prepared by

Preplanning

  • Daily safety plan done each day?

  • Stretching out every morning?

  • AWAIR manual/MSDS on site?

Personal Protective Equipment (PPE)

  • Appropriate eye protection worn?

  • Appropriate head protection worn?

  • Appropriate Hand protection worn?

  • Hearing protection worn when required?

  • High visibility vest worn when required?

  • Respirator used when required?

  • Fit test and training performed?

  • PPE properly used and maintained?

Housekeeping

  • Work area including walkways clean and free of tripping hazards?

  • Lunch area clean?

  • Trash barrel with lid in lunch areas?

  • Tools and materials properly stored?

Electrical

  • Monthly inspection on electrical panels?

  • Temporary lighting hung by non-conductive materials with bulb guards?

  • Do all cords have a grounded plug?

  • Extension and equipment cords free from visible damage?

  • Lockout/Tagout procedures followed when required?

  • GFI used when required?

  • Electrical panels labeled and covered?

  • Energized work being performed?

  • Proper PPE worn?

  • PPE is current (no expired)?

  • Is the worker wearing any metallic accessories?

  • Insulated tools are being used?

  • Work area is secured?

  • Proper training?

Power tools

  • All guards in place?

  • Side handle in place (not removed)?

  • Proper use of tool?

Fall protection

  • Employees exposed to fall hazards tied off?

  • Tied off point can hold at least 5000 pounds?

  • Employees below protected from falling objects?

  • Fall protection equipment properly used?

  • Employees exposed to unprotected edges?

Ladders

  • Used in fully open position?

  • Free from defects?

  • Secured to prevent slipping, sliding or falling?

  • Extended at least 3 feet above landing?

  • Ladder used properly?<br>

  • Ladders in good working conditions?

Lifts

  • Gate chains and swing gates closed?

  • Free from tripping hazards?

  • Tied off when required?

  • Operator standing on platform and not on railing?

Hot Work

  • Hot work permit filled out?

  • Flammable materials cleared out of work area?

  • Fire extinguishers located at all hot work?

  • Fire watch utilized when required?

  • Proper PPE worn

Swing stage scaffold

  • Outriggers beams w/counterweights assembled to support the rated load of the hoist with a 4:1 safety factor

  • Checklist completed each day

  • Parapet clamps or hooks (if needed) are mounted on parapet wall capable of carrying rated load of hoist with a 4:1 safety factor

  • Rigging secured against unintentional movement

  • Tie back cables installed at right angle to face of building without slack and to a structurally sound portion of building

  • Wire ropes free of kinks and flat spots. Bullet ends checked

  • Clamps, pins, bolts tightened or fastened securely

  • Proper fall protection used

Confined Space

  • Atmospheric testing completed?

  • Permit completed and posted?

  • On-site rescue device provided (if needed)

  • Competent person on site?

  • Entering employees properly trained?

  • Lockout/Tagout procedures followed?

  • Attendant present when required?

Ergonomics

  • Proper number of workers for each operation?

  • Proper lifting techniques followed?

  • Proper body posture?

General safety

  • Work practices observed were performed safely?

  • OSHA posters posted?

  • First aid available?

  • Other observations

  • Observation
  • Add media

  • Client contact

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.