Title Page
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Document No.
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Audit Title
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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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0-40% = Unacceptable/ Immediate Action Needed 41-80% = Some Improvement Needed 81-100% = Good Standard/ No Improvement Required
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Acceptable = 2 Needs Attention = 1 Unacceptable = 0 Not Applicable = X
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Are there an appropriate risk assessment and method statement in place?
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Has the employee read and signed the method statement and risk assessment?
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Is the method statement being followed correctly?
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Has a ‘Personal Hazard Risk Assessment’ (700/05) been completed?
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Have all the necessary permits been completed (Including signing in)?
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Is the correct PPE/RPE being used correctly?
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Are the correct tools being used in the correct manner?
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Is the task being completed to a satisfactory standard and all paperwork in place?
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Is the standard of housekeeping in the work area satisfactory?
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Does the employee have the required training for the task
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Is the employee’s personal training file up to date?
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Is the appearance of the employee acceptable?
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Is the employee’s vehicle clean and tidy?
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Are there any issue or causes of delay? i.e. due to materials, equipment, access, etc.
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Background Information - Phoning Office (General, Concerns, Issues)
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Paperwork Accuracy
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OBSERVATIONS/RECOMMENDATIONS FOR IMPROVEMENT
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MANDATORY ACTIONS TO BE COMPLETED
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SIGNED (AUDITOR):
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SIGNED (STAFF):
