Final construction inspection

CLIENT DETAILS PRE VISIT

• Client name & ID

• Conducted on

  Date

• Policy start date

  Date

• # of open claims

• WC Codes currently in use

• Total # of employees

• NAICS

• FEIN

• States operating in

• Prepared by

• Location
  Address

Confirmation Questions

• Does the total number of employees seem accurate?

  Yes

  No

  N/A

• Do the current worker’s comp codes seem accurate?

  Yes

  No

  N/A

• Are the states operation in accurate?

  Yes

  No

  N/A

• Does the NAICS seem accurate?

  Yes

  No

  N/A

• Areas of concern the business contact has surrounding safety/WC that they want inspected for sure before the end of the visit.

Site Visit Questions

• Do you currently have an existing and updated IIPP?

  Yes

  No

  N/A

• Would the client be interested in additional help in this area?

  Yes

  No

  N/A

• Do you currently have an existing and updated Emergency Action Plan?

  Yes

  No

  N/A

• Would the client be interested in additional help in this area?

  Yes

  No

  N/A

• Do you currently have a Safety Committee?

  Yes

  No

  N/A

• How frequently do they meet?

  Weekly

  Quarterly

  Semi-annually

  Other

• Would you like more information on this?

  Yes

  No

  N/A

• Do you currently have an updates SDS Binder?

  Yes

  No

  N/A

• Would you like some assistance in setting one up?

  Yes

  No

  N/A

• Has Client been sited by OSHA in the last year ?

  Yes

  No

  N/A

• Does client have a return to work program in place?

  Yes

  No

  N/A

• Are all proper OSHA and labor laws poster posted and completed?

  Yes

  No

  N/A

FLOORS AND WALKWAYS

• Are walkways and stairways kept clear of obstructions?

  Yes

  No

  N/A

• Are buckets and mops available to clean up spills so no one will slip?

  Yes

  No

  N/A

• Are non-slip mats, grates, or slip-free coatings used in wet areas to revent falls?

  Yes

  No

  N/A

• Do stairways have handrails?

  Yes

  No

  N/A

• Are carpets and rugs causing a potential trip hazard?

  Yes

  No

  N/A

LADDERS AND FALL PROTECTION

• Are the appropriate ladders for the job available and in good condition?

  Yes

  No

  N/A

• Are they inspected before each use?

  Yes

  No

  N/A

• Do ladders have safety feet?

  Yes

  No

  N/A

• Proper Pitch ( Between 30 & 50 Degrees from Parallel )?

  Yes

  No

  N/A

• Are non-metal ladders used when there is a chance of electric shock?

  Yes

  No

  N/A

• Employees Kept Clear of Suspended Loads?

  Yes

  No

  N/A

• Contractor Fall Protection Plan (on file at site)<br>100% Fall Protection Rule?

  Yes

  No

  N/A

• If work is done on an elevated work location (above 30 inches,or 48 inches if the platform is not part of the building), are guard rails installed?

  Yes

  No

  N/A

FIRE SAFETY

• Proper permits obtained from fire department?

  Yes

  No

  N/A

• Are all fire extinguishers currently up-to-date on their monthly checks?

  Yes

  No

  N/A

• What company is responsible for completing sprinkler system checks?

  Yes

  No

  N/A

• Are there at least two fire exits for each building?

  Yes

  No

  N/A

• How often does the 3rd party company check the system?

  Yes

  No

  N/A

• Are fire exits clearly marked and pathways to the exits clear?

  Yes

  No

  N/A

• Have employees been told what to do in case of a fire or other emergency?

  Yes

  No

  N/A

• Are there fire extinguishers of the correct type in or close to each work area?

  Yes

  No

  N/A

• Are the locations of fire extinguishers clearly marked?

  Yes

  No

  N/A

• Is there a sprinkler system in place?

  Yes

  No

  N/A

• Are the fire alarm system and sprinkler system regularly tested?

  Yes

  No

  N/A

• Are there regular fire drills?

  Yes

  No

  N/A

• Smoking policy in place?

  Yes

  No

  N/A

• Who is responsible for monthly safety inspections of Fire Extinguishers?

ELECTRICAL HAZARDS

• Are electrical cords in good condition (no fraying or other defects)?

  Yes

  No

  N/A

• Have employees who use machinery been told how to

  Yes

  No

  N/A

• recognize when a machine has been locked out and tagged (electrical power of, locked out and machine tagged)?

  Yes

  No

  N/A

• Are cords kept out of areas where someone could trip?

  Yes

  No

  N/A

• Are power tools and other equipment in good condition?

  Yes

  No

  N/A

• Is all electrical equipment, including power tools, properly grounded?

  Yes

  No

  N/A

• Are there enough outlets so extension cords don’t have to be used?

  Yes

  No

  N/A

LIGHTING

• Is there adequate lighting throughout the workplace?

  Yes

  No

  N/A

• Are the areas around all machines well lighted?

  Yes

  No

  N/A

• Are outside pathways and parking lots adequately lighted at night?

  Yes

  No

  N/A

MACHINE GUARDING AND MECHANICAL SAFETY

• Are emergency cut-of switches easily located and identified, and do employees know where they are?

  Yes

  No

  N/A

• Do employees know how to turn off machines in an emergency?

  Yes

  No

  N/A

• Are machines securely attached to the floor?

  Yes

  No

  N/A

• Have employees been trained in how to work safely around machines?

  Yes

  No

  N/A

• Have employees been told to report missing machine guards to their supervisors?

  Yes

  No

  N/A

• Do machines have guards on them?

  Yes

  No

  N/A

OTHER SAFETY ISSUES

• Are hot surfaces guarded to prevent accidental contact?

  Yes

  No

  N/A

• Are sharp objects properly stored so they don’t present a hazard?

  Yes

  No

  N/A

• Do furniture and equipment have seismic restraints or bracing?

  Yes

  No

  N/A

• Is shelving secured to walls?

  Yes

  No

  N/A

CHEMICAL HAZARDS

• Are chemicals (including pesticides, solvents, and cleaning products) properly labeled and stored?

  Yes

  No

  N/A

• Are flammable and combustible liquids inside the buildings stored properly?

  Yes

  No

  N/A

• Has an inventory been done of toxic substances used in the workplace?

  Yes

  No

  N/A

• Have Material Safety Data Sheets (MSDS) been obtained for all chemicals you use?

  Yes

  No

  N/A

• Has monitoring been done to make sure exposure levels are within legal limits?

  Yes

  No

  N/A

• Are records of monitoring results available to employees?

  Yes

  No

  N/A

• Are employees told where Material Safety Data Sheets on chemicals are kept?

  Yes

  No

  N/A

• Has annual training been conducted for all employees who use chemicals?

BIOLOGICAL HAZARDS, SANITATION, AND HOUSEKEEPING

• Are adequate toilet facilities provided and well maintained?

  Yes

  No

  N/A

• Industrial Hygienist/Air Monitoring/Testing?

  Yes

  No

  N/A

• Trash maintained and kept in storage bins

  Yes

  No

  N/A

• Are there sinks with hot and cold water, and disposable hand towels?

  Yes

  No

  N/A

• Are insects and rodents adequately controlled?

  Yes

  No

  N/A

• Toilet Facilities (adequate number)?

  Yes

  No

  N/A

• Are there clean eating areas separate from work and chemical storage areas?

  Yes

  No

  N/A

ERGONOMIC HAZARDS

• Can employees get help when lifting more than 30 pounds (as per NIOSH’s recommendation)?

  Yes

  No

  N/A

• Have employees been trained in proper lifting methods?

  Yes

  No

  N/A

• Are mechanical lifting devices available if needed?

  Yes

  No

  N/A

• Are job tasks that require repetitive movements varied or rotated?

  Yes

  No

  N/A

• Are computer workstations set up to avoid awkward postures and to fit the individual?

  Yes

  No

  N/A

• Are employees able to avoid standing or sitting for long periods of time?

  Yes

  No

  N/A

NOISE

• Do workers feel noise levels are comfortable?

  Yes

  No

  N/A

• Is there a program for noise reduction?

  Yes

  No

  N/A

• Do workers know when and where hearing protection is necessary?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Is personal protective equipment (PPE) provided as needed (coveralls, gloves, eye protection, respirators, earplugs, etc)?

  Yes

  No

  N/A

• Have workers using PPE been trained in its proper use?

  Yes

  No

  N/A

• Is PPE cleaned, maintained, and stored properly?

  Yes

  No

  N/A

• Are multiple sizes of PPE available to different workers?

  Yes

  No

  N/A

GENERAL WORKPLACE ISSUES

• Does the workplace have a written Injury and Illness Prevention Program (IIPP) as required by Cal/OSHA, and has a responsible person been identified?

  Yes

  No

  N/A

• Is there a written Emergency Action Plan and have all employees been trained in what to do during an emergency?

  Yes

  No

  N/A

• Have all employees received health and safety training?

  Yes

  No

  N/A

• Is there someone in the workplace trained in first aid and CPR?

  Yes

  No

  N/A

SITE SAFETY

• Emergency Phone Numbers Posted?

  Yes

  No

  N/A

• Warning Signs (hard hats, No Trespassing, etc)?

  Yes

  No

  N/A

• First Aid Supplies Accessible?

  Yes

  No

  N/A

• Travel/Access ways (unobstructed and maintained)?

  Yes

  No

  N/A

• First Aid Supplies Stocked?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Eye Wash Available and Maintained?

  Yes

  No

  N/A

• Necessary Detours, Canopies, Sidewalks?

  Yes

  No

  N/A

• Posters (OSHA, etc)?

  Yes

  No

  N/A

• Guardrails > 6 feet high?

  Yes

  No

  N/A

• Copy of Company Safety & Health Program & MSDSs?

  Yes

  No

  N/A

• Visitor Controls (Signs, Visitor PPE, etc)?

  Yes

  No

  N/A

• Training Records including Tool Box Safety Meeting Records?

  Yes

  No

  N/A

CONTRACTOR PROVISIONS

• Ensure All Contractors Have Site Specific Safety Plan?

  Yes

  No

  N/A

• All Contractor's Have Designated Safety Rep/Competent?

  Yes

  No

  N/A

• All Contractors Have Submitted HazComm Program and MSDS?

  Yes

  No

  N/A

• All Contractors Are Conducting Safety Orientation w/new employees?

  Yes

  No

  N/A

• All Contractors Holding Tool Box Safety Meetings?

  Yes

  No

  N/A

• Inspections/Service Records/Operators Manual (Filed At Site)?

• All Contractors are familiar with Emergency Action Plan?

  Yes

  No

  N/A

• Contractor Fall Protection Plan (on file at site)?

• 100% Fall Protection Rule?

  Yes

  No

  N/A

• Residential Roofing (Fall Protection Plan, Slide?

  Yes

  No

  N/A

HAND AND POWER TOOLS

• Tools Properly Stored?

  Yes

  No

  N/A

• Cutoffs/Kill Switches/ Anti-Restart Functioning?

  Yes

  No

  N/A

• Tools Used Properly?

  Yes

  No

  N/A

• Tools effectively grounded or Double Insulated?

  Yes

  No

  N/A

• Tools Inspected Frequently (at least before each use)?

  Yes

  No

  N/A

• Tools Equipped with Required Guards?

  Select Yes No N/A

  • Yes
  • No
  • N/A

TRENCHING & EXCAVATION

• Training and Insurance of Proper Use?

  Yes

  No

  N/A

• Other Barricades and Warnings (Pedestrians, Stop Logs, etc)?

  Yes

  No

  N/A

• Wood Shoring (per OSHA tables)?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Trench Shield (Manufacturer Placard & Data on File at Site)?

• Aluminum Hydraulic Shoring (per OSHA tables)?

  Yes

  No

  N/A

• Material Stored at Least 2" from Edge?

  Yes

  No

  N/A

DEMOLITION & BLASTING

• Demolition Plan in Place (On File at Site)?

• HazMat Remediation Activities?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Utilities Disconnected, Purged, Etc?

  Yes

  No

  N/A

• Licensed Blaster Present at All Times?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• All State & Local Permits on File?

  Yes

  No

  N/A

• Use, Handling & Disposal of Blasting Materials?

  Yes

  No

  N/A

• Warning System/ Warning Signs?

  Yes

  No

  N/A

WELDING

• Performed by Qualified Individuals?

  Yes

  No

  N/A

• Proper Work Area (All Fire Hazards Removed or Properly Stored?

  Yes

  No

  N/A

• Equipment Inspected Before Use?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Separation of stored Oxy & Fuel Gases/oils by 20' or 1/2 hr fire-rated wall?

  Yes

  No

  N/A

• Cylinders Upright and Secured?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Fuel Gas Shut Off Key/Wrench Available?

  Yes

  No

  N/A

• Fully Charged Fire Extinguisher Available?

  Yes

  No

  N/A

Innoworks Support Questions

• Do you currently utilize the Innoworks-provided AFLAC plan to reduce false Worker’s Comp claims (free of charge)

  Yes

  No

  N/A

• Would you like more information on this plan and how it can help reduce costs?

  Yes

  No

  N/A

• Would you like more information on other Innoworks-provided services, such as medical insurance benefits and 401(K)?

  Yes

  No

  N/A

• What would you like more information about?

  Medical Benefits

  401K

SIGNATURE

• Site Safety Rep Signature

  Sign