Audit

LOCATION OF TASK OBSERVED:

DATE & TIME OF OBSERVATION:

BRIEF DESCRIPTION OF WORK BEING OBSERVED:

NUMBER OF PEOPLE BEING OBSERVED:
CRAFT BEING OBSERVED

EQUIPMENT BEING WORKED ON (OPTIONAL):

WAS A PRE-JOB BRIEFING CONDUCTED?

WAS "EYES ON PATH" USED DURING YOUR OBSERVATION?

WAS "EYES ON HANDS" USED DURING YOUR OBSERVATION?

CATEGORY A - Communication

All craft participated in Pre-task meeting and understand task hazards. A.1

Workers demonstrate a questioning attitude about their surroundings. A.2

Work groups share information about identified hazards with other nearby workers. A.3

Workers are paired up (buddy system) as a good practice. A.4

Backing vehicles and vehicles in congested areas are using spotters. A.5

CATEGORY B - Personal Protective Equipment

Personal Protective Equipment is correct for the hazard. B.1

PPE is being used properly and is in good condition. B.2

Hot work PPE is in good condition and free of holes. B.3

CATEGORY C - Housekeeping

Scrap material is controlled to prevent accumulations on walking and working surfaces. C.1

Work areas are cleaned before work begins. C.2

Work areas are maintained clean and orderly during the work day. C.3

Cords, leads and hoses are elevated above work areas and walkways. C.4

Cords, leads and hoses are protected from damage caused by vehicle traffic. C.5

CATEGORY D - Tools

Tools are inspected before use and are in good condition. D.1

Tools in use are correct for the task and are used properly. D.2

Measures are in place to prevent dropped tools and material from reaching a lower work elevation. D.3

Defective tools are immediately discarded or removed from the work area. D.4

CATEGORY E - Rigging and Lifting Practices

Rigging equipment is inspected before use. E.1

The crane is level and all outriggers are placed on pads. E.2

There is one dedicated signal person and clear signals are provided. E.3

Tag lines are used on all loads. E.4

The load path is clear of overhead obstructions and hazards. E.5

Others are audibly alerted to overhead loads and lift areas are identified by barriers or spotters. E.6

CATEGORY F - Fall Protection

Fall protection equipment is inspected before use and in good condition. F.1

Harness is worn and adjusted properly. F.2

Anchor point is above users back D-ring. F.3

Equipment and attachment configuration prevents contact with a lower elevation in the event of a fall. F.4

User remains within 15 degrees of attachment point prevent a swing fall. F.5

User remains tied off 100% of the time while at elevation. F.6

Observation Feedback
Observation Category

Feedback Provided

Observation Category

Feedback Provided

Observation Category

Feedback Provided

Pre-Incident Learning Questions

How can someone get hurt doing this task? How have we avoided that?

Have you experienced or heard of recent close calls? What happened? What did we do about it?

What is your biggest safety concern on this job?

9/29/2013 Frank Deller Failure to feedback is acceptance of the behavior.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.