JLN Associates - Construction Safety Assessment

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Site Conditions

• Housekeeping in good condition?

  Yes

  No

  N/A

• Working areas and walkways clear of obstructions?

  Yes

  No

  N/A

• Nails removed from lumber or lumber material cleaned up?

  Yes

  No

  N/A

• Work area access controlled?

  Yes

  No

  N/A

• Fire extinguishers inspected and in good condition?

  Yes

  No

  N/A

Work Conditions

• Adequate amenities (toilets, wash areas, lunch rooms, etc)?

  Yes

  No

  N/A

• Sufficient lighting?

  Yes

  No

  N/A

• Adequate housekeeping?

  Yes

  No

  N/A

• Adequate noise/vibration control?

  Yes

  No

  N/A

Daily Documentation

• JSA/JHA complete for task?

  Yes

  No

  N/A

• Whole crew performing work signed off on JSA/JHA?

  Yes

  No

  N/A

• All hazards have been identified?

  Yes

  No

  N/A

• All hazards have a control method/procedure?

  Yes

  No

  N/A

• Is the control method/procedure being properly followed?

  Yes

  No

  N/A

Incident Report

• Any injury, near-hit, damage, or theft has been documented in writing and kept on-site for the duration of the project?

  Yes

  No

  N/A

Site Specific Documentation

• Adequate Site Safety Plan?

  Yes

  No

  N/A

• Orientation for workers, contractors, visitors?

  Yes

  No

  N/A

Emergency Action Plan

• Emergency plans for site?

  Yes

  No

  N/A

• Emergency procedures displayed and in place?

  Safe

  At Risk

  N/A

• Training and rehearsal of emergency plans implemented?

  Safe

  At Risk

  N/A

• Adequate first aid kits aid equipment for site?

  Yes

  No

  N/A

• Access to formally trained First Aiders on site or available through local channels?

  Yes

  No

  N/A

• Suitable or adequate communication equipment?

  Yes

  No

  N/A

Training Requirements

• All employees have received orientation?

  Yes

  No

  N/A

• Workers have been trained to use hand tools?

  Yes

  No

  N/A

• Workers have been trained in accordance with scope of work and the associated hazards?

  Safe

  At Risk

  N/A

• Workers have been trained on operation of motorized equipment?

  Safe

  At Risk

  N/A

Compressed Gas Cylinders

• Cylinders secured? (with proper material)

  Yes

  No

  N/A

• Protective cap fastened?

  Yes

  No

  N/A

• Incompatible cylinders separated (oxygen / fuel)?

  Yes

  No

  N/A

Hazardous Chemical Storage / Usage

• Proper containers being used?

  Yes

  No

  N/A

• Containers properly labeled?

  Yes

  No

  N/A

• Safety Data Sheets for chemicals brought on site?

  Yes

  No

  N/A

• Reactivity labels on container?

  Yes

  No

  N/A

• Chemical dispensing (bonding, grounding and containment) requirements?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Incompatible chemicals stored near each other?

  Safe

  At Risk

  N/A

• Aadequate spill containment equipment?

  Yes

  No

  N/A

• Excessive quantities stored on site or in vehicles?

  Yes

  No

  N/A

• Proper PPE?

  Yes

  No

  N/A

Hot Work

• Hot work permit?

  Yes

  No

  N/A

• Is there fire hazards in the area (flammable or combustible materials)?

  Yes

  No

  N/A

• Fire watch needed or present?

  Yes

  No

  N/A

• Welding leads and gas hoses in good condition?

  Yes

  No

  N/A

• Welding screen in place?

  Yes

  No

  N/A

• Fire extinguishers or other fire extinguishment media present?

  Yes

  No

  N/A

• Do crews have a way to report fires?

  Yes

  No

  N/A

Electrical Safety and Hazards

• Lockout/Tagout performed properly?

  Yes

  No

  N/A

• Electrical equipment/extension cords in good condition? (damaged, out of test date or untested)

  Safe

  At Risk

  N/A

• Grounding GFCI protection policy in place and being used?

  Yes

  No

  N/A

• Leads placed on ground or on metal structures?

  Yes

  No

  N/A

• Outlets being overloaded?

  Safe

  At Risk

  N/A

• Electrical equipment near water?

  Safe

  At Risk

  N/A

• Is Electrical equipment near flammables?

  Safe

  At Risk

  N/A

Hand Tools

• Are hand tools in good condition?

  Yes

  No

  N/A

• Are they being used safely?

  Yes

  No

  N/A

• Are guards in place?

  Yes

  No

  N/A

• Are cords in good condition?

  Yes

  No

  N/A

• Is proper PPE being used?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• 2.1. Use of safety glasses?

  Yes

  No

  N/A

• 2.2. Use of face shields?

  Yes

  No

  N/A

• 2.3. Proper footwear?

  Yes

  No

  N/A

• 2.4. Hand and or arm protection? (Please specify)

  Yes

  No

  N/A

• 2.5. Hard hat?

  Yes

  No

  N/A

• 2.6. Respiratory protection?

  Yes

  No

  N/A

• 2.7. Hearing protection?

  Yes

  No

  N/A

• 2.8. Is there a lack of, or inadequate PPE (including sun protection)

  Yes

  No

  N/A

• 2.9. Other please fill in.

  Safe

  At Risk

  N/A

Motorized Equipment (fork truck, cranes, etc)

• Equipment in good working condition?

  Yes

  No

  N/A

• Back up alarms working?

  Yes

  No

  N/A

• Crane reports complete?

  Yes

  No

  N/A

• Daily inspections completed?

  Yes

  No

  N/A

• Operators trained on all pieces of equipment they are operating?

  Yes

  No

  N/A

• Safe work/operating procedures being followed?

  Yes

  No

  N/A

• Seat belts worn?

  Yes

  No

  N/A

Rigging

• Tears, cuts, abrasions, or exposed core yarns present?

  Safe

  At Risk

  N/A

• Legible and present tags?

  Yes

  No

  N/A

• Tell Tails (twin-path) visible?

  Yes

  No

  N/A

• Bird caging/crushing/broken wires present?

  Safe

  At Risk

  N/A

• Corrosion present?

  Safe

  At Risk

  N/A

• Bent/twisted/stretched links?

  Safe

  At Risk

  N/A

• Maintenance, testing and inspection?

  Safe

  At Risk

  N/A

• Qualified riggers being used?

  Yes

  No

  N/A

Excavations

• Location of underground utilities identified?

  Yes

  No

  N/A

• Soil classification selected?

  Yes

  No

  N/A

• The soil has to be classified before work begins. This is done to choose the correct protection system to put in place.

• Dig safe called 72hrs before excavation?

  Yes

  No

  N/A

• Appropriate sloping and or shoring?

  Yes

  No

  N/A

• Type C soil requires a 34 degree slope
  Type B soil requires a 45 degree slope
  Type A soil (rock) requires a 63 degree slope

• Spoil pile has a 2 foot minimum distance form excavation wall?

  Yes

  No

  N/A

• Means of entry and or egress every 25ft?

  Yes

  No

  N/A

• Competent person? Clearly defined?

  Yes

  No

  N/A

• Work area access controlled?

  Yes

  No

  N/A

• Control of hazardous conditions (air toxics)?

  Yes

  No

  N/A

Confined Space

• Permit required confined space?

  Yes

  No

• Air monitor meets the scope of work requirements and has a good calibration date?

  Yes

  No

  N/A

• Safe entry requirements have been met (hazards are controlled via LOTO, forced air ventilation, etc. to allow safe entry)?

  Yes

  No

  N/A

• All appropriate safety equipment being used and or available?

  Yes

  No

  N/A

• Is there an Attendant? Are they trained?

  Yes

  No

  N/A

• Is there rescue equipment and plans in place?

  Yes

  No

  N/A

• All hazards have been eliminated or engineered out for the duration of the work assignment?

  Yes

  No

  N/A

• If the hazards have not been eliminated or engineered out then the confined space becomes permit required.

Ladders and Scaffolds

• Proper ladder for the job?

  Yes

  No

  N/A

• Ladders secured and tied off when necessary (when used as access to elevated working surface)?

  Yes

  No

  N/A

• Ladders positioned properly?

  Yes

  No

  N/A

• Ladders in Good working condition?

  Yes

  No

  N/A

• Damaged ladders need to be tagged out of service and or disposed of

• Scaffolding written inspection completed by competent person?

  Yes

  No

  N/A

• Scaffolding guardrails have top rail (45''-39''), mid rail (halfway between top rail and deck), and toe board (3'')?

  Safe

  At Risk

  N/A

• Scaffolding in good working condition as identified by inspection tag?

  Safe

  At Risk

  N/A

• Scaffolding components are matching manufacturers?

  Yes

  No

  N/A

• The competent person is aware and can explain how the mis-match will not alter the 4 times max intended load required rating?

  Yes

  No

  N/A

Harness and Equipment

• PFAS in good working condition?

  Yes

  No

  N/A

• Safe and certified anchor points (minimum 5000lbs per worker)?

  Yes

  No

  N/A

• Compatible hooks and equipment?

  Yes

  No

  N/A

• Proper equipment for elevated job requirements?

  Yes

  No

  N/A

• Current inspection on all equipment?

  Yes

  No

  N/A

• PFAS and fall protection systems training?

  Yes

  No

  N/A

Elevated Work Areas Heights

• Openings in floors and walls guarded?

  Yes

  No

  N/A

• Appropriate fall protection being used?

  Yes

  No

  N/A

• Guardrails in place where necessary?

  Yes

  No

  N/A

• Guardrails built correctly using top rail (45''-39'' and support 200lbs), mid rail (21'' minimum or halfway between top rail and deck), toe board (3.5'')?

  Yes

  No

  N/A

• Guardrails built correctly using top rail that supports 200lbs of force, mid rail that supports 150lbs of force, and toe board that supports 50lbs of force?

  Yes

  No

  N/A

Environmental Hazards

• Environmental control plan available for site?

  Yes

  No

  N/A

• For heavy dust operations, are engineering controls in place to keep the exposure down?

  Yes

  No

  N/A

• Controls have been established to prevent runoff into sewer drain?

  Yes

  No

  N/A

• Summary of Findings