Implementation of Site Safety Management Plan CHECKLIST

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• THIS FORM IS USED FOR INITIAL SITE SAFETY VISIT. A FULL AUDIT WILL BE CONDUCTED MONTHLY

1.Management Responsibility

• Has the Principal Contractor a copy of the Site-Specific Safety Management Plan available on site

  Yes

  No

  N/A

2. Communication

• The Principal Contractor has established communication arrangements for the site

  Yes

  No

  N/A

• Are all visitors and workers required to sign in when entering site ?

  Yes

  No

  N/A

3. Risk Management - safe work method statement

• Has Principal Contractor/Sub Contractors provided job hazard analysis [JHA] for current high risk activities?

  Yes

  No

  N/A

• Has the Principal Contractor reviewed the JHA'S provided by the SubContractors?

  Yes

  No

  N/A

• Has the Principal Contractor monitored subcontractor compliance with OSHA regulations?

  Yes

  No

  N/A

• Has the Principal Contractor established procedures for managing site emergencies?

  Yes

  No

  N/A

4. At the time of the site visit were the any high risk construction work activities observed? If yes a JHA is required for that activity

• At the time of visit were any high risk activities observed

  Yes

  No

  N/A

• Were proper JHSs in place for these activities?

  Yes

  No

  N/A

5. Are measures in place to manage the risk associated with construction work

• call before you dig?

  Safe

  At Risk

  N/A

• Asbestos removal undertaken by a licensed contractor and workers supervised <br>

  Yes

  No

  N/A

• Site securely fenced to prevent unauthorized access

  Yes

  No

  N/A

• No electrical work is being done live

  Yes

  No

  N/A

• Signed confined space entry permits and JHA'S

  Yes

  No

  N/A

• Scaffolds fully decked with hand and mid rails in place and kick boards used <br>

  Yes

  No

  N/A

• Edge protection for persons at risk of fall from height

  Yes

  No

  N/A

• Traffic management plan available and is it being implemented

  Yes

  No

  N/A

• <br>if a Mobile plant being operated, eg. Barricaded areas, plant/people separated, reversing alarms, flashing lights, spotter for work close to overhead/underground power lines/cables

  Safe

  At Risk

  N/A

• Scaffold handover and inspection certificates available

  Yes

  No

  N/A

• Excavations shored and/or benched

  Safe

  At Risk

  N/A

• Location of underground services identified and clearly marked, provided to persons engaged to carry out excavations

  Safe

  At Risk

  N/A

• Items of electrical plant being used on site have current inspection and test tags<br>

  Yes

  No

  N/A

• Engineers inspection certificates available for form work

  Yes

  No

  N/A

• High risk construction work being carried out as described in JHA'S

  Yes

  No

  N/A

• Site security fence panels not being used are laid on the ground or secured to prevent them from tipping over

  Yes

  No

  N/A

• Name of Principal Contractor and after hours contact details displayed at entrance

  Yes

  No

  N/A

• Signs and barricades in place to prevent unauthorised entry to work areas

  Safe

  At Risk

  N/A

• Signs at entrance detailing all site safety and sign in requirements

  Safe

  At Risk

  N/A

6. OSHA Training

• Has Principal Contractor verified site workers OSHA training / qualification <br> work card or certificate recorded

  Yes

  No

  N/A

• Has the Principal Contractor provided orientation, training and instruction to workers with signed copies kept.<br><br>If none of the multiple choice answers chosen, contractors must demonstrate how training and induction is provided to workers

  site induction register

  site induction records eg. site induction forms

  training registers

• Have the site workers been instructed/trained in the requirements of their site specific JHA

  Yes

  No

  N/A

7. Inspection, Testing and Servicing

• Has the Principal Contractor been carrying out documented site safety inspections (audits)<br><br>Sighted completed site safety inspection records

  Yes

  No

  N/A

• Has the Principal Contractor taken action to correct issues identified in audits [if any]<br><br>Sighted sign off recording that action was taken to correct the safety issues identified

  Yes

  No

  N/A

• Has the Principal .Contractor available for review records of inspections, testing and servicing

  Site Specific Emergency Procedures displayed and the evacuation point sign posted

  emergency plan implemented

  First aid kit on site

8. Observed Safety Breaches [if any]

• Observed safety breaches [if any]

  Safe

  At Risk

  N/A

• Have you brought any observed safety breaches to the immediate attention of the Principal Contractor site management representative

  Yes

  No

  N/A

• Have you issued a site safety instruction for any observed safety breaches

  Yes

  No

  N/A

• Completed by.

  Sign

• date and time recorded

  Date

• notes:

• The purpose of the on site review of the implementation of the site specific safety management plan is for the Principal Contractor to demonstrate their site specific safety management plan. The review program for the implementation do the site specific safety management plan must be based on the project risk assessment. As a minimum an on site review [AUDIT] of the Principal Contractors implementation do the site specific safety management plan should be carried out within one month of construction work commencing on site and then once every month until completion