Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Housekeeping and Physical surroundings

  • 1. Does the customer provide Kelly employees with site-specific emergency response training (e.g., fire evacuation, severe weather shelter-in-place, fire extinguisher)? <br> <br>

  • 2. Do floors appear to be clear of slip, trip and fall hazards?<br> <br>

  • 3. Do stairways, aisles and emergency exits appear to be clear, open, and accessible (i.e., unblocked, free of objects)?<br> <br>

  • Are all employees and subcontractors employees wearing safety glasses?

  • 5. Does the air quality, lighting, and general work environment appear acceptable?<br> <br>

  • 6. Do fire alarms and portable extinguishers appear to be unblocked and accessible?<br> <br>

Powered Industrial Truck

  • 1. Does customer agree to train and certify Kelly employees on the use of powered industrial vehicles?<br>

  • 2. Do powered industrial vehicles appear to be well maintained and in good working order (e.g., good tires, seat belts in good condition, fire extinguishers)?<br>

  • 3. Do powered industrial vehicle operators wear seatbelts and drive in a safe and controlled manner?<br>

  • 4. Are dock boards (i.e., dock plates, bridge plates) used when loading or unloading tractor/semi-truck trailers or other containers?<br>

  • 5. Are wheel chocks and/or a mechanical dock locking system used when loading or unloading tractor/semi-truck trailers or other containers?<br>

  • 6. If only wheel chocks are used, are procedures in place to verify that the wheel chocks are in place prior to loading or unloading tractor/semi-truck trailers or other containers?<br>

  • Are all work areas, tool storage, equipment, and lay-down areas properly marked and barricaded or protected?

  • Do all fenced areas have "no trespassing" signs posted on perimeter fencing?

Powered Lifts

  • Do all operators of powered lifts have appropriate and current (w/in 3 years) licensing through Woods to operate that equipment?

  • Are all scissor lift chains in place?

  • Are all feet planted on the platforms of the lifts (I.e. not on railings)?

  • Lull and Forklift: are seat belts being used?

  • Articulating boom and mobile platforms attached to lifts: are harnesses being used, properly worn and properly tethered?

  • Are operators of lifts outside the building wearing DOT / Hi-Viz vest?

General Safety - Observations

  • Are all barricade doors closed and locked?

  • Are all barricade edges lined up so there are no trip hazards?

  • Do all emergency exit routes and doors have free and easy access and a clear path of travel both to the door and from the door away from the building?

  • Are all ladders in use being used safely? Set up correctly / No standing on top 2 steps / etc...?

  • Are all fire extinguishers, electrical panels, fire risers/shutoffs, and other emergency equipment free from obstruction and clearly accessible?

  • Are all workers operating internal combustion equipment inside the building or other enclosed space(s) using a Carbon Monoxide monitor?

  • Are all propane containers NOT IN USE stored outside the building?

  • Are workers involved in spraying operations wearing approved respirators?

  • Are workers within 10 feet of leading edge (>6' fall to next level) wearing harness and tether to approved attachment point (5400 lbs cap.)?

  • Do all containers containing chemicals have a label showing container contents?

  • Are there any other trip/fall hazards observed inside or out as you walk the site (flooring transitions, temporary flooring changes, sidewalks, parking lots, etc...)?

Superintendent / Foreman Comments & Signature

  • COMMENTS:

  • Foreman Signature

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