Title Page

  • Location / Site

  • Prepared by

  • Conducted on

Office and Amenities

  • Health & Safety notice boards available, unobstructed and with relevant information

  • Emergency persons names / photos displayed i.e. HSR’s, Wardens, First Aid Attendants

  • Facility Emergency Management Plan available containing correct information, staff have signed acknowledgement section

  • Emergency Wardens have completed relevant training

  • Evacuation diagram is displayed and correct for building

  • Are incident report forms (Staff and Public) or Elumina available

  • Fire extinguishers available, serviceable, tagged (up to date) & correctly identified

  • Access to fire extinguishers unobstructed

  • Entry & exits clearly marked and unobstructed

  • Bins provided & emptied regularly

  • Kitchen area clean and tidy

  • Electrical Equipment in good working order and tested / tagged

  • Toilets clean and tidy, hand wash, soap, paper towel

  • Floor surfaces secure ie carpet, tiles in good order.

  • All walkways clear from unnecessary obstructions

First Aid Facilities

  • Current first aid equipment list available in cabinet.

  • Contents within use by dates

  • Sign showing where first aid kit is located

Mobile Plant

  • Photos

  • ID:

  • Model:

  • Daily pre start inspection checklist completed by operator.

  • Faults identified have been signed off.

  • Operator competencies verified

  • Safety devices fitted – seat belts / fire extinguishers / reverse alarms / machine guards / brakes / flashing beacon

  • Safe working load charts in place and legible.

  • Motion alarms fitted and operational

  • Vehicles and trucks are maintained to manufacturers specification.

  • Operators manual on site and available to operator.

  • Mobile plant being used correctly eg. Use of spotters, not overloaded etc.

  • Motion alarms fitted and operational if required

  • Mobile plant not blocking access ways

Risk Assessment

  • Title:

  • Has a SWMS / JSA been carried out for the task?

  • Is the SWMS / JSA sufficient for the task?

  • Does SWMS reflect the current job steps?

  • Have all hazards associated with the task been identified?

  • Are the hazard controls adequate?

  • Was the work group involved in development of the SWMS / JSA?

  • Has the work group signed on the SWMS / JSA?

  • Is the work being carried out in line with SWMS / JSA?

  • Are emergency requirements identified in the SWMS / JSA?

Chemical Management

  • Photos of storage

  • Register of substances on site, current and up to date.

  • Access to register and SDS sheets available to employees

  • Segregated from other works and warning signs displayed

  • Compliance by Personnel with SDS / SWMS & PPE requirements.

  • Emergency equipment adequate and available ie. Spill containment.

  • All containers are correctly labelled

  • Are risk control measures in place and known by end users

  • Are adequate first aid facilities available at storage area i.e. Eye wash

  • Are training records available for personnel using or handling hazardous substances.

  • Are Hazardous substances being disposed of correctly

  • Access and egress unobstructed to storage areas

  • Ventilation adequate to remove and maintain atmospheric levels below exposure limits

  • All PPE as per the SDS (section 8) is available on site

  • Spillage retention measures adopted where containers are opened for transfer

  • Storage of chemicals is such, that spillage cannot affect other chemicals?

Traffic Management

  • Adequate segregation of plant / equipment including public vehicles and pedestrians

  • Exclusion zones set up during loading / unloading when in close proximity to other plant / vehicles / pedestrians

  • Park up areas correctly designed.

  • Traffic management and / or control plans in place, available and followed.

  • Speed limits posted correctly.

  • All signs, markings and delineating devices as seen by road users are acceptable

Contractor Management

  • Contractors have a SWMS / JSA for the task

  • Contractor have signed onto Visitor / Site Inspection SWMS

  • Contractor is aware of emergency evacuation procedure

  • Contractor has all required Personal Protective Equipment

  • All licences and accreditation's are current and available for inspection

  • Further Findings:


  • Name:

  • Select date

  • 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.