Information

  • Audit Title

  • Job Site Name & Number

  • Audit Inspector

  • Company

  • Conducted on

  • Location

Site Information

  • Sign-in Sheet

  • Sing-in Sheet Pictures

  • Work Start Time

  • Lunch Start Time

  • Lunch End Time

  • Work End Time

  • Comments

Crews on site

  • # Framers/Rockers

  • # Finishers

  • # EIFS/Plaster workers

  • # Scaffold Crew

  • Comments

General

  • Emergency telephone numbers & procedures posted.

  • There a competent person, someone capable of identifying existing and predictable hazards which are unsanitary, hazardous or dangerous, and who has authorization to take prompt corrective measures to eliminate them, on site.

  • First aid supplies are adequate.

  • Weekly safety meetings are being held and safety sheets are being signed.

  • SDS is on site and accessible to all employees.

  • Comments

Housekeeping

  • Housekeeping: aisles clean, scrap removed, work areas clean and free of dangerous waste and material.

  • Work areas have appropriate lighting.

  • Adequate supply of water or water jugs, cups and trash containers.

  • Comments

Personal Protective Equipment (PPE)

  • Head, eye, face, foot, and hand protection utilized as needed/required.

  • Warning/Danger signage posted as needed.

  • PFAS worn when needed/required.

  • Comments

Fire Protection & Prevention

  • Fire extinguishers provided in adequate number and type and in readily accessible locations.

  • Fire extinguishers are properly charged.

  • All employees and subcontractors know the location of the fire extinguishers.

  • Flammable & combustible liquids stored in approved containers only.

  • Comments

Electrical

  • All equipment is either grounded or double insulated.

  • GFCI receptacle used, including when using permanent power.

  • Temporary light are equipped with guards (when required) to prevent accidental contact with bulb.

  • Extension cords are not frayed or cut and are in good repair with intact ground pin.

  • Electrical cords are not ran over sharp edges unprotected.

  • Electrical cords are hung or placed in a way to prevent a tripping hazard.

  • Comments

Tools

  • All tools are in good working order.

  • Tool cords are free of cuts or abrasions and are in good repair.

  • Proper tool being used for the task.

  • Tools are being used properly.

  • Guards are in place on tools being used.

  • Comments

Ladders

  • Ladders are in good condition with all appropriate labels and have slip resistant feet and are positioned away from electrical exposures.

  • Ladders are properly secured to prevent slipping, sliding or falling.

  • Straight ladders extend 36" above top of landing.

  • Stepladders are fully open when in use.

  • No employee is standing on a ladder rung which is deemed unsafe.

  • Comments

Perry/Baker Scaffolding

  • Components are in good repair.

  • Scaffold is set up on baseplates or casters.

  • Baseplates are used in place of casters in stairway.

  • Wheels are locked when in use.

  • Stacked scaffolds have outriggers in use OR are tied/braced to prevent movement/tipping.

  • Working surface is free of debris and excess material.

  • All open sides and ends of the working platform more than 6' above ground are provided with guardrails.

  • No employee is standing on guardrails or material in order to gain height.

  • Comments

Tube & Coupler Scaffolding, Large Frame Scaffolding, or System Scaffolding

  • Scaffolding is constructed by a qualified person.

  • Scaffold equipment in good working order.

  • Inspected by competent person daily before use.

  • Scaffolding was erected per the manufacturers instructions and will meet the guidelines outlined in OSHA standards.

  • Footing and anchors are sound, rigid, and capable of carrying 4 times the maximum intended load without settling or displacement.

  • The scaffold is set up on adequate flat baseplates, mud sills, screw jacks, etc.

  • All connections are pinned or fastened securely.

  • Scaffolding is properly supported on scaffold jacks and not on stacks of wood, boxes, bricks, barrels or any other unstable materials.

  • Planks are certified scaffold planks or structural lumber.

  • Planks overlap the end of the scaffold no less than 6" and no more than 12".

  • The working surface is fully planked.

  • Planks are secured to prevent slipping.

  • Less than a 1" gap to prevent tools, etc. from falling through.

  • Less than 14" between scaffold and working surface.

  • Ladders are used to gain access to scaffold work platforms.

  • Maximum spacing of rungs is 16-3/4".

  • Scaffold is free of debris and excess material.

  • All open sides and ends of the platform more than 6' above ground are provided with top rails, midrails, and toeboards.

  • Top rails are between 38" to 45" high, midrails are midway between working platform and top rail.

  • Guardrails are capable of withstanding 200 lbs of force along the top rail.

  • Scaffold is tied off every 30' horizontally and 26' vertically if the height exceeds 4 times the width of the base.

  • On suspended scaffolds, vertical lifelines are attached to structure and a PFAS is used.

  • Comments

Fall Protection

  • Floor openings are covered OR guardrails are in place.

  • Open-sided floors and wall opening have guardrails.

  • Roof edges are adequately guarded.

  • Leading edge protection & signage utilized where required.

  • 100% fall tie off for all heights above 6 ft with proper anchor points.

  • Employees are protected from fall exposures.

  • Employees are using proper equipment and work platforms to gain height as needed.

  • Warning lines are being used properly.

  • Comments

Aerial & Scissor Lifts

  • Only those who are authorized to operate the lift are permitted to do so.

  • Lift inspection checklists are being completed.

  • Employees are keeping their feet on the work platform in the basket.

  • Fall restraint & fall protection are being used correctly.

  • Fire extinguishers are installed on all lifts.

  • Lifts are being used properly.

  • Comments

Industrial Trucks / Forklift

  • Only those who are authorized to operate the forklift are permitted to do so.

  • Forklift inspection checklists are being completed.

  • Seat belts are being used.

  • Fire extinguishers are installed on all forklifts.

  • Forklifts are being used properly.

  • Forklift operator is within 25 feet of the forklift when the forks are raised.

  • Comments

General Comments

Sign Off

  • Framers/Rockers Supervisor Signature

  • Finishers Supervisor Signature

  • EIFS/Plaster Supervisor Signature

  • Scaffold Crew Supervisor Signature

  • Safety Representative Signature

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.