Information

  • Audit Reference Number

  • Auditor

  • Team/People/Branch Manager

  • Team/Work Group/Branch

  • State

  • Business Unit\ District Name

  • Region

  • Division

  • Conducted on

  • Personnel Involved

OVERVIEW

  • Opening Meeting Completed

  • If NO, please state reasons

HEALTH AND SAFETY PERFORMANCE

  • 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?

PLAN

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  • Last year's plan has been archived and stored appropriately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

RECORD

  • 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.

DO

  • 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

CHECK

  • 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

KNOW

  • 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

CLOSE

  • 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

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.