Title Page
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Conducted on
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Prepared by
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Location
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Main Contractor’s name?
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Number of operatives under supervision
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Have all operatives signed in/ out as required
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Briefly explain why operatives have not signed in
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Are all operatives wearing suitable 5 point PPE?
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Why is suitable PPE not being worn and what actions have been taken?
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Have all operatives read and signed the project specific RAMS?
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Why have the RAMS not been read & signed?
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Is suitable task specific PPE being used where RAMS require it? For example RPE when floor fixing
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What task has been undertaken and why has the relevant PPE not been used?
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What PPE has been used?
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Is there suitable segregation between working area and others? (Store Colleagues/ public/ other contractors)
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Why is segregation not in place?
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Is the working area being kept tidy, including trailing cables?
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Why is the area not tidy and what actions are being taken to prevent accidents?
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Are all materials being stored/ stacked safely?
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Why are materials not being stored safely?
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Has suitable plant/ mechanical aid been provided to assist in manual handling? For example pallet trucks & PAVS
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What is the task and what mechanical aid is required?
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Are there any other potential Health and safety concerns you may have on this particular site?
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Please explain?
