Information

  • Client/Project Name

  • Job Number

  • Region

  • Conducted on

  • Prepared by

  • Superintendent

  • Project Manager

  • Location

Project Planning and Education

  • Grade

  • B&G site specific safety plan, hazcom, msds present?

  • Safety orientation being done and up to date?

  • Bi-weekly PM/Supt safety walks up to date?

  • Daily JSA's completed? Quality? Entire crew attending?

  • Weekly safety meeting held/documented?

  • Training - OSHA 10/30 hour and specific equipment

  • Safety as a main topic in Schedule/Coordination meetings?

  • Safety notebook current?

  • Comments:

  • Attachments

  • Attachments

Subcontractor Management

  • Grade

  • Startup meetings completed and documented?

  • Safety documents current?

  • Participation in regular safety walks as required?

  • Sub supervision showing accountability for personnel in field?

  • B&G holding sub supervision accountable?

  • Following up on safety issues? Increasing accountability for repeat items?

  • Training - Adequate for scope of work being performed, including specific equipment?

  • Competent person, OSHA 10/30 for supervision is required?

  • Comments:

  • Attachments

  • Attachments

Injury/Accident/Incident Management

  • Grade:

  • Reported in a timely manner?

  • Accident/Incident report(s) complete?

  • Root cause reports complete?

  • Corrective actions implemented

  • Actively managing employee return to work, modified duty provided

  • Injury diary maintained for injured employee(s)

  • Injury log maintained job wide

  • Current Stats

  • # of recordables

  • # of lost time days

  • # of first aids

  • Comments:

  • Attachments

  • Attachments

Current Site Conditions/Behaviors

  • Grade:

  • Jobsite posting & documentations

  • Housekeeping/material storage/general appearance

  • Building pad and surrounding areas

  • Excavations

  • Scaffolding

  • Elevated floors

  • Roof areas

  • Personal protective equipment

  • Fuel storage

  • Equipment

  • Electrical including weekly GFCI inspections

  • Hand/power/powder actuated tools

  • Foreman - performance in required level of supervision

  • Foreman - superintendent expectations communicated

  • Comments:

  • Attachment

  • Attachment

Safety Summary:

  • Overall Grade:

  • Project Manager Signature:

  • Superintendent Signature:

  • Safety Manager 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.