KEELEY COMPANIES COVID-19 Awareness Assessment

• Project

• Subcontractor

  Yes

  No

  N/A

• Company Name

• Foreman/Supervisor

• Conducted on

  Date

• Prepared by

• Location
  Address

Is COVID-19 part of the job briefing? Symptoms, hygiene practices, maintaining social distance from others for low risk tasks?

• Safe

  At Risk

  N/A

Is the job briefing conducted in a manner that maintains social distancing (outdoors, instead of congregating in a small job trailer)?

• Safe

  At Risk

  N/A

Are hand washing facilities or hand sanitizing(gel stations, disinfecting wipes) materials available on the job site?

• Safe

  At Risk

  N/A

Are crews following adequate social distancing during work for low risk tasks and on breaks? (not congregating in same location for lunch or breaks)?

• Safe

  At Risk

  N/A

Are crews aware of the Symptoms of COVID-19 and are aware to not show up to the job if they have symptoms?

• Safe

  At Risk

  N/A

Are shared areas and the general condition of the job site kept in a clean and sanitary manner?

• Safe

  At Risk

  N/A

Are the team members practicing social distancing when operating equipment or traveling to and from the job sites

• Safe

  At Risk

  N/A