Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
General Information
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Time Begun
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Today's Date
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Location
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Site Code
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Service Code
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Subcontractor
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Subcontractor
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Task Observed
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Observers
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Observations
General
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1. Is there a Notice Board for Minutes, Policies etc.?
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Comments
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2. Is the HSE Policy displayed?
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Comments
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3. Is the Rehabilitation Policy displayed?
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Comments
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4. Are the HSE Committee Minutes displayed?
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Comments
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5. Are monthly/periodic safety statistics displayed?
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Comments
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6. Is the injury reporting procedure flowchart displayed?
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Comments
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7. Has a JHA/SWMS been conducted for the task hazards?
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Comments
AMENITIES:
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8. Is the toilet facility in a clean and sanitary condition?
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Comments
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9. Is the kitchen area in a clean, tidy and hygienic condition?
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Comments
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10. Is the shower and wash room in a clean and tidy condition?
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Comments
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11. Is the locker room clean and tidy?
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12. Has the rubbish been cleared?
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13. Is there adequate supply of clean, fresh drinking water?
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14. Are the amenities in good repair?
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Comments
EMERGENCY RESPONSE PREPAREDNESS:
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15. Are all fire extinguishers / hose reels readily accessible?
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16. Have all extinguishers been tested in the last six months?
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Comments
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17. Are signs indicating specific use of fire extinguishers in place?
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Comments
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18. Have site personnel been trained in the use of extinguishers?
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Comments
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19. Are combustible materials properly stored/disposed of?<br>
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Comments
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20. Is there easy access to firefighting equipment?
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Comments
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21. Do emergency service vehicles have clear access to the site?
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Comments
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22. Have evacuation drills been carried out in the last six months?
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Comments
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23. Is there a functioning alarm system for emergencies?
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Comments
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24. Is the emergency evacuation diagram displayed?
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Comments
First Aid:
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25. Is there an adequate number of first aid kits?
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Comments
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26. Are the first aid kits well stocked and readily accessible?
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Comments
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27. Is there a list of qualified first aiders attached to each kit?
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Comments
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28. Are the kits clearly visible/accessible?
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Comments
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29. Are first aiders identified by safety vests or similar
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Comments
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30, Are emergency eyewash/shower facilities clean and serviceable?
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Comments
HEALTH, SAFETY & ENVIRONMENT REPRESENTATIVES
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31. Is there a Site HSE Committee with elected HSE representatives?
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Comments
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32. Do personnel know who the HSE Representatives are?
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Comments
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33. Have HSE Representatives/Committee inspected the site?
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Comments
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34. Have the HSE Representatives/Committee been trained?
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Comments
PEOPLE:
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35. Are personnel undertaking the work task trained/qualified?
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Comments
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36. Are personnel undertaking the task in a competent manner?
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Comments
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37. Have personnel involved been consulted regarding the task?
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Comments
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38. Is plant & equipment being used safely as per procedures?
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Comments
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39. Are safety procedures covered during induction being adhered to?
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Comments
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40. Are safe work procedures understood and followed?
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Comments
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41. Are any unacceptable behaviours observed?
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Comments
HOUSEKEEPING:
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42. Is the work area in a clean and tidy state?
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Comments
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43. Is there adequate, appropriate and clear signage?
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Comments
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44. Are all storage areas tidy and heavy items not stored high?
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Comments
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45. Is the work area clear and free from trip hazards?
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Comments
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46. Is a recycling program in place?
Access and Egress
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47. Is there safe access around the work area?
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Comments
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48. Is lighting adequate for safe access?
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Comments
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49. Are access ways in storage areas/containers free of obstructions?
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Comments
Ladders
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50. Are all ladders stable and securely fixed at the top and bottom?
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Comments
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51. Are all rungs and stiles intact and in good condition?
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Comments
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52. Is the slope of the ladder at a safe angle 4:1?
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Comments
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53. Are the ladders clear of doorways?
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Comments
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54. Do the ladders extend at least 1m above landing places?
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Comments
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55. Are only fibreglass or timber ladders used near electricity?
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Comments
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56. Are ladders protected from moving vehicles?
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Comments
Electrical
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57. Have all electrical equipment / leads been tested & tagged?
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Comments
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58. Are they currently in date for test & tag?
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Comments
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59. Are RCD’s used with all portable electrical equipment?
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Comments
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60. Are electrical appliances, leads and cables in good condition?
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Comments
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61. Is electrical equipment properly stored when not in use?
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Comments
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62. Are extension leads supported above work and damp areas?
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Comments
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63. Do ‘made-up’ leads have clear plugs fitted?
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Comments
COMPRESSED GASES:
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64. Are cylinders stored upright and secured?
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Comments
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65. Are cylinders free from grease and oil?
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Comments
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66. Are cylinders turned off at the main valve and not the regulator?
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Comments
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67. Is storage and transport adequate?
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Comments
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68. Are all cylinders fitted with flashback arresters?
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Comments
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69. Are gas cutting equipment hoses in good condition?
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Comments
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70. Are compressed air hoses secured with pins/chains?
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Comments
PLANT, EQUIPMENT & VEHICLES:
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71. Are all plant / trucks fitted with functioning reversing alarms?
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Comments
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72. Is there a schedule for plant, equipment & vehicles maintenance?
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Comments
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73. Do only qualified/licensed personnel operate the plant/equipment?
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Comments
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74. Are extinguishers installed and operable?
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Comments
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75. Is the plant working too close to overhead power lines?
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Comments
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76. Does all plant have Safe Working Loads (SWL) clearly displayed?
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Comments
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77. Is plant in enclosed spaces fitted with exhaust emission devices?
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Comments
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78. Does each item of plant have a correctly filled out logbook?
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Comments
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79. Are Personal Danger Tags correctly completed and in place?
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Comments
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80. Are Out of Service Tags correctly completed and in place?
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Comments
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81. Are barricades / barrier tape in use?
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Comments
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82. Are isolations / lockouts in use?
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Comments
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83. Are loading exclusion zones established?
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Comments
PERSONAL PROTECTIVE EQUIPMENT:
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84. Is eye protection worn when necessary?
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85. Are hard hats worn when necessary?
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86. Is foot protection adequate?
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87. Is SPF30+ sunscreen provided for personnel exposed to the sun?
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88. Has appropriate clothing been supplied?
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89. Are appropriate gloves provided to protect hands?
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90. Is hearing protection worn when necessary?
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91. Is respiratory protection worn when necessary?
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92. Is PPE regularly checked and replaced if necessary?
HAZARDOUS SUBSTANCES:
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93. Is there a register of Dangerous Goods & Haz. Subs?
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94. Is there a store for Dangerous Goods & Haz. Subs?
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95. Are SDS’s available for all substances in this area/store?
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96. Is there adequate signage around this store?
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97. Are all containers clearly labelled?
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98. Is ventilation equipment operating effectively?
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99. Is the amount stored in accordance with statutory limits?
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100. Is waste material stored/disposed in a safe manner?
EXCAVATION WORK:
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101. Are sides of excavations shored or otherwise made safe?
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102. Is access into excavations adequate?
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103. Are excavations adequately barricaded/fenced?
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104. Has the area been checked for buried services?
SCAFFOLDING:
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105. Are there solid foundations under the scaffolding?
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106. Are there proper sole and base plates for the standards?
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107. Is there adequate bracing in all directions?
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108. Are handrails & toe boards in place on all scaffolds over 2m/6ft.8in.?
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109. Are all work platforms fully decked out?
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110. Is scaffolding tied to the structure at least every 3.6m/11ft. in height?
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111. Do mobile scaffolds have lockable castor wheels?
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112. Are all wheels locked when the scaffold is in use?
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113. Is there safe ladder access to the mobile scaffold?
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114. Are scaffolds inspected regularly by a competent/qualified person?
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115. Are protruding parts of the structure covered to prevent injury?
WELDING AND GRINDING:
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116. Are protective screens used during welding operations?
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117. Are welder/grinder/cutter operators using appropriate PPE?
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118. Are all personnel protected against welding/grinding operations?
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119. Has a hot work permit been completed?
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120. Is atmospheric monitoring required?
MANUAL HANDLING:
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121. Have all personnel been trained in manual handling techniques?
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122. Are correct manual handling techniques being followed?
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123. Is mechanical equipment available for lifting heavy loads?
ENVIRONMENTAL WORK PRACTICES:
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124. Have inspections confirmed no leaks/spills exist causing pollution?
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125. Is waste being stored and disposed appropriately?
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126. Do checks confirm no noise/air pollution from plant & equipment?
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127. Is there sufficient containment for drums, tanks & other containers?
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128. Are there spill kits available for use?
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129. Is possible impact to land, air, water & noise monitored?
CONTRACT SPECIFIC HAZARDS: (INSERT YOUR OWN)
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Any Other Conments
COMMENT / CORRECTIVE ACTION
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Comment / Corrective Action / Responsible Person / Risk Ranking / Due Date / Date Completed
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