Page 1: Initial questions

  • Document Number

Client

  • Client Site

  • Visit Type

  • Account Executive

  • Inspector

  • Conducted on

  • Service specialist
  • Name of service specialist

  • Is the service specialist a contractor

  • Contractor company name

  • Convergint ID in Date

  • Site Inductions
  • Sub contractor/employee site induction

Wellbeing of Embedded service specialist

  • Does the engineer feel supported

COSHH

  • Are Chemicals being used

  • Are they stored correctly and engineer has access to SDS

RAMS

  • Have RAMS been reviewed

  • Are PTW requirements in place

  • Are the RAMS signed/ has service specialist received general service RAMS through MyCompliance

  • Does Service Specialist Know how to access Point of Work Risk Assessment in PowerApps - POWRA

  • Competency levels
  • Service Specialist has conducted health and safety training

  • What training has been completed

  • Service specialist training is relevant to their job

  • PPE
  • suitable and sufficient for task

  • Operative complying with PPE requirements for site

  • PPE in good condition

Working Environment

  • Asbestos in working area

  • Is excess noise being produced that exceeds the EAL

  • Is task lighting being used where necessary

  • Is there dust and fumes being generated by any activity

  • Is the temperature reasonable at the work area

  • Are there any aspects of the work or the environment that you feel are a safety concern

Work at Height

  • Scaffold /mobile towers in use

  • Erected/dismantle by a competent person

  • MEWPS: Are they in use

  • Has it been inspected

  • Has the operative got the right competency for the plant

Ladders & Podiums

  • Are they in use

  • Are they Inspected and tagged and in good condition

  • What are the tag numbers

  • Is there a suitable storage area allocated on site

  • Is the ladder on the register held on Sharepoint

Extendable Pole

  • Has a pole been issued to the Service Specialist

  • Is the pole in good condition and working well

Signage & Barriers

  • Are they available and in use where required

Housekeeping

  • Do the engineers have a storage area to ensure tools equipment etc can be secured at the end of the day

  • Are high standards of housekeeping being implemented

  • Are all tools & equipment being stored appropriately

Calibration & PAT testing

  • Are both up to date

  • Harness & Lanyard
  • Has harness been inspected and being stored appropriately

  • Is the harness on the register

Welfare facilities

  • Are there adequate sanitary faclities

  • Is there somewhere that the service specialist can make hot food and drink

  • Service Vehicle
  • Does the service specialist have a vehicle they drive for work purposes to carry equipment and tools

  • Is the vehicle in good condition and has a recent vehicle check been carried out

Page 2: Follow up checklist

Corrective Actions

  • Are Corrective Actions required

  • What Corrective Actions are required?

  • Close out Deadline

Completion

  • I have read the report and will complete any outstanding action

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.