Title Page
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Client / Site - where audit undertaken
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Conducted on
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Prepared by
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Location / Address
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Personnel (list who attended)
Business actions and reports arising from last meeting
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What has been completed and by who?
Employee
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Action Completed
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Completed by
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Comments
Review incident/accident reports and data for trends
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Any injuries since last meeting?
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Any near misses or hits since last meeting?
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Have all incidents/accidents been recorded?
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Total number of new incidents/accidents recorded since last meeting
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Comments
Review risk/hazard identification and controls
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Any new risks/hazards since last meeting?
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Are they documented?
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Have all new risks/hazards been discussed?
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Any existing risks/hazards requiring an annual review/discussion?
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Comments
Review monthly monitoring auditing/inspections
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Have they been completed?
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Have all recommendations and corrective actions been completed?
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Comments
Visitor and Contractor Management
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Visitor or Contractor
Person
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Date of visit
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Who visited
- Contractor
- Visitor
- WorkSafe
- External auditor
- ACC
- Ministry of Primary Industries (MPI)
- Food Safety Authority (FSA)
- Customer/client
- Forestry Industry Safety Council (FISC)
- Other
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Further detail
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Comments
Review any new internal or external information on health and safety matters
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Any new WorkSafe alerts to discuss?
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Discuss any industry advice
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Discuss any external reports
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Comments
Review and discuss any identified management or staff training
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What type of training and who?
Employee
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Employee name
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Type of training
- Induction
- Risk/hazard management
- Accident investigation
- Rep training
- SOP training
- Emergency management
- HSNO training
- Other
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Comments
Review the Emergency Planning and drills
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Have you reviewed previous reports?
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Have the dates of all planned drills been discussed?
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Have you discussed responsibilities in terms of emergency planning?
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Any wardens training required?
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Has an emergency assembly point been established?
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Comments
Review chemical (HSNO) management
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Are MSDs current?
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Do we have a current chemical inventory available on site?
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Is any HSNO training required?
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Is chemical storage satisfactory as per industry guidelines?
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Have we had any spillages since last meeting?
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Comments
Brag time and recommendations for the future
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What have we achieved to date?
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What do we need to do for the continuous improvement of our health and safety systems?
Audit Sign Off
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Sign Off
Employee
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Signature
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I am a:
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Job Title / Company