Information

  • FSE Name:

  • Territory:

  • Field Visit Number.

  • Conducted on

  • Location

  • Prepared by

AREA VEHICLE

  • Does the vehicle have a cargo barrier? Not applicable to dual cab utilities.

  • Explanation

  • Date to rectify

  • Is the vehicle clean and tidy?

  • Explanation

  • Is everything in the vehicle properly secured?

  • Explanation

  • Date to rectify

  • Is the sign writing in good condition?

  • Explanation

  • Date to rectify

  • If the response is Yes

  • Provide Photo Evidence

  • Is there a suitable fire extinguisher (with a hose) in the vehicle and has it been properly maintained?

  • Explanation

  • Date to rectify

  • Provide photo evidence

  • Is there a fully stocked and suitable First Aid Kit? ( equivalent to the one for use on a construction site)?

  • Explanation

  • Date to rectify

  • Provide photo evidence

  • Is a register maintained of items updated in the First Aid Kit?

  • Are there traffic management devices in the vehicle - witches hats and bollards?

  • Explanation

  • Date to rectify

  • Are there flashing lights in the vehicle (only as per site specific requirements)?

  • Explanation

  • Does the Franchisee have suitable and sufficient tools to perform required tasks?

  • Explanation

  • Date to rectify

  • Is there a stock of equipment for repairs?

  • Explanation

  • Date to rectify

  • Is there a suitable work area in the vehicle ?

  • Explanation

  • Date to rectify

  • Explanation

  • Does the Franchisee have a clean uniform where required (appropriate for client) ?

  • Explanation

  • Does the Franchisee have a current drivers licence?

  • Explanation

  • Date to rectify

  • provide photo evidence

  • Are the Franchisee's manuals current? (Electronic format ok if accessible on the day via laptop or tablet)

  • Explanation

  • Date to rectify

  • Are the service requirements for the vehicle up to date?

  • Explanation

  • COMMENTS

UNIFORM

  • Is the Franchisee in complete uniform ? (Current design and cotton drill style shorts or pants)

  • Explanation

  • Date to rectify

  • Is the uniform in good condition?

  • Date to rectify

  • Are the boots clean?

  • COMMENTS

PERSONAL PROTECTIVE EQUIPMENT (PPE)

  • Helmet?<br>

  • Date to rectify

  • Steel capped boots for construction sites?

  • Date to rectify

  • Hi-Visibility Safety Vest or shirt?

  • Date to rectify

  • Safety Glasses Available ?

  • Date to rectify

  • Hearing Protection Available ?

  • Date to rectify

  • Does the Franchisee use electrical grade gloves or a 10 milliamp RCD when leakage testing?

  • Date to rectify

  • COMMENTS

PRINTED STATIONERY AND REFERENCE MATERIAL

  • Copy of relevant standards (based on services provided)

FIRE

  • Australia Only. Is the Franchisee's Jim's Test & Tag/Jim's Fire Safety FPAA. membership valid?

  • Explanation

  • Date to Rectify

  • Provide Photo Evidence

  • Australia Only. Does the Franchisee and FPAS accreditation?

  • Explanation

  • Date to Rectify

  • Provide Photo Evidence

  • AS 1851:2012 (Australia only)

  • Date to rectify

  • AS 2444:2001 (Australia only)

  • Date to rectify

  • AS/NZ 1841.1:2007

  • Date to rectify

  • AS 2441:2005 (Australia only)

  • Date to rectify

  • NZS 4503:2005 (NZS only)

  • Date to rectify

TEST & TAG

  • AS/NZS 3760:2010

  • AS/NZS 3012:2010

EMERGENCY & EXIT LIGHTS

  • AS/NZS 2293.2:1995

  • AS/2293.3:2005 (Australia only)

  • Business Cards ?

  • Are the invoices in an approved format and do they include term of trade ?

  • Best Practices in Test & Tagging of Electrical Equipment to AS/NZS 3760

  • Has the Franchisee tailored their brag book or Formitize to contain relevant certificates eg: fire competency

  • Carry a stock of stubby holders and other promotional material ?

  • COMMENTS

TECHNICAL

  • IS THE FRANCHISEE'S EQUIPMENT CALIBRATED ?

  • PAT

  • Date to rectify

  • Provide photo evidence

  • RCD Tester (if separate - not included in new tester)

  • EFLI Tester

  • HIOKI Clamp meter

  • Spare PAT and Equipment

  • Does the Franchisee have a current logbook of their equipment ?

  • Date to rectify

  • Has the Franchisee provided you with a current certificate of the results of the online technical quiz ? <br>(Results required to be greater than 80%)

  • Date to rectify

  • Provide photo evidence

  • Franchisor to review Franchisee technical knowledge - (Refer to TRA180).<br>

  • Date to rectify

  • Can the Franchisee talk through the process of testing emergency and exit light? (Including filling out the log book)?

  • Can the Franchisee talk through testing of portable fire units for all levels of services according to the applicable standards?

  • COMMENTS

TESTING

  • Review sample of PATGuard reports to determine that the Franchisee:

  • Does the FSE perform an Earth Resistance or EFLI on all GPOs the tester is plugged into and record the results in the Asset Data Log ?

  • The Franchisee selects the correct tests?

  • Leakage test are conducted where required ?

  • Reports are accurate ?

  • Correct reports are being generated ?

  • Does the Franchisee take due time to complete the test process (for example, you should notice different leakage results on monitors)

  • Are the emergency and exit log books being filled out correctly? (If held in vehicle and service provided)

  • Explanation

  • Date to rectify

  • Does the Franchisee set up in a practical way ?

  • Explanation

  • Are visual inspections carried out with due diligence ?

  • Explanation

  • Are repairs performed in a timely manner ?

  • Explanation

  • Is the Franchisee capable of explaining the Tests we perform ? <br>Refer review of knowledge above.

  • Explanation

  • Date to rectify

  • Does the Franchisee invoice within our guidelines ?

  • Explanation

  • Does the Franchisee offer a leakage test on 3 phase equipment ? If so do they have the required equipment ?

  • Explanation

  • Date to rectify

  • Does the Franchisee have all the required testing equipment ?

  • Explanation

  • Date to rectify

  • Does the Franchisee use only authorised testing equipment ?

  • Explanation

  • Date to rectify

  • Is the Franchisee's data being backed up?

  • COMMENTS

WORK PRACTICES

  • Does the Franchisee accept credit card payments ?

  • Does the Franchisee support preferred suppliers ? ( Refer to the intranet for a complete list of preferred suppliers)

  • Explanation

  • Does the Franchisee update Jim's On-line for pickups ?

  • Does the Franchisee use our standard documents as a basis for their advertising and marketing information ?

  • Does the Franchisee ensure they ( or preferably another party) proof read all marketing material and correspondence ?

  • Is the Franchisee's phone message appropriate ? Are there two separate messages - one for unavailable and one if on another call ?

  • Explanation

  • Date to rectify

  • Does the Franchisee answer their phone appropriately ?

  • Explanation

  • Date to rectify

  • Is the Franchisee providing any Fire or Exit light services to any customers?

  • Please provide evidence of qualifications

  • COMMENTS

PARTICIPATION - DOES THE FRANCHISEE

  • Accept proactive calls?

  • Explanation

  • Accept site visits?

  • Explanation

  • Attend regular breakfast and/or regional meetings?

  • Explanation

  • Provide constructive feedback in accordance with our culture ?

  • Explanation

  • COMMENTS

EMPLOYEES-IF THE FRANCHISEE HAS EMPLOYEES

  • Does the Franchisee have Employees please Tick

SAFETY

  • Does the Franchisee consider safety issues when setting up?

  • Explanation

  • Does the Franchisee have a site specific assessment for all clients they have tested and do they address hazards not covered in the standard SWMS?

  • Provide photo evidence of sample

  • Explanation

  • Has the Franchisee prepared a site specific assessment that is appropriate to their current work location?

  • Provide photo evidence

  • Explanation

  • Date to rectify

  • Did the Franchisee work in accordance with the SWMS?

  • Explanation

  • Date to rectify

  • Is the Franchisee's First Aid certificate current?

  • Explanation

  • Date to rectify

  • Provide photo evidence

  • Does the Franchisee review the Safety Authority website in their area on a regular basis?

  • Does the Franchisee have a relevant general construction induction training card (or equivalent)?

  • Provide photo evidence

  • Explanation

  • Date to rectify

  • Does the Franchisee wear appropriate PPE when required?

  • Explanation

  • Date to rectify

  • Has the Franchisee provided you with a current certificate (completed within the last 12 months) of the results of the required safety quizzes? (results required to be greater than 80%)

  • Provide photo evidence

  • Explanation

  • Date to rectify

  • COMMENTS

OTHER

  • Does the Franchisee have a working with children check?

  • Provide photo evidence

  • Does the Franchisee have a current ID card?

  • Date to rectify

  • Provide photo evidence

  • Does the Franchisee review the intranet for updated items weekly?

  • Date to rectify

  • Is the Email signature correct?

  • Date to rectify

  • Is the Franchisee's insurance cover current and do they have a current certificate of currency?

  • Date to rectify

  • Provide photo evidence

  • Did the Franchisee attend the last divisional conference or have they recorded their CPD hours? (Use BUS020 to record CPD hours and submit to FSO).

  • Date to rectify

  • Is the Franchisee providing services outside operations manual?

  • Explanation

  • Date to rectify

  • Does the Franchisee advertise their mobile number outside or their territory (is their mobile number on the internet)?

  • Date to rectify

  • Is the Franchise using an approved format for fire reports (PG3 or FPA log book are the only accepted formats)

  • take picture of random client

  • COMMENTS

ACTION PLAN

  • AREAS OF CONCERN

  • Date to rectify

ADDITIONAL COMMENTS OR ACTIONS

  • Additional comments or concerns

  • FSE Name & Code

  • FSO Name

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.