KDC 2021 Safety Observation Report

• Audit Title

• Client / Site

• Prepared by

• Personnel

SIGNAGE and COVID19 Controls

• Face Coverings

  Pass

  Fail

  N/A

• Sanitizing

  Pass

  Fail

  N/A

• Current Sanitizing Log

  Yes

  No

  N/A

• Temp Screening

  Pass

  Fail

  N/A

• COVID19 Posters

  Pass

  Fail

  N/A

• Hand Sanitizer

  Pass

  Fail

  N/A

• Warning Signs

  Good

  Fair

  Poor

  N/A

• Laser Sign if needed

  Good

  Fair

  Poor

  N/A

• Silica Sign if risk present

  Good

  Fair

  Poor

  N/A

• Haz Assessment Thoroughly Completed - Does it reflect ALL risks?

  Safe

  At Risk

  N/A

• Sign In

  Yes

  No

  N/A

• DOL Poster

  Safe

  At Risk

  N/A

• Cal OSHA Safety Poster

  Safe

  At Risk

  N/A

• KDC rules posted

  Safe

  At Risk

  N/A

• MPN and map posted

  Safe

  At Risk

  N/A

• Incident Reporting instructions posted

  Safe

  At Risk

  N/A

• Emergency Evac

  Safe

  At Risk

  N/A

• Fire Extg

  Safe

  At Risk

  N/A

Public

• Pedestrian / Public Protection Plan

  Safe

  At Risk

  N/A

• Fencing

  Safe

  At Risk

  N/A

• Access

  Safe

  At Risk

  N/A

• Any trip hazards for public

  Safe

  At Risk

  N/A

Fall Protection/Prevention

• Scissor lift safety and compliance

  Safe

  At Risk

  N/A

• Fall protection if exposed to a free fall six feet or more

  Safe

  At Risk

  N/A

Scaffold Compliance

• Rolling Scaffold Plan

  Good

  Fair

  Poor

  N/A

• Scaffold Safety

  Safe

  At Risk

  N/A

• Scaffold Plan

  Safe

  At Risk

  N/A

Trenching Excavation

• Soil Testing

  Good

  Fair

  Poor

  N/A

• Annual Trench Permit from OSHA

  Good

  Fair

  Poor

  N/A

• 811 Called Ticket No

  Good

  Fair

  Poor

  N/A

• Permit

  Safe

  At Risk

  N/A

• Access Egress 4ft or >

  Safe

  At Risk

  N/A

• Cave In Protection

  Safe

  At Risk

  N/A

• Fall Protection 6ft or >

  Yes

  No

  N/A

• Tabulated Data Sheets

  Yes

  No

  N/A

Electrical / Tools

• Tool safety

  Safe

  At Risk

  N/A

• Equipment safety

  Safe

  At Risk

  N/A

• Electrical Safety - GFCI, Temp Power, Cords, Open Panels, LOTO

  Safe

  At Risk

  N/A

Ladders

• Ladder Safety including manufacturing labels

  Safe

  At Risk

  N/A

• Ladder usage and set up

  Safe

  At Risk

  N/A

Housekeeping

• Housekeeping [Interior & Exterior]

  Safe

  At Risk

  N/A

• Water in compliance with HIPP

  Safe

  At Risk

  N/A

• Caught In-between/Struck By

  Safe

  At Risk

  N/A

• Any trip and fall hazards

  Safe

  At Risk

  N/A

• Impalement Protection

  Safe

  At Risk

  N/A

Safety Plans - Required Permits

• Silica Mngt Plan

  Safe

  At Risk

  N/A

• Demo Plan

  Safe

  At Risk

  N/A

• Hot Work Permit

  Safe

  At Risk

  N/A

• Fall Protection Plan 15 or>

  Yes

  No

  N/A

• Scaffold Plan

  Safe

  At Risk

  N/A

• Pedestrian Protection Plan (Signed)

  Safe

  At Risk

  N/A

• Crane Plan

  Safe

  At Risk

  N/A

• Lock Out Tag Out Plan

  Safe

  At Risk

  N/A

• Fork/Boom Lift Certs

  Safe

  At Risk

  N/A

• Powder Actuated Tool Lic

  Safe

  At Risk

  N/A

PPE

• PPE Compliance - Z87.1, N95, N100, Hardhats, Gloves, Hearing P, Class II Vests

  Safe

  At Risk

  N/A

• SWPPP ISSUES?

  Safe

  At Risk

  N/A

• Dust Control

  Safe

  At Risk

  N/A

Sanitation

• External Wash Station

  Good

  Fair

  Poor

  N/A

• Clean with supplies

  Safe

  At Risk

  N/A

Crane Lift Inspection

• All Paperwork Submitted

  Good

  Fair

  Poor

  N/A

• 1. Name of the operator<br><br>2. Operators crane card<br><br>3. Annual Crane Cert<br><br>4. What are we are lifting<br><br>5. Weight of item<br><br>6. Total boom length<br><br>7. Boom length time of lift<br><br>8. Swing Radius<br><br>9. Rigging Being used<br><br>10. Party executing rigging

  Compliant

  Non-Compliant

  N/A

• Pre Lift Meeting - This meeting shall be held prior to the lift at each new work location and shall be repeated for any employees newly assigned to the operation

  Yes

  No

  N/A

• Inspection of all blocks, straps, guy lines.Examination for damaged, cracked, or worn parts, loose nuts and bolts, and of lubrication and condition of straps and guy lines

  Safe

  At Risk

  N/A

• Confirm there is no heat damage including weld splatter Arc stripes or evidence of tearing or splitting

  Safe

  At Risk

  N/A

• Confirm there is no excessive nicks, cuts, splices or corrosion.

  Safe

  At Risk

  N/A

• Confirm all shakels are USA made precluding and rigging from China.

  Safe

  At Risk

  N/A

• Review for legible manufacturers tags of rigging straps with rated load

  Safe

  At Risk

  N/A

• Tag Lines Being Used

  Safe

  At Risk

  N/A

• % of lift compared to max capacity based on load chart MUST be 70% or less

  Safe

  At Risk

  N/A

Training/Coaching Provided

• Areas of training were provided. Be specific.Hiw did we help? What did we do?

• Signatures

  Sign