Information

  • Observer:

  • Other Observer:

  • COMPANY:

  • Conducted on

  • Location
  • Property photo

  • Describe Work Being Done:

  • Employees On Job:

  • PFM Contract:

  • PFM Contract:

POLICY COMPLIANCE REQUIREMENT (Y/N)

  • 1. Individual paperwork complete?

  • Corrective Action/Positive Comments

  • Root Cause

  • 2. Vehicle/Equipment paperwork complete?

  • Corrective Action/Positive Comments

  • Root Cause

  • 3. Job paperwork complete?

  • Corrective Action/Positive Comments

  • Root Cause

  • 4. Equipment maintained all faults reported and paperwork complete?

  • Corrective Action/Positive Comments

  • Root Cause

  • 5. Crew have correct PPE and uniform?

  • Corrective Action/Positive Comments

  • Root Cause

  • 6. JCF comprehensive and accurate?

  • Corrective Action/Positive Comments

  • Root Cause

  • 7. Job on time and budget & crew understand targets required?

  • Corrective Action/Positive Comments

  • Root Cause

  • 8. Personnel appearance is appropriate?

  • Corrective Action/Positive Comments

  • Root Cause

  • 9. Conduct with client is professional and polite?

  • Corrective Action/Positive Comments

  • Root Cause

  • 10. Work plan achieves optimal results for client?

  • Corrective Action/Positive Comments

  • Root Cause

  • 11. Resource usage minimised, no excessive use?

  • Corrective Action/Positive Comments

  • Root Cause

  • 12. Waste is minimised and controlled?

  • Corrective Action/Positive Comments

  • Root Cause

  • 13. Impact on plants, atmosphere & animals is minimised?

  • Corrective Action/Positive Comments

  • Root Cause

  • 14. All waste is removed responsibly?

  • Corrective Action/Positive Comments

  • Root Cause

  • 15. Hazardous substances known (ie MSDS) & controlled?

  • Corrective Action/Positive Comments

  • Root Cause

  • 16. SWMS is correct, read & followed?

  • Corrective Action/Positive Comments

  • Root Cause

  • 17. SWMS/JSEA complete & focuses on specific issues?

  • Corrective Action/Positive Comments

  • Root Cause

  • 18. Job site is defined & controlled?

  • Corrective Action/Positive Comments

  • Root Cause

  • 19. Personnel have correct endorsements/licences for work?

  • Corrective Action/Positive Comments

  • Root Cause

  • 20. ALL safe practices are followed at all times?

  • Corrective Action/Positive Comments

  • Root Cause

  • 21. Crew have task skills to perform work?

  • Corrective Action/Positive Comments

  • Root Cause

  • 22. Crew have skills to manage competing priorities?

  • Corrective Action/Positive Comments

  • Root Cause

  • 23. Crew have contingency management skills to deal with change?

  • Corrective Action/Positive Comments

  • Root Cause

  • 24. Crew perform job role skills & deal with people on the job?

  • Corrective Action/Positive Comments

  • Root Cause

  • 25. Attitudes are positive & professional?

  • Corrective Action/Positive Comments

  • Root Cause

ACTIONS REQUIRED:

  • Details of any actions required:

  • Entered into records:

  • Signature:

  • Actions Closed:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.