Title Page
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Conducted on
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Prepared by
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Location
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Job/Service Number
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System Type(s)
Safety Audit
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Does the technician have all of the required PPE on site? I.E. hardhat, high vis, safety glasses, steel-toed boots, ear protection, work gloves, and face mask.
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What PPE was missing?
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Does the missing PPE need to be oredered?
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Was all applicable PPE used as required?
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What were the safety requirements that were not being followed?
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Was this discussed with the technician?
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Were ladders used properly? I.E. height, type, slip provention.
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How were the ladders used incorrectly?
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Was the improper use of the ladder discussed with the technician
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Are the ladders in good working condition?
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What is damaged?
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Was the tech directed to return the ladder to the Facility Manager?
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Is a lift being used?
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Is the appropriate lift on the job?
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Why wasn't the correct lift being used?
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Was the appropriate harness being used?
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Why was the apparopriate harness not used?
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Does the correct harness need to be ordered?
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Are extension cords being used?
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Are the cords appropriate for the job?
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What type was being used?
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Does the correct grade of cord need to be ordered?
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Are the extension cords in good condition?
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What is damaged?
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Does the cord need replaced?
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Are there any fall hazards? I.E. large openings, lack of railings, slippery surfaces.
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What type of fall hazards were present?
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Were the fall hazards properly dealt with to prevent falling?
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What prevented corrective action?
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Is work space in clean and orderly fashion?
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Was the disorderly work space discussed with the technician and corrected?
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Are there any large obstacles that will require additional assistance to move or maneuver around safely?
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What arrangements are needed to safely move these obstacles?
