Jurassic Fibre Supervisor SHE / Quality Inspection

• Conducted on

  Date

• Prepared by

• Team

  Civils

  Cabling

  Surveyors

  QC and Fluidity

  Service Delivery
• Location
  Address

• Activity being undertaken

General Safety and Documentation

• Do you want to answer the questions on General Safety and Documentation?

  Yes

  No

• Has a suitable Point of work risk assessment been completed or checked by Supervisor

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Has a suitable Permit be completed or checked by Supervisor and being followed by the team.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Work activity covered by relevant RAMS and they can locate them and demonstrate they are followed.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• ID and training cards carried by Supervisor ( in date / relevant for the task being complete)

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Is the Supervisor wearing the correct PPE and is this in good condition.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Vehicle

• Do you want to answer the questions on Vehicle?

  Yes

  No

• Vehicle has been safety parked having regards public

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Vehicle in good order, tyres, lights brakes etc and maintained clean and tidy inside

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Are vehicles and required plant fitted with fully functional amber flashing beacons

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Tools are stored correctly in the vehicle and secured to avoid damage

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor has the correct tools on board vehicle

  Select CAT Genny Lid Lifter Mechanical Lifter Gas detection Unit Harness, lanyard and or work positioning belt. Splicing Kit Other

  • CAT
  • Genny
  • Lid Lifter
  • Mechanical Lifter
  • Gas detection Unit
  • Harness, lanyard and or work positioning belt.
  • Splicing Kit
  • Other

• provide details of additional equipment

  Select Compliant Some learning Poor N/A

  • Compliant
  • Some learning
  • Poor
  • N/A

• Tools are in good condition, inspected and calibrated

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Site Set up

• Do you want to answer the Site Set Up questions

  Yes

  No

• Supervisor have correct NRSWA Accreditation / Registration for the work being executed where required?

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor have access to the Red Book - Safety at Street Works and Roads Work on site

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• General site set up in good order and follows the Red Book -Signing, lighting, guarding, Safety zones, Pedestrian Walkway meets / exceeds COP minimum width requirements

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Site is maintained in a tidy condition, tools, materials stored to avoid hazards.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• All contractors vehicles positioned safely as per the code of practice.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Hygiene / Welfare

• Do you wish to answer these questions

  Yes

  No

• Do the Team have First Aid supplies on site as required?

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Are Washing Facilities available on site?

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Work within Chambers

• Do you wish to answer questions relating to accessing or working in chambers

  Yes

  No

• Does supervisor have a suitable gas detector which is calibrated and fit for use.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Where practical mechanical or other means are being used to reduce the need for manual handling

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Has the underground network been gas tested and chamber opened correctly

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Has the chamber been secured and safely signed and guarded to protect the operative and public

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor aware of risk from leptospirosis and taking suitable controls.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor aware of the risk of discarded used syringes and have the equipment to deal with them.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Behaviours and Leadership

• Supervisors demonstrating commitment to health and safety and encouraging contractors/ employees to work safely.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrates good awareness about the importance of reporting hazards, incidents and injuries and know how to do this using JFL systems.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrating commitment to ensuring good quality of work and encouraging contractors / employees to strive to provide high quality standards

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrating interest and care in customer experience - demonstrates the ability to understand customer' expectations and needs

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrating willingness and ability to include and collaborate with others to ensure improved operations, compliance and safety

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrating behaviors which are appropriate to demonstrate integrity, accepting of own responsibility and accountability, dealing with other employees honestly and fairly.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrates a good understanding of company policy and procedures and is behaving in an appropriate manner to adhere to these.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisor demonstrating ability to solve problems and help others to find suitable solutions -thinking out of the box and going that extra mile.

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Supervisors demonstrating good communication skills and engaging well with employees /contractors

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

• Other notable Good Practice seen

  Select N/A Good Practice Compliant Some learning Poor Repeat Failure

  • N/A
  • Good Practice
  • Compliant
  • Some learning
  • Poor
  • Repeat Failure

Sign Off and Learning

• Provide details of any learning or action agreed for the Supervisors

• Supervisor sign to identify they understand the finding of the Inspection

  Sign

• Inspector sign to demonstrate the Inspection is a record of the findings

  Sign