Workplace Inspection

• Document No.

• Audit Title

• Site

  VBM

  DST

  Satellite

• Location (Building, Level, Room)

• Conducted on

  Date

• Prepared by

• Personnel

General Information

• Subcontractor

  Yes

  No

  N/A

• Task Observed

• Observers

Observations

General

• Is there a Notice Board for Minutes, Policies etc.?

  Yes

  No

  N/A

• Comments

• Is the HSE Policy displayed?

  Yes

  No

  N/A

• Comments

• Is the Rehabilitation Policy displayed?

  Yes

  No

  N/A

• Comments

• Is the EAP poster displayed?

  Yes

  No

  N/A

• Comments

• Is the listing of first aiders and fire wardens displayed?

  Yes

  No

  N/A

• Comments

• Are the HSE Committee Minutes displayed?

  Yes

  No

  N/A

• Comments

• Are all walkways clear and free of trip hazards?

  Yes

  No

  N/A

• Comments

AMENITIES:

• Is the toilet facility in a clean and sanitary condition?

  Yes

  No

  N/A

• Comments

• Is the kitchen area in a clean, tidy and hygienic condition?

  Yes

  No

  N/A

• Comments

• Is the shower and wash room in a clean and tidy condition?

  Yes

  No

  N/A

• Comments

• Are the amenities in good repair?

  Yes

  No

  N/A

• Comments

EMERGENCY RESPONSE PREPAREDNESS:

• Are all fire extinguishers / hose reels readily accessible?

  Yes

  No

  N/A

• Have all extinguishers been tested in the last six months?

  Yes

  No

  N/A

• Comments

• Are exit signs all working?

  Yes

  No

  N/A

• Comments

• Have fire wardens been appointed and communicated?

  Yes

  No

  N/A

• Comments

• Are combustible materials properly stored / disposed of?<br>

  Yes

  No

  N/A

• Comments

• Are fire / emergency exits clear of obstructions?

  Yes

  No

  N/A

• Comments

• Have evacuation drills been carried out in the last six months?

  Yes

  No

  N/A

• Comments

• Is the emergency evacuation plan clearly displayed?

  Yes

  No

  N/A

• Comments

First Aid:

• Are the first aid kits well stocked and readily accessible?

  Yes

  No

  N/A

• Comments

• Is there a list of qualified first aiders attached to each kit?

  Yes

  No

  N/A

• Comments

HOUSEKEEPING:

• Is the work area in a clean and tidy state?

  Yes

  No

  N/A

• Comments

• Are adequate waste receptacles provided?

  Yes

  No

  N/A

• Comments

• Are all storage areas tidy and heavy items not stored high?

  Yes

  No

  N/A

• Comments

• Is the work area clear and free from trip hazards?

  Yes

  No

  N/A

• Comments

Electrical

• Have all electrical equipment / leads been tested & tagged?

  Yes

  No

  N/A

• Comments

• Are they currently in date for test & tag?

  Yes

  No

  N/A

• Comments

• Are electrical appliances, leads and cables in good condition?

  Yes

  No

  N/A

• Comments

CONTRACT SPECIFIC HAZARDS: (INSERT YOUR OWN)

• Any Other Conments

COMMENT / CORRECTIVE ACTION

• Comment / Corrective Action / Responsible Person / Risk Ranking / Due Date / Date Completed

  Yes

  No

  N/A

• Photo

  Media