Audit

General Information
Select date

Place of Observation

Work Description

JSEA #

Duration

Number of people being observed

Number of Observers

Observation team

Full Name and Position

Observations
Work Environment/Conditions

Housekeeping and Layout

Securing of Equipment

Barricades and Signage

Environmental Controls

Systems/Standards/Procedures

Lock-out & Tag-out

Work Permits

Competence for task

JSEA/SOP/WI/Pre Start Check/MSDS

Available?

Adequate?

Understood?

Followed

Tools and Equipment

Condition

Availability

People/Behaviour
Positions

In, On or Between

In the Line of Fire

Actions

Exerting or Rushing

Ascending or Descending

Loading, Lifting or Handling

Working at Heights

Communication

Protection

Use of P.P.E

Electrical Hazards

Hazardous Substances

Other Energy Sources

Tools/Equipment/Machinery

Tools and Equipment

Vehicles & Machinery

Good Observations

Category and Observation

At-Risk Observations

Category and Observation

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.