Goleman Work Site Audit Form

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Specific Site Information

• Is there appropriate paperwork on site, filled out and signed by all crew?

  Yes

  No

  N/A

• Add media

  Media

• Do all crew members have relevant inductions

  Yes

  No

  N/A

• Add media

  Media

2.0 Emergency Plans & Procedures

• Are crew familiar with emergency evacuation procedures and assembly areas?

  Yes

  No

  N/A

• Add media

  Media

• Is there a rescue plan in place for the works being undertaken?

  Yes

  No

  N/A

• Add media

  Media

• Is everyone in the work party familiar with the plan and their responsibilities?

  Yes

  No

  N/A

• Add media

  Media

3.0 First Aid

• Is at least one crew member first aid trained with a current certificate?

  Yes

  No

  N/A

• Add media

  Media

• Is there a first aid kit in the company vehicle

  Yes

  No

  N/A

• Add media

  Media

• Is the first aid kit appropriate for the task being carried out?

  Yes

  No

  N/A

• Add media

  Media

4.0 PPE

• Is the PPE available to the crew fit for purpose and appropriate for the task?

  Yes

  No

  N/A

• If no, why not?

• Add media

  Media

• Is the PPE being worn and/or used correctly<br>

  Yes

  No

  N/A

• If not, cease works until it is.

• Add media

  Media

5.0 Methodology

• is the methodology applied to the task safe and allow logical progression to completion?

  Yes

  No

  N/A

• Add media

  Media

• Has the methodology been developed with input from all crew members on site?

  Yes

  No

  N/A

• Add media

  Media

6.0 Rope Access and Fall Arrest Operations

• Is the site set up safely and appropriately for safety of crew

  Yes

  No

  N/A

• Add media

  Media

• Are there exclusion zones set up underneath the work area?

  Yes

  No

  N/A

• Add media

  Media

• Is there safe alternative access / egress for pedestrians?

  Yes

  No

  N/A

• Add media

  Media

• Are there other contractors on site?

  Yes

  No

  N/A

• Add media

  Media

• Are there concurrent works which require special consideration to keep crew safe?

  Yes

  No

  N/A

• Add media

  Media

7.0 Rope Access and Fall Arrest Equipment

• Does the task involve Rope Access , Fall Arrest or Working at Heights?

  Yes

  No

  N/A

• Do the crew members have appropriate training, certification, and competence to perform this task?

  Yes

  No

  N/A

• If the answer to the previous question is 'No', cease works and contact your local manager

• Is all equipment and hardware fit for purpose and in certification / inspection?

  Yes

  No

  N/A

• Add media

  Media

8.0 Chemicals and Hazardous Substances

• List chemicals being used:

• Is there an MSDS available for reference for each chemical on site?

  Yes

  No

  N/A

• Add media

  Media

• Are the chemicals on site being transported and stored safely (as per manufacturers guidelines)?

  Yes

  No

  N/A

• Add media

  Media

9.0 Electric Tools

• Does the task require the use of electric or power tools?

  Yes

  No

  N/A

• Are there electric tools on site to complete the task?

  Yes

  No

  N/A

• Add media

  Media

• Are the crew trained in the use of the tools?

  Yes

  No

  N/A

• Add media

  Media

• Are the electric tools on site fit for purpose and tagged / in cert.

  Yes

  No

  N/A

• Add media

  Media

10.0 Hand Tools

• Does the task require the use of hand tools?

  Yes

  No

  N/A

• Are the hand tools on site fit for purpose and in good condition?

  Yes

  No

  N/A

• Add media

  Media

11.0 Ladders

• Does the task require the use of ladders?

  Yes

  No

  N/A

• Are the ladders on site the correct type and size to complete the task ?

  Yes

  No

  N/A

• Add media

  Media

• Are the ladders being used correctly in line with company policies and the current BPG?

  Yes

  No

  N/A

• Add media

  Media

12.0 EWP's / MEWP's

• Does the job require the use of MEWPS? (Knuckle booms, scissor lifts, cherry pickers)

  Yes

  No

  N/A

• Are the machines on site fit for purpose

  Yes

  No

  N/A

• Add media

  Media

• Are crew certified and competent to use the machines?

  Yes

  No

  N/A

• Add media

  Media

• Has the log book been filled out prior to machine use?

  Yes

  No

  N/A

• Add media

  Media

15.0 Confined Space Works

• Does the task involve entry into a confined space?

  Yes

  No

  N/A

• Are crew adequately trained, certified and competent to carry out con-space works?

  Yes

  No

  N/A

• Add media

  Media

• Is the con-space properly set up for entry?<br>- atmosphere tested<br>- vented<br>-isolated<br>

  Yes

  No

  N/A

• Add media

  Media

• Is the task clear to all crew?

  Yes

  No

  N/A

• Add media

  Media

• Is there a rescue plan in place?

  Yes

  No

  N/A

• Add media

  Media

16.0 Quality of Works

• Window Cleaning.<br>Are the windows satisfactorily cleaned as per scope? (no scratches, corners done, frame cleaned up)<br>

  Yes

  No

  N/A

• Add media

  Media

• Building Wash / Roof Wash<br>Is the building satisfactorily cleaned as per scope?

  Yes

  No

  N/A

• Add media

  Media

• Gutters & Spouting.<br>Are gutters clear of leaves and debris<br>Is the rainhead cleared<br>Waste bagged and removed from site<br><br>

  Yes

  No

  N/A

• Add media

  Media

• Maintenance.<br>Correct tools and materials on site<br>Method and process appropriate<br>

  Yes

  No

  N/A

• Add media

  Media

• Leaks.<br>Leak found and fixed<br>Water tested to prove<br>

  Yes

  No

  N/A

• Add media

  Media

17.0 General Methodology

• Is the general methodology and process of the job of a quality which meets Goleman standards and adheres to relevant procedures and policies?

  Yes

  No

  N/A

• Add media

  Media

18.0 Professionalism

• Work being completed in a timely manner in line with accepted quote

  Yes

  No

  N/A

• Add media

  Media

• Communication between crew and client

  Yes

  No

  N/A

Sign Off

• Auditor

  Sign

• Notes:

• Yes

  No

  N/A