Title Page
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Client / Site
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Project Reference
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Address
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Region
- Heathrow
- Rugeley
- Skipton
- PTL
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Site Supervisor
SECTION 1 - NON OPERATIONAL HEALTH AND SAFETY DOCUMENTATION
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1.1 Is there a copy of the Health and Safety policy statement displayed or held in the site file?
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Please explain why:
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1.2 Is there a copy of the Environment and Energy policy statement displayed or held in the site file?
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Please explain why:
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1.3 Is there a copy of the Quality policy statement displayed or held in the site file?
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Please explain why:
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1.4 Is there a copy of the Employees Liability Insurance certificate displayed or held in the site file?
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Please explain why:
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1.5 Have all employees been issued with the latest ISS Health & Safety handbook and tear out page been completed? (Clarification may need to be sought by the Regional Admin)
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Please explain why:
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1.6 Are all documents current and controlled copies?
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Please explain why:
SECTION 2 - OPERATIONAL HEALTH AND SAFETY DOCUMENTATION
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2.1 Has a site specific risk assessment (QREC13) been completed, does it identify significant risks and are suitable and sufficient control measures in to place?
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2.1.1 Have all employees signed onto the risk assessment?
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Please explain why:
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Please explain:
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2.1.2 Please take a picture of each page of the risk assessment including the signing sheet
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2.2 Has the contents of the risk assessment been communicated to all employees and are they available for everyone to view?
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Please explain why:
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2.3 Are method statements available for the tasks to be carried out?
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Please explain:
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2.4 Can you ensure that employees training certification for the equipment being used is valid? (Clarification may need to be sought by the Regional Admin)
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Please explain why:
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2.5 Have daily inspections been carried out for all MEWP's if applicable and recorded on QREC 94?
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Please explain why:
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2.6 Have scaffold tower inspection sheets or 'scaff tags' been completed if applicable and recorded on QREC 54?
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Please explain:
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2.7 If the project requires a permit to work is one in place? This could include, hot work, roof work, confined spaces, rope access etc.
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Please explain why:
SECTION 3 - SITE INDUCTION
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3.1 Have ALL employees been inducted to site and has this been recorded on QREC 45?
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Please explain why:
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3.2 If toolbox talks have been carried out, have these been recorded on QREC 90?
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Please explain why:
SECTION 4 - ACCIDENT REPORTING
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4.1 Have you communicated to your team the accident / incident reporting procedure?
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Please explain why:
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4.2 Has an accident occurred on site?
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4.2.1 Has this been reported directly to the Health and Safety Team?
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Please explain why:
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4.2.2 Have Witness & Supervisor accident statements been completed?
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Please provide evidence
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Please explain why:
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4.3 Have there been any Near Hits / Hazards on site?
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4.3.1 Have all Near Hits / Hazards been recorded within Near hit's site booklet and been dealt with appropriately?
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Please explain why:
SECTION 5 - FIRST AID
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5.1 Is there access to a suitably stocked First aid box?
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Please explain why:
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5.1.1 Do ALL sterile contents of the First aid box have a valid date?
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Please explain why:
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5.2 Are you or one of your team first aid trained?
Name of first aider on site
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Name of first aider on site
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5.2.1 Is the First aider identifiable either via first aider images, label on hard hat, badge or identified on Hi Vis Vest?
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Please explain why:
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5.3 Is there suitable first aid reference readily available on site? (St John Ambulance booklet or similar)
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Please explain why:
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5.4 Are the local emergency service details available in the event of an accident or incident occurring?
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Please explain why:
SECTION 6 - HOUSEKEEPING
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6.1 Is there a suitable storage facility for ISS Restoration's equipment? i.e. flight box, an agreed cupboard, store, container or as a last resort a van
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Please explain why:
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6.2 Is there a general tidiness on site? e.g cables routed safely, spillages dealt with immediately after they occur, good access routes, safe systems of work
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Please explain why:
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6.3 Is there sufficient lighting to carry out the tasks?
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Please explain why:
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6.4 Has debris / scrap / consumables been disposed of in a safe manner, separated and unlikely to cause anyone injury including non employees?
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Please explain why:
SECTION 7 - COSHH
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7.1 Are chemical being used on site?
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7.1.1 What chemical are you using on site?
- Air Neutraliser
- APM (All Purpose Maintenance Product)
- Arklean
- Brick Acid
- Cater Cleanse
- Clean Film
- Cream Cleanser
- Defoamer
- Demineralised Water
- Extraction Plus
- F42
- Fixsoot
- Food Safe Finish & Lube
- Food Safe Sanitiser
- F429
- Galv Cleaner
- Gas Oil
- IPA
- MPG Coolcant (Glycol)
- MSR
- Multi Pro
- Oven Cleaner
- Peek Polish
- Power Clean
- Reflection
- Rust Preventative Thick
- Sensitive Surfaces (Graffiti Remover)
- Silicone Spray Dashboard Renovator
- Slix
- Smoke Solv
- Solban 40
- Stain Pro
- Steelgard (GP)
- TRIO (Sanikill)
- UCR
- Wax Polish
- White Spirit
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7.1.2 Are you able to access COSHH assessments for all chemicals used on site via your tablet? <br>(If not, please contact Tim Copp or Nigel Waddington on 01756 790907)
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Please explain:
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7.1.3 Are you able to access manufacturer's 16 point safety data sheets for all chemicals used on site via your tablet? <br>(If not, please contact Tim Copp or Nigel Waddington on 01756 790907)
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Please explain:
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7.1.4 Have all chemicals being used been approved by ISS Restoration?
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Please explain:
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7.1.5 Are all containers and spray bottles identified with labels stating contents<br>and dilution rates? (See COSHH assessment for further info)
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Please explain:
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7.1.6 Is appropriate PPE being worn when using chemicals? (See 'PPE' section in COSHH assessment for further info)
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Please explain:
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7.1.7 Are chemicals being stored and transported correctly?
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Please explain:
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7.1.11 Is signage being displayed relating to chemicals / slippery floors?
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Please explain:
Flammables
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7.1.8 Are flammables being stored correctly? e.g flammable cabinet, lockable storage facility or as a last resort securely stored and contained in the van
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Please explain:
Waste chemicals
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7.1.9 Are waste substances being suitably disposed of? (See 'Disposal arrangements' section in COSHH assessment for further info)
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Please explain:
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7.1.10 Are waste substances being suitably stored and clearly identified via signage?
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Please explain:
SECTION 8 - PERSONAL PROTECTIVE EQUIPMENT
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Identify PPE being worn on site
- Safety Over Spectacles
- Safety Glasses (Timor)
- Safety Goggles (SG10)
- Ear Plugs
- Ear Defenders
- Disp Respirator (P2)
- Disp Respirator (P3)
- Moldex Half Face Mask Respirator
- Moldex Full Face Mask Respirator
- Moldex P3 Filter Disc (pair)
- Moldex ABEK1 Carbon Filter Disc (pair)
- Face Shield - Complete
- Hard Hat
- Wetsuit
- Tyvek Overalls
- Chemical Grade Suits (Tychem)
- Hi Viz Vest
- Disp Nitrile Gloves
- Nitrile Gloves
- Black Rubber Guantlets
- Light Industrial Glove (PVN)
- MP1 Gloves (Scaff Gloves)
- Cut Resistant Glove - Kutlass
- Puncture Resistant Gloves (Turtleskin -Utility)
- Tyvek Overboots
- Wellington Boots
- Steel Toe-Capper Boots
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8.1 Has a variety of PPE available for specific tasks or for agency workers been provided and does it offer adequate protection for the tasks being undertaken?
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Please explain:
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8.2 Have all occasional employees / full timers been issued with a PPE bag and has this been been signed for. (Clarification may be required via the Workshop Supervisor)
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Please explain:
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8.3 Are all items of PPE available within the bag that have been signed?
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Please explain:
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8.4 Is there evidence that PPE is being worn?
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Please explain:
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8.5 Is the PPE in good condition and properly stored?
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Please explain:
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8.5.1 Is PPE "CE" marked & within validity dates? (Hard hats 5 years since commissioning & Respirator filters as specified by the manufacturer)
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Please explain:
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8.6 Are all employees suitably dressed for the task in ISS Restoration<br>provided work wear?
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Please explain:
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Are harnesses required?
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8.7 Are Harness's being inspected by the user prior to use, recorded, and are they being worn & stored suitably?
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Please explain:
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8.8 Are Harness's within certification & no older than 5 years from date being put into service? (Clarification may be required via the Workshop Supervisor)
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Please explain:
SECTION 9 - EQUIPMENT
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9.1 Is there evidence that test equipment being used is calibrated? (Clarification may be required via Workshop Supervisor or other)
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Please explain:
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9.2 Are Residual Current Devices (RCD's) being used on equipment especially where being used in wet, humid and flooded environments?
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Please explain:
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9.3 Does the equipment clearly show a current portable appliance test & has it been carried out at intervals as per ISS Restoration's policy?
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Please explain:
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9.4 Has any equipment identified as being faulty been suitably dealt with by the Site Supervisor?
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Please explain:
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9.5 Is ALL equipment being used safely and as it was designed for? e.g hand held tools, access, etc.
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Please explain:
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9.5.1 Is all equipment free from defects and if applicable quarantined?
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Please explain:
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9.6 Is there evidence that equipment is being cleaned and stored<br>appropriately after use?
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Please explain:
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9.7 Are employees trained in the use of the equipment being used?<br>(Clarification may be required via National training matrix)
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Please explain:
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9.8 Is the lowest possible voltage being used where ever possible?
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Please explain:
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9.9 Has a suitable assessment been made of the electrical supply and<br>the consumption of electrical equipment being utilised for the project?
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Please explain:
SECTION 10 - EMERGENCY PROCEDURES
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10.1 Are all emergency exits clear of obstruction?
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Please explain:
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10.2 Are all employees aware of the nearest egress point in the event of<br>emergency?
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Please explain:
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10.3 Are all employees aware of the sound emitted indicating fire and are<br>familiar with the fire evacuation procedure?
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Please explain:
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10.4 Can ALL employees of ISS Restoration be accounted for whilst on site<br>either by signing in book, up to date timesheets or other means?
SECTION 11 - WELFARE
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11.1 Is there an agreed suitable W/C on site for ISS Restoration employees?
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Please explain:
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11.2 Is the W/C being maintained / cleaned appropriately?
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Please explain:
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11.3 Is there a fresh water supply on site and facility to heat water?
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Please explain:
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11.4 Is there a clean area away from the workplace available for the<br>consumption of food and drink?
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Please explain:
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11.5 Is there an area that employees can "warm up" in cold conditions?
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Please explain:
SECTION 12 - OTHER
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12.1 Is the clients designated smoking policy / allocated area being adhered to?
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Please explain:
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12.2 Is H&S signage being used on site to advise on safety issues
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Please explain:
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12.3 Are areas of ISS Restoration's responsibility clearly separated from the<br>client's employees / members of the public where ever possible?
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Please explain:
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12.4 Are ISS Restoration's vehicles parked in agreed designated area?
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Please explain:
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12.5 Are vehicles secure and in a generally clean and well maintained<br>condition?
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Please explain:
Signature Section
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I confirm that......
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Document Details: