Information

  • Request No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Persons Present

Summary Page

  • Assessor Comment

  • Key Issues

Company Information / Profile

  • Profile

  • Employee Numbers

  • Competent Person (Employed or Consultant)

  • Turnover

  • Wage-roll

  • Add media

  • Business Trend

  • Claims History

  • Photograph of company premise or working site

Policy Exclusions/Limitations/Information

  • Are all policy exclusions, limitations and information correct?

  • Comment:

  • n/a - Does not apply to this company
    0 - No evidence of compliance
    1 - In early stages of development/minimal evidence/anecdotal
    2 - Evidence available - out of date/incomplete
    3 - Evidence of full compliance/best practice

  • Observations - statement of facts recorded by the assessor from evidence provided at the time of the audit

    Action : to be completed within 30 days
    Recommendations - risk improvements suggested by the assessor to ensure conformity with legislation and regulations ( to be completed during the course of the policy)

  • SECTION A - HEALTH AND SAFETY MANAGEMENT

Management Understanding of Responsibilities

  • Have Directors been trained in their health and safety responsibilities?

  • Have all Managers/Supervisors been trained in their health and safety responsibilities?

  • Does the company have adequate access to competent advice?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Health and Safety Training and Development

  • Are all new starters inducted into the company health and safety issues?

  • Are all new starters given departmental health and safety issues?

  • Is health and safety included in the employee appraisal process?

  • Are employees being provided with adequate training for the tasks being carried out?

  • Is all health and safety training recorded and signed for? (Consider task, industry and statutory training).

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Security

  • Does the business have appropriate perimeter protection from trespassers?

  • Does the company have appropriate entry/exit security?

  • Are there appropriate arrangements for visitors?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Control of Contractors

  • Are contractors health and safety standards vetted prior to engagement?

  • Are contractors inducted prior to starting work?

  • Is contractor performance reviewed during and after the project/task?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Accident and Incident Management

  • Are the details of all accidents/incidents/near misses recorded?

  • Are there procedures for identifying and reporting accidents/incidents/near misses to enforcing authorities?

  • Is there a procedure for accidents/incidents/near misses investigation?

  • Are the findings of accidents/incidents/near misses investigations implemented?

  • Are accidents/incidents/near misses statistics produced and reviewed by the directors?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

  • SECTION B - RISK MANAGEMENT SYSTEMS

Health and Safety Documentation

  • Does the company have a suitable and current health and safety management system?

  • Does the company have suitable and sufficient risk assessments?

  • Does the company have assessments for all of the hazardous chemical substances being stored &used in the workplace?

  • Does the company have adequate manual handling assessments?

  • Are there records of the communication of health and safety documentation with employees?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Working Practices

  • Does the company produce documented safe systems of work for tasks?

  • Does the company implement appropriate permit to work systems?

  • Are working practices in line with industry best practice standards?

  • Are working practices adequately managed/supervised?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Work Equipment

  • If any of the following are applicable, score according to the overall management of the work equipment in accordance with regulations, industry best practice, manufacturers instruction, risk assessments, safe systems of work, inspection and maintenance

  • Mobile Plant - including excavators, dumpers, fork lift trucks

  • Compressors

  • Fixed Machinery - including guarding

  • Work at Height Equipment - including mobile towers, podiums, stepladders, ladders

  • PPE

  • Electrical Equipment - fixed and portable

  • Scaffolding

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Occupational Health

  • Do employees complete medical questionnaires?

  • Are all records/evidence of medical examinations kept?

  • Are all records of medical surveillance kept?

  • Asbestos - does the company come into contact with asbestos during the course of their undertakings? If so is there adequate management including safe systems of work and training?

  • Vibration- is vibration an issue in the work place? If so is there adequate management including safe systems of work and training?

  • Noise - is noise an issue in the work place? If so is there adequate management including safe systems of work and training?

  • Lead - does the company come into contact with lead during the course of their undertakings? If so is there adequate management including safe systems of work and training?

  • Drug and Alcohol - does the company have a clear policy and procedures suitable to the undertakings on the business?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Workplace

  • Is the workplace set-up suitable for the company undertakings?

  • Has fire safety been given adequate consideration? (Consideration given to fire risk assessment, detection, equipment, access, egress, lighting, drills)

  • Are good housekeeping standards evident at the company premise or other workplaces?

  • Have adequate arrangements been made for the segregation of vehicles and pedestrians?

  • Observation:

  • Action : to be completed within 30 days

  • Recommendation:

  • Add media

Signature of those in attendance

  • POS Auditor

  • Insured or Representative

  • Insurance Broker

  • Comments from the Insured (or representative)

  • Comments from the Broker

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.