Title Page

  • Site

  • Supervisor

  • Manpower

  • Prepared by

  • Conducted on

  • Location

Jobsite (General)

  • Have employees attended jobsite orientation?

  • Does supervisor have his/her OSHA 30 and CPR training?

  • Are JHA's filled out daily ?

  • Does the jobsite have waters

  • Are safety meetings up to date?

  • Are S.D.S available to employees?

  • Is a first-aid available and adequately stocked ?

  • Is there adequate air ventilation?

  • Are fire extinguisher available?

HouseKeeping

  • Work area neat, debris picked up, free of slip, trips, fall hazards and Proper lighting?

  • Passageways and walkways clear?

  • is Floor Sweep available?

  • Is Jobox in good condition?

  • Is Jobox organized?

Electrical

  • Is electrical equipment properly maintained free of damage ?

  • Are employees using 12 gauge electrical cords?

  • Is equipment properly grounded ?

  • Do electrical devices have a current inspection tape?

  • Are GFCI being used when there is permanant power?

Personal Protective Equipment (PPE)

  • Are hard hats being used?

  • Are safety glasses being used?

  • Are Respirators being used when required?

  • Has employee been medical evaluated and fit tested?

  • Are employees using gloves?

  • Is employee wearing proper work boots?

  • Are safety vest being used?

  • Does task require any special P.P.E?

Hand Tool

  • Are inspections and proper maintenance performed prior to use ?

  • Are proper tool(s) being used for the job?

Power Tools

  • Has Power tool been inspected prior to usage?

  • Power tools properly assembled (guards / handles) ?

  • Are damaged or malfunctioning tools tagged out until repaired or replaced ?

Ladders

  • Are ladders inspected and in good condition ?

  • Are ladders labels legible?

  • Proper type of ladder for task?

  • Are ladders secured to prevent slipping, sliding, or falling ?

  • Are employee's using fiberglass ladders ?

  • Are ladders being use properly, two top steps of ladder not used?

Scaffolds

  • Is personnel trained?

  • Is scaffolding inspected daily by the competent person?

  • Has inspection tag been signed off by scaffold user?

  • Are guard rails, and toeboards in place ?

  • Are baseplates in place?

  • are casters locked?

  • Is proper access provided?

Fall Protection

  • Is employee exposed to a fall?

  • Is employee using the proper PFAS?

  • Do employees have Fall Protection training?

  • Was Fall protection equipment inspected prior to usage?

  • Is Fall Protection worn properly?

  • Is employee using appropriate anchorage point?

Stilts

  • Is employee experience with stilts?

  • Were stilts inspected prior to usage?

  • Did employee do housekeeping?

  • Is employee following Carrco or GC stilt policy?

Lifts

  • Is operator certified/authorized?

  • Is the lift inspection form filled out?

  • Is fall protection being used?

  • Is platform clear of debris?

  • Are operation controls in good conditions/labeled?

  • Are paths clear of holes/debris?

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.