Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • Time Begun

  • Today's Date

  • Location
  • Site Code

  • Service Code

  • Add signature

  • Subcontractor

  • Subcontractor

  • Task Observed

  • Observers

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

Observations

General

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

  • Comments

  • 2. Is the HSE Policy displayed?

  • Comments

  • 3. Is the Rehabilitation Policy displayed?

  • Comments

  • 4. Are the HSE Committee Minutes displayed?

  • Comments

  • 5. Are monthly/periodic safety statistics displayed?

  • Comments

  • 6. Is the injury reporting procedure flowchart displayed?

  • Comments

  • 7. Has a JHA/SWMS been conducted for the task hazards?

  • Comments

AMENITIES:

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

  • Comments

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

  • Comments

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

  • Comments

  • 11. Is the locker room clean and tidy?

  • 12. Has the rubbish been cleared?

  • 13. Is there adequate supply of clean, fresh drinking water?

  • 14. Are the amenities in good repair?

  • Comments

EMERGENCY RESPONSE PREPAREDNESS:

  • 15. Are all fire extinguishers / hose reels readily accessible?

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

  • Comments

  • 17. Are signs indicating specific use of fire extinguishers in place?

  • Comments

  • 18. Have site personnel been trained in the use of extinguishers?

  • Comments

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

  • Comments

  • 20. Is there easy access to firefighting equipment?

  • Comments

  • 21. Do emergency service vehicles have clear access to the site?

  • Comments

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

  • Comments

  • 23. Is there a functioning alarm system for emergencies?

  • Comments

  • 24. Is the emergency evacuation diagram displayed?

  • Comments

First Aid:

  • 25. Is there an adequate number of first aid kits?

  • Comments

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

  • Comments

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

  • Comments

  • 28. Are the kits clearly visible/accessible?

  • Comments

  • 29. Are first aiders identified by safety vests or similar

  • Comments

  • 30, Are emergency eyewash/shower facilities clean and serviceable?

  • Comments

HEALTH, SAFETY & ENVIRONMENT REPRESENTATIVES

  • 31. Is there a Site HSE Committee with elected HSE representatives?

  • Comments

  • 32. Do personnel know who the HSE Representatives are?

  • Comments

  • 33. Have HSE Representatives/Committee inspected the site?

  • Comments

  • 34. Have the HSE Representatives/Committee been trained?

  • Comments

PEOPLE:

  • 35. Are personnel undertaking the work task trained/qualified?

  • Comments

  • 36. Are personnel undertaking the task in a competent manner?

  • Comments

  • 37. Have personnel involved been consulted regarding the task?

  • Comments

  • 38. Is plant & equipment being used safely as per procedures?

  • Comments

  • 39. Are safety procedures covered during induction being adhered to?

  • Comments

  • 40. Are safe work procedures understood and followed?

  • Comments

  • 41. Are any unacceptable behaviours observed?

  • Comments

HOUSEKEEPING:

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

  • Comments

  • 43. Is there adequate, appropriate and clear signage?

  • Comments

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

  • Comments

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

  • Comments

  • 46. Is a recycling program in place?

Access and Egress

  • 47. Is there safe access around the work area?

  • Comments

  • 48. Is lighting adequate for safe access?

  • Comments

  • 49. Are access ways in storage areas/containers free of obstructions?

  • Comments

Ladders

  • 50. Are all ladders stable and securely fixed at the top and bottom?

  • Comments

  • 51. Are all rungs and stiles intact and in good condition?

  • Comments

  • 52. Is the slope of the ladder at a safe angle 4:1?

  • Comments

  • 53. Are the ladders clear of doorways?

  • Comments

  • 54. Do the ladders extend at least 1m above landing places?

  • Comments

  • 55. Are only fibreglass or timber ladders used near electricity?

  • Comments

  • 56. Are ladders protected from moving vehicles?

  • Comments

Electrical

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

  • Comments

  • 58. Are they currently in date for test & tag?

  • Comments

  • 59. Are RCD’s used with all portable electrical equipment?

  • Comments

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

  • Comments

  • 61. Is electrical equipment properly stored when not in use?

  • Comments

  • 62. Are extension leads supported above work and damp areas?

  • Comments

  • 63. Do ‘made-up’ leads have clear plugs fitted?

  • Comments

COMPRESSED GASES:

  • 64. Are cylinders stored upright and secured?

  • Comments

  • 65. Are cylinders free from grease and oil?

  • Comments

  • 66. Are cylinders turned off at the main valve and not the regulator?

  • Comments

  • 67. Is storage and transport adequate?

  • Comments

  • 68. Are all cylinders fitted with flashback arresters?

  • Comments

  • 69. Are gas cutting equipment hoses in good condition?

  • Comments

  • 70. Are compressed air hoses secured with pins/chains?

  • Comments

PLANT, EQUIPMENT & VEHICLES:

  • 71. Are all plant / trucks fitted with functioning reversing alarms?

  • Comments

  • 72. Is there a schedule for plant, equipment & vehicles maintenance?

  • Comments

  • 73. Do only qualified/licensed personnel operate the plant/equipment?

  • Comments

  • 74. Are extinguishers installed and operable?

  • Comments

  • 75. Is the plant working too close to overhead power lines?

  • Comments

  • 76. Does all plant have Safe Working Loads (SWL) clearly displayed?

  • Comments

  • 77. Is plant in enclosed spaces fitted with exhaust emission devices?

  • Comments

  • 78. Does each item of plant have a correctly filled out logbook?

  • Comments

  • 79. Are Personal Danger Tags correctly completed and in place?

  • Comments

  • 80. Are Out of Service Tags correctly completed and in place?

  • Comments

  • 81. Are barricades / barrier tape in use?

  • Comments

  • 82. Are isolations / lockouts in use?

  • Comments

  • 83. Are loading exclusion zones established?

  • Comments

PERSONAL PROTECTIVE EQUIPMENT:

  • 84. Is eye protection worn when necessary?

  • 85. Are hard hats worn when necessary?

  • 86. Is foot protection adequate?

  • 87. Is SPF30+ sunscreen provided for personnel exposed to the sun?

  • 88. Has appropriate clothing been supplied?

  • 89. Are appropriate gloves provided to protect hands?

  • 90. Is hearing protection worn when necessary?

  • 91. Is respiratory protection worn when necessary?

  • 92. Is PPE regularly checked and replaced if necessary?

HAZARDOUS SUBSTANCES:

  • 93. Is there a register of Dangerous Goods & Haz. Subs?

  • 94. Is there a store for Dangerous Goods & Haz. Subs?

  • 95. Are SDS’s available for all substances in this area/store?

  • 96. Is there adequate signage around this store?

  • 97. Are all containers clearly labelled?

  • 98. Is ventilation equipment operating effectively?

  • 99. Is the amount stored in accordance with statutory limits?

  • 100. Is waste material stored/disposed in a safe manner?

EXCAVATION WORK:

  • 101. Are sides of excavations shored or otherwise made safe?

  • 102. Is access into excavations adequate?

  • 103. Are excavations adequately barricaded/fenced?

  • 104. Has the area been checked for buried services?

SCAFFOLDING:

  • 105. Are there solid foundations under the scaffolding?

  • 106. Are there proper sole and base plates for the standards?

  • 107. Is there adequate bracing in all directions?

  • 108. Are handrails & toe boards in place on all scaffolds over 2m/6ft.8in.?

  • 109. Are all work platforms fully decked out?

  • 110. Is scaffolding tied to the structure at least every 3.6m/11ft. in height?

  • 111. Do mobile scaffolds have lockable castor wheels?

  • 112. Are all wheels locked when the scaffold is in use?

  • 113. Is there safe ladder access to the mobile scaffold?

  • 114. Are scaffolds inspected regularly by a competent/qualified person?

  • 115. Are protruding parts of the structure covered to prevent injury?

WELDING AND GRINDING:

  • 116. Are protective screens used during welding operations?

  • 117. Are welder/grinder/cutter operators using appropriate PPE?

  • 118. Are all personnel protected against welding/grinding operations?

  • 119. Has a hot work permit been completed?

  • 120. Is atmospheric monitoring required?

MANUAL HANDLING:

  • 121. Have all personnel been trained in manual handling techniques?

  • 122. Are correct manual handling techniques being followed?

  • 123. Is mechanical equipment available for lifting heavy loads?

ENVIRONMENTAL WORK PRACTICES:

  • 124. Have inspections confirmed no leaks/spills exist causing pollution?

  • 125. Is waste being stored and disposed appropriately?

  • 126. Do checks confirm no noise/air pollution from plant & equipment?

  • 127. Is there sufficient containment for drums, tanks & other containers?

  • 128. Are there spill kits available for use?

  • 129. Is possible impact to land, air, water & noise monitored?

CONTRACT SPECIFIC HAZARDS: (INSERT YOUR OWN)

  • Any Other Conments

COMMENT / CORRECTIVE ACTION

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

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