Homesafe

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

RISK ASSESSMENT / HAZARD AWARENESS

• Job Ref No. Date of Visit<br><br><br><br>

  Yes

  No

  N/A

• SAFE or. UNSAFE?<br>

  Safe

  At Risk

  N/A

• WHAT? WHY?<br>

  Safe

  At Risk

  N/A

• HOW?<br><br>Recognise / Refine / Rectify<br>

  Safe

  At Risk

  N/A

• Add signature

  Sign

MANUAL HANDLING

• Job Ref No. Date of Visit

  Yes

  No

  N/A

• SAFE. or. UNSAFE?

  Safe

  At Risk

  N/A

• WHAT? WHY?

  Safe

  At Risk

  N/A

• HOW? Recognise / Refine / Rectify

  Safe

  At Risk

  N/A

• Add signature

  Sign

PPE USAGE

• Job Ref No: Date of Visit

  Yes

  No

  N/A

• SAFE. or. UNSAFE?

  Safe

  At Risk

  N/A

• WHAT? WHY?

  Safe

  At Risk

  N/A

• HOW? Recognise. /. Refine. /. Rectify

  Safe

  At Risk

  N/A

• Add signature

  Sign

LADDER / CABLING HIERARCHY

• Job Ref No: Date of Visit:

  Yes

  No

  N/A

• SAFE. or. UNSAFE?

  Safe

  At Risk

  N/A

• WHAT? WHY?

  Safe

  At Risk

  N/A

• HOW? Recognise. /. Refine. /. Rectify

  Safe

  At Risk

  N/A

• Add signature

  Sign

DAMAGE AWARENESS

• Job Ref No: Date of Vist:

  Yes

  No

  N/A

• SAFE. or. UNSAFE?

  Safe

  At Risk

  N/A

• WHAT? WHY?

  Safe

  At Risk

  N/A

• HOW? Recognise. /. Refine. /. Rectify

  Safe

  At Risk

  N/A

• Add signature

  Sign

OVERALL BEHAVIOUR

• Job Ref No: Date of Visit:

  Yes

  No

  N/A

• SAFE. or. UNSAFE?

  Safe

  At Risk

  N/A

• WHAT? WHY?

  Safe

  At Risk

  N/A

• HOW? Recognise. /. Refine. /. Rectify

  Safe

  At Risk

  N/A

• Add signature

  Sign