Information
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Audit Title
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Auditors
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Completed On
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Location
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Click here to add employee found to be non-compliant.
Employee
General Information
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Time
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Department
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Job Position
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Employee
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Direct Supervisor
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Department Manager
Re-Occurrence Details
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Is this non-compliance a re-occurrence?
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Is this non-compliance a repeat occurrence for the direct supervisor? Please provide details in the comments section.
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Provide addition details and comments pertaining to the matter's re-occurrence. (I.E. has the employee, supervisor, department manager or plant manager been made aware of previous non-compliance? Were previous corrective measures required to be taken such as discipline, discussion, etc.)
Non-Compliance Details
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Specify the required PPE/Hands Off tool not being used by the employee (include PPE that is being used or worn incorrectly)?
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Specify the body parts that are unprotected as a result of the non-compliance
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Is the employee's direct supervisor aware of the non-compliance. The auditor is required to provide sufficient details substantiating the response to this question.
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Is the department manager aware of the non-compliance. The auditor is required to provide sufficient details substantiating the response to this question.
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Select the action(s) that was taken at the time of the initial observation of non-compliance.
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Reasons for non-compliance according to employee (if discussion was initiated)
Conclusion
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Auditors determination as to why this particular non-compliance has occurred.
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Recommendations to ensure future compliance
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Additional Comments