• Audit Reference Number

  • Auditor

  • Team/People/Branch Manager

  • Team/Work Group/Branch

  • State

  • Business Unit\ District Name

  • Region

  • Division

  • Conducted on

  • Personnel Involved


  • Opening Meeting Completed

  • If NO, please state reasons


  • How many incidents have been reported in the workgroup\team\branch (Not Scored) ?

  • How many lost time injuries were reported in the past 12 months

  • How many claims are currently open ?

  • What is the last well managed audit Score?


  • Assess the set up of the Health and Safety Operational Plan

  • Strategic Plan has been inserted into folder in leadership section

  • Risk / Hazard Profile

  • Workgroup Details Completed

  • Staff consultation has taken place

  • Generic risk / Hazard profile control template has been tailored

  • Summary page has had applicable / not applicable actions marked

  • Local Hazards Table completed where required

  • (Office Only) Site Based Action responsibility has been assigned

  • Last year's plan has been archived and stored appropriately

  • (Office Only) Evidence that Site Based Actions have been completed across multiple locations has been requested and confirmed (e.g. via email)

  • Comments


  • Assess the documented completion of the Monthly Actions
    This is a combined assessment worksheet for both Office and Branch Health and Safety Operational Plans. Where an element is not applicable, select N/A.

  • Plan has a name allocated to each action and date action completed (Month by Month basis)

  • Completed forms are on site e.g. relevant checklists (if online, known and accessible by staff)

  • Evidence of monthly action completion such as Team Talk template, meeting minutes, emails etc.


  • Enter all actions scheduled in the past 6 months and assess completion

  • Branch\People Manager Action
  • Branch / People Manager Action Name

  • Action Completed

  • Have all actions been signed off by the Branch / People Manager


  • These key plan actions have been sourced for the Office / Branch Quarterly Workplace Inspections. Auditors are to use the Quarterly Workplace Inspection checklist as guidance when reviewing the actions.

  • HSW Noticeboard

  • Emergency Planning and Preparedness

  • Manual Handling

  • Office Equipment

  • Electrical

  • Chemicals

  • Step ladder / Platform Ladder

  • Housekeeping

  • Noise / Headsets (Contact Centres Only)

  • Contractors and Visitors

  • Lighting (not applicable in major buildings)

  • Cleaners Equipment (if stored on premises and accessible)

  • Outdoor Areas (Branch only)

  • Review of action plan

  • BBQ / Gas Cylinders


  • Interview of Manager\s and Employees of the following elements
    1. Information and Training
    2. Managing Hazards
    3. Managing Incidents

    As a minimum of 3 interviews must be completed (including a manager)

  • Knowledge Check

  • Interview
  • Select role

  • Enter Initials

  • Hazard Management

  • Understanding of a hazard and how to manage it

  • Actions to take if a hazard is observed

  • Managing Incidents

  • Understanding of types of emergencies in the workplace

  • Understanding of how and when incidents are reported

  • Understanding of priorities when and incident is reported

  • Understanding of type of incidents that need to be reported

  • Information and Training

  • Provision of health and safety information on a regular basis

  • Emergency Management and response

  • Accessibility of health and safety information

  • Induction of new / transferred staff into the health and safety requirements of ANZ


  • Documentation and Activities as noted on the audit scope were assessed according to the Audit Schedule

  • All relevant observations, comments and scores were discussed and agreed with the appropriate personnel

  • A plan of recommended actions has been agreed with the Branch / People Manager

  • A closing meeting was conducted

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