Title Page
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Client / Site
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Region/Program
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Conducted on
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Prepared by
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Location Address
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INSTRUCTIONS
1. Please answer "Yes", "No" or "N/A" on the questions below.
2. Add Photos and Findings as notes by clicking on the Paperclip icon
3. To add a Corrective Action click on the Paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
4. Complete audit by providing digital signature
5. Share your report by exporting as PDF, Word, Excel or Web Link
1 ENTRY, EGRESS & OUTDOOR AREA
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1.01 Are pathways and verandas free from slip / trip hazards
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1.02 Is the area around the building clear from rubbish and materials
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1.03 Is the lawn and gardens maintained
2 INDOOR AREAS
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2.01 Are the indoor areas clean and clear of waste build up, pests and mould
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2.02 Are all sharp knives locked away
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2.03 Is fridge/freezer clean and clear of spoilt food
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2.04 Are hot water urns or kettles situated on a stable surface
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2.05 Are lint filters on dryers clean, and regularly checked
3 LIGHTING / VENTILATION
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3.01 Are all internal/external areas adequately lit and lights working
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3.02 Are all light covers free from dust and bugs
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3.03 Are individuals satisfied with the air temperature/air quality
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3.04 Are portable heaters not located near flammable items
4 FIRE
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4.01 Are all smoke alarms working (test required)
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4.02 Are smoke detectors fitted near bedroom areas and on every level of the premises
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4.03 Are there an adequate number of fire extinguishers
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4.04 Is there a fire blanket hung in the kitchen
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4.05 Have all extinguishers/blankets been tested within 6 months
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4.06 Are the locations of fire extinguishers indicated by signage
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4.07 Are all emergency exits clear from obstruction
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4.08 Is there a designated emergency exit for wheelchairs
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4.09 Are building evacuation drills conducted every 6 months
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4.10 Are building emergency procedures / floor plans displayed
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4.11 Does site have a recent (reviewed in the last year) bush fire survival plan in place –for bush fire prone properties.
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4.12 Are there any trees overhanging the roof
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4.13 Is the building fitted with a monitored fire alarm system
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4.14 Has the building been issued a fire safety certificate in the past year
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4.15 Are there non-ambulant people residing in the household?
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4.16 If yes, are there equipment aids to assist these people in the event of a fire (drag mats etc)?
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4.17 Do the people who reside in the household know what to do in the event of a fire?
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4.18 Are the people who
5 HAZARDOUS SUBSTANCES
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5.01 Are chemicals stored out of reach of clients or locked away
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5.02 Are all chemical containers clearly labelled
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5.03 Is there a current hazardous substances register and Safety Data Sheets for hazardous substances used on site
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5.04 Are gas bottles stored correctly and free from rust or damage
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5.05 Is an asbestos register available
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5.06 If asbestos is present do labels identify the asbestos areas
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5.07 If asbestos is present are the walls/areas not damaged
6 ELECTRICAL
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6.01 Are all light switches and power points in working order with no cracks or faults
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6.02 Are there sufficient power point outlets
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6.03 Are all walkways free from electrical leads
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6.04 Are power points free from overloading i.e. piggybacking of power boards
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6.05 Are all leads on the ground tapped down or run behind furniture to avoid a trip hazard
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6.06 Have all portable RCD’s been tested and tagged in the last 3 months
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6.07 Do power boards have socket covers & trip switches
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6.08 Are all other electrical test tags in date, including, bedroom bathroom, kitchen, living areas and portable items
7 FIRST AID
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7.01 Are there suitable first aid kits available and accessible
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7.02 Are all kits fully stocked, and items in date
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7.03 Is a site Register of Injuries in place and up to date
8 FLOORS
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8.01 Are all floors clean and free from rubbish and clutter
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8.02 Are all carpeted areas free from rips and worn patches
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8.03 Are all floors free from uneven surfaces, with no major cracks or holes present?
9 EQUIPMENT/PLANT
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9.01 Is machinery guarded against unsupervised use
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9.02 Is the LPG cylinder pressure valve pointing away from the premises
10 HOUSEKEEPING
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10.01 Is garden equipment, fuels, gas bottles and pool chemicals stored safely in a locked & ventilated shed/garage
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10.02 Are gas bottles free from rust or damage
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10.03 Are all curtain/blind cords either tethered to the wall or raised to a height inaccessible to children
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10.07 Are furniture and equipment in good condition and well maintained
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10.08 Has defective equipment / furniture been removed from use
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10.09 Are air conditioning outlets & filters clean and free from dust
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10.10 Is all disability assistance equipment i.e. shower chairs, nonslip mats etc. in good working condition
11 SECURITY
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11.01 Is staff bedroom/office areas lockable, and locks are working
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11.02 Are all window/door locks and deadbolts in working order
12 SIGNAGE
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12.01 Are emergency contact details on display and up to date
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12.02 Are high risk hazards marked by appropriate signage
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12.03 Are all safety signs clearly visible
13 Other Safety Concerns
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13.01 Photographs required in the following areas:
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Front of House (taken from curb)
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Back yard
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Electrical switchboard
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Kitchen / Dining / Living Rooms
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Bedrooms
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Bathrooms
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For all ongoing hazardsthat are not controlled, add to HSE 07 03 007 Site Risk Register
Manager Review
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Completed by: (Name and Signature)
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By signing below you agree that the actionsindicated will be reviewed and implemented to mitigate the identified hazard.
You agree that un-eliminated hazards have been added to the Site Risk Register for regular review. -
Name and Signature
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Position
