Title Page
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Document No.
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Audit Title
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Conducted on
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Prepared by
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Location
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Personnel
Pre-site checks
Pre-site checks
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Have you checked the CRIP rating - if the property is tenanted
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Have you checked the property/surrounds risk information
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Have you completed a SWP if needed<br>
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Have you arranged the visit as per established protocols and notified others
Self Assessment
Self assessment and Situational Awareness
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Is my Secure Locate activated
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Is it safe to exit my vehicle
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Is the site secure and safe to enter
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Am I inducted to this site
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Am I wearing the correct PPE
Site Assessment - Part 1
Site Assessment Mandatory Section
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Is fencing installed to prevent access to site
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Is access control effective, no unauthorised access
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Is "Sign in and out" system in place
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Is the Hazard/Risk Register board in place
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Has the Hazard/Risk Register board been updated today
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Are the PPE requirements displayed
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Are "No Entry" signs in place
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Is a "Report to site office" sign in place
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Are "Danger" signs in place and appropriate for risk (e.g. asbestos)
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Is induction offered to me
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Are the risks on site described
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Do the risks mentioned match the Hazard/Risk Register board
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Are PPE requirements described
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Is my induction recorded
Site Assessment - Part 2
Site Assessment Optional Section depending on activities on site/to be targeted
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Emergency Equipment Section
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Is a fire extinguisher available
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Is the first aid kit complete and available
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Is a spillage kit on site
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Are risk specific Emergency Response Plans available and easy to access
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Are emergency numbers available and easy to access
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Documentation Section
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Are clearance certificates on site e.g. asbestos, methamphetamine
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Is a SSSP available on site
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Are safety meeting minutes added to SSSP
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Is the SSSP in daily use
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Is SSSP content known on site
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Are SDS available and easy to access
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If asbestos being removed, is an Asbestos Removal Control Plan at site and being followed
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If a Traffic Management Plan is in place, is it being followed
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Site housekeeping and facilities Section
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General site tidy and orderly, free of trip hazards
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Are materials stacked safely
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Are materials damaged beyond use (chemical decon only)
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Are stacking areas demarcated
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Are hazards demarcated (e.g. trenches)
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Are waste materials stored in bins
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Are waste materials sorted for recycling
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Are bins used for hazardous materials lined
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Are bins marked correctly
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Are toilet facilities and running water accessible on site
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Are exposed reinforcing bars capped
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Personnel on site Section
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ID tags carried and current
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Supervisor or designated backup available on site during visit
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PPE and manual handling Section
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Are requirements known on site
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Are all workers wearing correct PPE
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Are there clean/contaminated areas for PPE on/off and cleaning
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Are acceptable manual handling methods being used for tasks observed
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Working at Height Section
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Has the most appropriate equipment been chosen for work at height e.g. scaffolding, mobile scaffolding, elevated platform, ladder
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Confirm no elevated work within 4 m of powerline
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Scaffolding Section
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Is edge protection installed effectively
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Is the tag valid (present, weekly inspection recorded, completed in full)
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If the scaffolding exceeds 5m in height has WorkSafe been notified<br>
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If the scaffolding exceeds 5m in height has it been erected by a holder of a current certificate of competence
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Is scaffolding installed to standard (incl. base boards, platforms, toe boards, stabilising legs, stand offs, gates, ladder attachments)
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Ladders Section
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Is the ladder set up at 1:4 ratio (1m horizontal to 4m vertical)
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Can users maintain 3 points of contact at all times
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Is the ladder secured at top and base to prevent slipping sideways/out
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Do all ladders have more than 3 steps
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Power Supply Section
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Are safety devices in place
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If power isolated is a lock out device in place with tag
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Have power source (e.g. distribution box) leads been tagged
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Are tags valid
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Do leads appear to be in good working order
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Are leads used in a safe manner
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Electrical Equipment Section
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Are power tools tagged
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Are tags valid
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Do the power tools appear to be in good working order
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Tools & Machinery Section
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Are safety devices operable i.e. not tampered with
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Are the right tools or machinery being used for the job
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Are all dangerous parts guarded
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Do all tools and machinery appear to be in good working order
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Hazardous Substances Section
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Is dust control in place at source for respirable dust and/or paint particles e.g. timber, silica, lead based paint
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Are lead test results on site
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Is plastic sheeting in place for lead based paint removal <br>
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Is HNZ permitted method used for lead based paint removal (chemical stripping, wet scraping, wet hand sanding, low-temperature heat processes (under 200°c))<br>
Summary
Positive Observations
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Add media
Opportunities for improvement
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Add media
Actions completed at site
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Add media
Agree future/corrective actions
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Add media