InFocus Safety Solutions, Inc. - PAMF PROJECT

• Audit Title

• Client / site

• Current Weather Conditions

• Conducted on

  Date

• InFocus Safety Solutions, Inc.

• Khoi Nguyen, Risk Management/Loss Control Manager

• Chris Tiamzon, Safety/Loss Control Consultant

1. Working at Heights

• 1.1. Fall risks of 6 feet or more? (including voids, pits, and trenches)

  Safe

  At Risk

  N/A

• 1.2. Lack of edge protection?

  Safe

  At Risk

  N/A

• 1.3. Unsafe or incomplete edge protection?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

2. Construction Tools and Equipment

• 2.1. Unsafe or damaged equipment? (including missing or damaged guards)

  Safe

  At Risk

  N/A

• 2.2. Incorrect equipment for job? (e.g. grinding discs for cutting)

  Safe

  At Risk

  N/A

• 2.3. Unsafe or incompatible attachments used with equipment?

  Safe

  At Risk

  N/A

• 2.4. Unlicensed operators?

  Safe

  At Risk

  N/A

• 2.5. Lack of fire extinguishers nearby? (Required for all internal combustion equipment).

  Safe

  At Risk

  N/A

• 2.6. Lack of training in safe operation, clean-up and maintenance?

  Safe

  At Risk

  N/A

• 2.7. Are electrical cords inspected and properly marked?

  Safe

  At Risk

  N/A

• 2.8. Are GFCI cords used?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

3. Scaffolds

• 3.1. Scaffolds inspected and green tagged by a competent person?

  Safe

  At Risk

  N/A

• 3.2. Lack of inspection protocol for scaffold?

  Safe

  At Risk

  N/A

• 3.3. Unsafe or incomplete scaffold?

  Safe

  At Risk

  N/A

• 3.4. Incompatible scaffold components? Planks properly rated for scaffold use?

  Safe

  At Risk

  N/A

• 3.5. Safe Work Load (SWL) exceeded? (tools, stored materials, number of persons)

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

4. Lifting Equipment

• 4.1. Unsafe or damaged equipment? (hydraulic leaks, oil leaks)

  Safe

  At Risk

  N/A

• 4.2. Loads lifted over persons, close proximity to obstacles incl. overhead power lines?

  Safe

  At Risk

  N/A

• 4.3. Operators wearing seat belts during operation?

  Safe

  At Risk

  N/A

• 4.4. Backup alarm observed?

  Safe

  At Risk

  N/A

• 4.5. Lack of daily inspection protocol?

  Safe

  At Risk

  N/A

• 4.6. Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?

  Safe

  At Risk

  N/A

• 4.7. Spotter/flagged observed when loads obstruct operator's view?

  Safe

  At Risk

  N/A

• 4.8. Unlicensed operators?

  Safe

  At Risk

  N/A

• 4.9 Are forks lowered when equipment is parked?

  Safe

  At Risk

  N/A

• 4.10. Are any lifting equipment capacity exceeded?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

5. Harness and Equipment

• 5.1. Unsafe or damaged harness or equipment?

  Safe

  At Risk

  N/A

• 5.2. Incompatible hooks/equipment?

  Safe

  At Risk

  N/A

• 5.3. Unlabelled or does not meet manufacturer's specifications?

  Safe

  At Risk

  N/A

• 5.4. Unsafe or uncertified anchor points?

  Safe

  At Risk

  N/A

• 5.5. Lack of inspection protocol for equipment?

  Safe

  At Risk

  N/A

• 5.6. Lack of or inadequate formal training for operators?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

6. Ladders

• 6.1. Unsafe or damaged ladders?

  Safe

  At Risk

  N/A

• 6.2. Unsafe positioning of ladders?

  Safe

  At Risk

  N/A

• 6.3. Ladder not properly secured?

  Safe

  At Risk

  N/A

• 6.4. Ladder unsuitable for job? (e.g. metal ladder used for electrical work)

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

7. At Risk Manual LiftingTasks

• 7.1. Proper lifting techniques observed?

  Safe

  At Risk

  N/A

• 7.2. Carts used to move materials?

  Safe

  At Risk

  N/A

• 7.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

  Safe

  At Risk

  N/A

• 7.4. Lack of training in risk controls and safe lifting/ team lifting techniques?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

8. Hazardous Chemical (including fuel and oil)

• 8.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  Safe

  At Risk

  N/A

• 8.2. Incompatible chemicals stored near each other?

  Safe

  At Risk

  N/A

• 8.3. Inadequate spill containment equipment?

  Safe

  At Risk

  N/A

• 8.4. Safety Data Sheets not accessible on site?

  Safe

  At Risk

  N/A

• 8.5. Lack of emergency procedures for injury/spills/fire etc?

  Safe

  At Risk

  N/A

• 8.6. Excessive quantities stored on site or in vehicles?

  Safe

  At Risk

  N/A

• 8.7. Insufficient ventilation?

  Safe

  At Risk

  N/A

• 8.8. Insufficient, or incorrect, PPE?

  Safe

  At Risk

  N/A

• 8.9. Unsuitable storage containers? (unlabeled or stored in food containers)

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

9. Emergency Response

• 9.1. Lack of, or no emergency plans for site?

  Safe

  At Risk

  N/A

• 9.2. Emergency procedures not displayed at site?

  Safe

  At Risk

  N/A

• 9.3. Lack of training and rehearsal of emergency plans?

  Safe

  At Risk

  N/A

• 9.4. Lack of, or inadequate first aid kits aid equipment for site?

  Safe

  At Risk

  N/A

• 9.5. Insufficient access to formally trained First Aiders for all shifts?

  Safe

  At Risk

  N/A

• 9.6. Unsuitable or inadequate communication equipment?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

10. Hot Work Operations

• 10.1. Is fire watch in place?

  Safe

  At Risk

  N/A

• 10.2. Fire extinguisher available? <br>

  Safe

  At Risk

  N/A

• 10.3. Sparks from grinding and cutting are shielded from flammables/combustibles?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

11. Personal Protective Equipment (PPE)

• 11.1. Lack of, or inadequate PPE

  Safe

  At Risk

  N/A

• 11.2. Lack of system to issue, inspect, replace and monitor PPE?

  Safe

  At Risk

  N/A

• 11.3. Lack of training in safe use, clean-up and inspection of PPE?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

12. Work Environment

• 12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  Safe

  At Risk

  N/A

• 12.2. Insufficient lighting?

  Safe

  At Risk

  N/A

• 12.3. Inadequate housekeeping?

  Safe

  At Risk

  N/A

• 12.4. Lack of, or inadequate noise/ vibration control?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

13. Electrical Hazards

• 13.1. Unsafe electrical leads? (damaged, out of test date or untested)

  Safe

  At Risk

  N/A

• 13.2. Temporary power supply secured?

  Safe

  At Risk

  N/A

• 13.3. Contact with underground utility lines?

  Safe

  At Risk

  N/A

• 13.4. Contact with overhead electrical lines?

  Safe

  At Risk

  N/A

• 13.5. Overloading outlets?

  Safe

  At Risk

  N/A

• 13.6. Leads placed on ground or on metal structures?

  Safe

  At Risk

  N/A

• 13.7. Electrical equipment near water?

  Safe

  At Risk

  N/A

• 13.8. Electrical equipment near flammables?

  Safe

  At Risk

  N/A

• 13.9. Electrical equipment near chemicals that could cause damage?

  Safe

  At Risk

  N/A

• 13.10. Electrical leads that may be damaged from contact with moving machinery parts?

  Safe

  At Risk

  N/A

• 13.11. Electrical leads on work surfaces?

  Safe

  At Risk

  N/A

• 13.12. Lack of Lock-out/tag-out (LOTO) procedures for electrical equipment?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

14. Environmental Hazards

• 14.1. Lack of/or inadequate Environmental Management plan (EMP)?

  Safe

  At Risk

  N/A

• 14.2. Lack of/or inadequate, dust suppression system?

  Safe

  At Risk

  N/A

• 14.3. Lack of/or inadequate systems to prevent contaminants entering stormwater drains?

  Safe

  At Risk

  N/A

• 14.4. Lack of water re-use systems?

  Safe

  At Risk

  N/A

• Subcontractors Observed Violating Section:

• Other Hazards noted?

  Safe

  At Risk

  N/A

Corrective Actions

• Enter any corrective actions that are pending

Sign Off

• InFocus Consultant's Signature

  Sign

• Tasks performed by InFocus Safety Solutions, Inc. today

• New hire orientation

• Jobsite inspections

• Pre task plan reviews

• Corrective actions

• Subcontractor coaching

• Email Report to:

• Bill Bunch

• Jason Oak

• John Diaz

• Joe Nelson

• Alan Thomas