General Workplace

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Reported by.

• 1.2 - Adjusting personal protective equipment

  Safe

  At Risk

  N/A

• Changing position

  Safe

  At Risk

  N/A

• Rearranging job

  Safe

  At Risk

  N/A

• Stopping job

  Safe

  At Risk

  N/A

• Performing lockouts

  Yes

  No

  N/A

Position of people

• Striking against objects

  Safe

  At Risk

  N/A

• Struck by objects

  Safe

  At Risk

  N/A

• Caught in,on or between objects

  Safe

  At Risk

  N/A

• Slips trips and falls

  Safe

  At Risk

  N/A

• Lifting,stretching and repetitive movements

  Safe

  At Risk

  N/A

• Awkward position

  Safe

  At Risk

  N/A

• Contact with temperature extremes

  Safe

  At Risk

  N/A

• Contact with electricity (underground / overhead)

  Safe

  At Risk

  N/A

• Inhailing/ingesting/overcome by hazardous substance

  Safe

  At Risk

  N/A

Personal protective equipment

• Head

  Safe

  At Risk

  N/A

• Eyes and face

  Safe

  At Risk

  N/A

• Ears

  Safe

  At Risk

  N/A

• Hi viz clothing

  Safe

  At Risk

  N/A

• Arms and legs covered

  Safe

  At Risk

  N/A

• Hands

  Safe

  At Risk

  N/A

• Feet

  Safe

  At Risk

  N/A

Tools and equipment

• Wrong tools or plant for the job

  Safe

  At Risk

  N/A

• Used incorrectly

  Safe

  At Risk

  N/A

• Missing safety equipment (signs, barriers,seatbelts)

  Safe

  At Risk

  N/A

• In unsafe condition

  Safe

  At Risk

  N/A

Procedures and housekeeping

• Correct procedures followed

  Safe

  At Risk

  N/A

• Procedures not known/understood

  Safe

  At Risk

  N/A

• Housekeeping standards inadequate

  Safe

  At Risk

  N/A

• Housekeeping standards not known/understood

  Yes

  No

  N/A

Safe acts observed

• Yes

  No

  N/A

Action taken to encourage continued safe performance

• Yes

  No

  N/A

Unsafe acts observed

• Yes

  No

  N/A

Immediate corrective action taken

• Yes

  No

  N/A

Corrective action to prevent recurrence (enter into Risk Manager)

• Yes

  No

  N/A

Inducted to site by

• Yes

  No

  N/A

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• On site representative

  Sign

• Auditor's signature

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