FIELD VISIT CHECKLIST V1.0

• FSE Name & Territory

• Division & Region

• Field Visit Number.

• Conducted on

  Date
• Location
  Address

• Prepared by

1.0 ELECTRICAL

• 1.1 Is a Residual Current Device (RCD) Available ?

  Yes

  No

  N/A

• 1.2 Are there any Broken Plugs, Sockets or Damaged Leads ?

  No

  Require Repair

• 1.3 Have all Electrical Items Been Test and Tagged in the Last 6 Months ?

  Yes

  Require Testing

2.0 CHEMICALS

• 2.1 MSDS Register is Available and Up to Date for Every Chemical ?

  Yes

  No

  N/A

• 2.2 Are all Containers Clearly and Accurately Labelled ?

  Yes

  No

  N/A

• 2.3 Are there any Unsuitable Storage Containers ?

  Safe

  At Risk

  N/A

3.0 FIRST AID KIT

• 3.1 First Aid Kit Adequately Stocked ?<br>

  Compliant

  Non-Compliant

  Needs To Improve

• 3.2 Easy Access to First Aid Kit ?

  Yes

  No

  N/A

• 3.3 Any Contents Past Their Expiry Date ?

  Compliant

  Non-Compliant

  Needs To Improve

4.0 PERSONAL PROTECTIVE EQUIPMENT (PPE)

• 4.1 Safety Cones (min 3) Available ?

  Yes

  No

  N/A

• 4.2 Safety Gloves Available ?

  Yes

  No

  N/A

• 4.3 Dust mask / Respirator Available ?

  Yes

  No

  N/A

• 4.4 Safety Goggles Available ?

  Yes

  No

  N/A

• 4.5 Hearing Protection Available ?

  Yes

  No

  N/A

• 4.6 Safety Shoes Available (Required for Construction Sites) ?

  Yes

  No

  N/A

• 4.7 Sunscreen ?

  Yes

  No

  N/A

• 4.8 Body Harness ?

  Yes

  No

  N/A

• 4.9 Safety Barriers/Signage ?

  Yes

  No

  N/A

• 4.10 Hi-Visibility Vest ?

  Yes

  No

  N/A

• 4.11 Hat/Cap ?

  Yes

  No

  N/A

5.0 LADDERS

• 5.1 Are All Ladders Industrial Rated to 150Kg ?

  Yes

  No

  N/A

• 5.2 Are All Ladders In Good Condition ?

  Yes

  No

  N/A

• 5.3 If Working Near Power Lines, Are They Non Conductive (Wood/Fibreglass ) ?

  Yes

  No

  N/A

• 5.4 Has The FSE Completed Heights Training ?

  Yes

  No

  N/A

6.0 EQUIPMENT & GENERAL SAFETY

• 6.1 Is all Equipment Well Maintained (i.e. Neat/Clean/Tidy) ?

  Yes

  No

  N/A

• 6.2 Is There a Full Compliment of Equipment as Required to Perform Work ?

  Yes

  No

  N/A

• 6.3 Are There any Obvious Safety Concerns with the Work Site that may Impact FSE or Client/s Safety ?

  Yes

  No

• 6.4 Is the Workplace Maintained in a Tidy Condition ?

  Yes

  No

  N/A

7.0 PRESENTATION

• 7.1 Is The FSE Using Correct Voicemail Message

  Yes

  No

• 7.2 Is the Uniform Clean and in Good Condition ?

  Yes

  No

  N/A

• 7.3 Is the Vehicle Clean and Tidy ?

  Yes

  No

  N/A

• 7.4 Is the Signage in Good Condition ?

  Yes

  No

  N/A

• 7.5 Is the FSE using Feedback Cards/Book ?

  Yes

  No

  N/A

• 7.6 Is the FSE using a Current Price List ?

  Yes

  No

  N/A

• 7.7 Is the FSE using the Business Stamp on Invoices ?

  Yes

  No

  N/A

8.0 COMPLIANCE

• 8.1 Is FSE in Full Uniform ?

  Yes

  No

• 8.2 Is FSE Using Correct Jimscleaning Email ?

  Yes

  No

• 8.3 Is FSE using Jimscleaning Business Cards ?

  Yes

  No

• 8.4 Is FSE using Jimscleaning Invoice Books ?

  Yes

  No

• 8.5 Does vehicle have Correct Division signage ?

  Yes

  No

• 8.6 Does vehicle have *Franchises Available* and *www.jims.net* signage ?

  Yes

  No

9.0 CUSTOMER SERVICE

• 9.1 Did you Observe the FSE Communicating with the Client whilst Conducting a Field Visit ?

  Yes

  No

  N/A

• 9.2 Where you Satisfied that Communication was Both Appropriate and Effective ?

  Yes

  No

  N/A

• 9.3 Did you Inspect the Quality of Work whilst you were Conducting the Field Visit ?

  Yes

  No

  N/A

• 9.4 Were you Satisfied that the Quality of Work was of an Appropriate Standard ?

  Yes

  No

  N/A

10.0 ADDITIONAL COMMENTS OR ACTIONS

• FSE Name & Code

  Sign

• FSO Name

  Sign