HSE Inspection & Behavioural Observations Form

• Audit Title/ Area Name

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• INSTRUCTIONS
  
  1. Answer "Yes" or "No" on the questions below.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link

1. General Safety

• Are walkways clear?

  YES

  NO

• Is lighting sufficient?

  YES

  NO

• Is the H&S Policy Statement on display?

  YES

  NO

• Are employees exposed to hazardous substances?

  YES

  NO

• Are up to date risk assessments available in the office?

  YES

  NO

• Are contractors working in the area? If so, are they using relevant PTW?

  YES

  NO

• Are Local Level meeting minutes on display?

  YES

  NO

• Are goods and/or equipment stored safely & securely?

  YES

  NO

2. Safe Systems of Work (STOPS)

• Is there a STOP available for the task being observed?

  YES

  NO

• Is the STOP adequate?

  YES

  NO

• Is the STOP being followed and understood?

  YES

  NO

• Is there a RA for this task, and if so is it adequate and up to date?

  YES

  NO

3. Emergency Aids

• Are First Aider names and photos on display?

  YES

  NO

• Is there a first aid box in the area? If so, is it correctly stocked with ‘in date’ supplies?

  YES

  NO

• Is there an accident book in the area?

  YES

  NO

• Are fire escape routes clear?

  YES

  NO

• Is fire equipment not blocked i.e. extinguishers and call points?

  YES

  NO

4. Behavioural Observations

• Is there any horse play?

  YES

  NO

• Are there any repetitive motions?

  YES

  NO

• Is the mandatory PPE being worn correctly?

  YES

  NO

• Is job specific PPE being used and if so, is it being worn correctly?

  YES

  NO

• Are colleagues putting themselves and/or others at risk?

  YES

  NO

5. Tools and Equipment

• Is the condition of the tools and/or equipment being used fit for use?

  YES

  NO

• Are they correct for the job?

  YES

  NO

• Are tools and/or equipment being used in the correct manner?

  YES

  NO

6. Environmental

• Is waste being correctly segregated?

  YES

  NO

• Are correct waste containers being used?

  YES

  NO

• Are there any spill kits in the area? If so, are they fully stocked?

  YES

  NO

• Is there any evidence of spillages that could have an adverse effect on the environment?

  YES

  NO

• Is machinery running unnecessarily when not in use?

  YES

  NO

• Is there any evidence of water leaks or taps/hoses being left on?

  YES

  NO

• Is there any evidence of excessive water usage?

  YES

  NO

• Lights left on

  YES

  NO

7. Additional Comments/Observations

• Click ADD Comments to enter additional comments and observations

Comments

• Comments/Observations

• Scroll up and click +ADD to add a new entry
  

Completion

• Name & Signature

  Sign