Background

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Nearest A and E Department

  • Travel route

Accident Records

Accident Record

  • Number of minor injuries reported in last 12 months.

  • Number of major injuries reported in last 12 months.

  • Name of insurers

  • Number of compensation claims made in last 12 months.

  • Photos of accident book records

Hazards

Car park

  • Is there adequate lighting available in the car park

  • Is the car park road surface in good condition

  • Other comments

Injury risks

  • Risk

  • Risk Details
  • Risk Type

  • Detail other.

  • Additional Information - cause of risk

  • Risk Factor

First Aid Requirements

First Aid Arrangements

  • First Aider cover requirements

  • Numbers Required

  • Current First Aiders

  • FA
  • First Aider Name

  • Expiry Date

  • Training company. Name and contact details

Action Plan

Conclusions

  • Conclusions

  • Auditor Sign off

  • Date of Next Review

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.