HCSC Copy

• Document No.

• Name of Contractor:

• Conducted on:

  Date

• Auditor

• Site Contact:

• Location
  Address

• Contract:

• Sites Serviced:

• What are the main risks identified from the audit?

• Areas to follow up:

• Audit score:

• Overall audit summary:

Background Information

• HSE check complete?

  Safe

  Low Risk

  High Risk

  N/A

• Any other relevant checks under taken?

  Safe

  Low Risk

  High Risk

  N/A

Financial Information

• Has a Dunn and Bradstreet risk review been undertaken?

  Yes

  No

  N/A

• Risk score

  1

  2

  3

  4

  5

• Details:

• Have the company Directors been subject to a Directors check?

  Safe

  Low Risk

  High Risk

  N/A

• Details:

Company Information

• Registered company name:

• Managing Director:

• Does the cleaning contractor have a parent company?

  Yes

  No

  N/A

• Parent company details:

• Does the cleaning contractor have any subsidiary companies?

  Yes

  No

  N/A

• Subsidiary company details:

1.1 Site Information

• 1.11Does the cleaning contractor require a waste carriers licence

  Safe

  Low Risk

  High Risk

  N/A

• Waste carrier licence information:

Waste carriers licence

• Name of registered carrier:

• Registered as:

• Registration number:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Date of registration:

• Date of expiry:

• 1.12 Is the cleaning contractor registered as a hazardous waste producer?

  Safe

  Low Risk

  High Risk

  N/A

• Registration reference:

• Start date:

• Expiry date:

1.2 Transport Information

• 1.21 Does the cleaning contractor require a operators licence?

  Safe

  Low Risk

  High Risk

  N/A

• Licence number:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Date issued:

• Review date:

• Last review date:

• Number of vehicles:

• Number of trailers:

• 1.22 Does the cleaning contractor have valid MOT certificates? (2 examples required)

  Safe

  Low Risk

  High Risk

  N/A

• MOT certificate information

MOT certificate

• Test certificate number:

• Vehicle:

• Start date:

• End date:

• 1.23 Are the cleaning contractors vehicles fitted with GPS tracking systems?

  Yes

  No

  N/A

• 1.24 Are the cleaning contractors vehicles fitted with a Safe Cycle system? (e.g. FORS scheme in London)

  Yes

  No

  N/A

2.1 Insurance Documentation

• 2.11 Does the cleaning contractor have valid insurance documentation?

  Safe

  Low Risk

  High Risk

  N/A

• Insurance document information:

Insurance

• Type of Insurance:

• Insurer:

• Policy holder:

• Policy number:

• Issue date:

• Expiry date:

3.0Waste Transfer Documents

• 3.11What is the cleaning contractorsSIC code?

  Safe

  Low Risk

  High Risk

  N/A

• 3.12 Does the cleaning contractor maintain waste transfer notes or consignment notes?

  Safe

  Low Risk

  High Risk

  N/A

• Waste transfer note information:

Waste transfer note

• Site name:

• Date:

• EWC code:

• SIC code:

• Commitment to waste heirachy:

• Description of the waste:

• Waste producer details:

• Signature of waste producer:

• Waste transferee details:

• Signature of waste transferee:

• Final disposal details:

• Signature of final disposal:

• 3.13 Has the cleaning contractor heard of EDOC?

  Yes

  No

  N/A

• Does the cleaning contractor have any plans to implement EDOC?

• All comments given below are the answers provided by the cleaning contractor representitive. A signature is required to confirm the information provided in Section 4.0 is correct to the best of their knowledge.

4.1 Complaints

• 4.11Has the cleaning contractor received any complaints from local businesses or residents with regards to its operations?

  Safe

  Low Risk

  High Risk

  N/A

4.2 RIDDOR

• 4.21 Has the cleaning contractor reported any RIDDOR incidents?

  Safe

  Low Risk

  High Risk

  N/A

• Contractor representative signature:

  Sign

5.1 Policy Statements

• 5.11 Does the cleaning contractor have a Health and Safety Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.12 Does the cleaning contractor have an Environmental Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.13 Does the cleaning contractor have a Quality Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.14 Does the cleaning contractor have a Data Protection Policy?

  Yes

  No

  N/A

• Date:

• Management endorsement:

• 5.15 Does the cleaning contractor have a Corporate Social Responsibility Policy?

  Yes

  No

  N/A

• Date:

• Management endorsement:

• 5.16 Does the cleaning contractor have an Equal Opportunities Policy?

  Yes

  No

  N/A

• Date:

• Management endorsement:

• 5.17 Does the cleaning contractor have a Lone Working Policy?

  Yes

  No

  N/A

• Date:

• Management endorsement:

5.2 Health and Safety

• 5.21 Who is the designated Health and Safety representative? (note if site or area)

  Safe

  Low Risk

  High Risk

  N/A

• Name of representative:

• Any relevant qualifications:

• 5.22 Does the cleaning contractor have a Health and Safety handbook?

  Safe

  Low Risk

  High Risk

  N/A

• Issue date:

• Review date:

• Management endorsement:

• Document control:

5.3 Risk Assessments

• 5.31 Has the cleaning contractor carried out risk assessments? (COSHH to be documented in section 8.2)

  Safe

  Low Risk

  High Risk

  N/A

• On site risk assessments?

  Yes

  No

  N/A

• Name of risk assessment:

• Start date:

• Review date:

• Document control:

• Hazards highlighted:

• Control measures:

• Off site risk assessments?

  Yes

  No

  N/A

• Name of risk assessment:

• Start date:

• Review date:

• Document control:

• Hazards highlighted:

• Control measures:

5.4 Business Continuity

• 5.41 Does the cleaning contractor have a Business Continuity/Disaster Plan?

  Yes

  No

  N/A

• Is the Business continuity plan provided compliant?

  Safe

  Low Risk

  High Risk

  N/A

• Issue date:

• Review date:

• Owner/Author:

• On site and off site procedures?

• Tested or desktop based?

6.1 Procedures

• 6.11 Does the cleaning contractor have any emergency procedures in place?

  Safe

  Low Risk

  High Risk

  N/A

• 6.12 Does the cleaning contractor conduct routine emergency drills? (Document evidence)

  Safe

  Low Risk

  High Risk

  N/A

• 6.13 Are employees required to wear PPE on and off site?

  Yes

  No

  N/A

• Does the cleaning contractor perform equipment checks on employee PPE?

  Yes

  No

  N/A

• 6.14 Does the cleaning contractor have a written accident reporting procedure?

  Yes

  No

  N/A

• 6.14 Has the cleaning contractor produced Method Statements/Safe Working Practises/ Safe Operating Procedures?

  Safe

  Low Risk

  High Risk

  N/A

• On site procedures?

  Yes

  No

  N/A

• Name of procedure:

• Start date:

• Review date:

• Document control:

• Off site procedures?

  Yes

  No

  N/A

• Name of procedure:

• Start date:

• Review date:

• Document control:

7.1 Employee Training

• 7.11 How are policies and procedures communicated?

  Safe

  Low Risk

  High Risk

  N/A

• 7.12 Does the cleaning contractor have an induction process for new employees?

  Safe

  Low Risk

  High Risk

  N/A

• 7.13 Does the cleaning contractor provide regular training for employees?

  Safe

  Low Risk

  High Risk

  N/A

• Internal training:

• External training:

• 7.14 Does the cleaning contractor have a training matrix?

  Safe

  Low Risk

  High Risk

  N/A

• Dates trained:

• Refresher training dates:

8.1 Safety Data Sheets

• 8.11 Does the cleaning contractor hold the safety data sheets?

• 8.12 Details of at least two examples

8.2 COSHH (Control Of Substances Hazardous to Health)

• 8.21 Does the cleaning contractor have COSHH risk assessments?

  Safe

  Low Risk

  High Risk

  N/A

• Name and Date of assessment

• Has the cleaning contractor developed COSHH data sheets?

9.1 Subcontractor Information

• The risk ranking for the contractors identified in the following section is subject to change if the sub-contractors are identified as a high risk.

• 9.11 Does the cleaning contractor utilise sub-contractors/ third parties on M&S sites?

  Safe

  Low Risk

  High Risk

  N/A

• Sub-contractor/ Third party details:

Sub-contractor

• Name of contractor:

• Tasks undertaken?

• How does the cleaning contractor choose a sub-contractor?

• How does the cleaning contractor monitor their sub contractors?

• Are KPIs set?

• Does the Sub contractor require a audit?

  Yes

  No

  N/A

• Contact name:

• Email address/Phone number:

• Date of audit:

• Audit ref:

10.1 Certificates

• 10.11 Does the SP have any certifications?

  Safe

  Low Risk

  High Risk

  N/A

• Certificate information:

Certificate

• Type of certificate:

• Start date:

• Expiry date:

10.2 Awards

• 10.21 Does the cleaning contractor hold any industry awards?

  Safe

  Low Risk

  High Risk

  N/A

• Awards information:

Award

• Type of award:

• Start date:

• Expiry date:

11.1 Name of site?

• 11.11 Does the site have copies of COSHH assessments?

  Safe

  Low Risk

  High Risk

  N/A

• 11.12 Does the site have copies of Risk Assessments?

  Safe

  Low Risk

  High Risk

  N/A

• 11.13 Does the site have procedures?

  Safe

  Low Risk

  High Risk

  N/A

11.2 Site employees

• 11.21 Is PPE used correctly on site?

  Safe

  Low Risk

  High Risk

  N/A

• 11.22 Are chemicals stored in a secure place?

  Safe

  Low Risk

  High Risk

  N/A

• 11.23 Are chemicals stored in the correct containers with labels?

  Safe

  Low Risk

  High Risk

  N/A

• Off site contact signature

  Sign

11.3 Site Observations

• 11.31 Any general observations?

  Safe

  Low Risk

  High Risk

  N/A

• Signature of of main site contact

  Sign

• Auditors Signature:

  Sign