Information
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Document No.
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Job no
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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The purpose of the assessment is to check that the engineer understands and uses Safe Working Procedures and is able to assess potential risk and use appropriate measures to avoid or reduce that risk.
The assessor will confirm the above by observing the engineer and / or asking relevant questions
Risk assessment
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Did the engineer take time to Stop & Think and consider potential risks
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Answered No: Explain
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Using the Field Terminal, did he complete safety screens ( or know how )
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Answered No: Explain
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Without using the Field Terminal, did he complete at least 1 S&T form each day?
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Answered No: Explain
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In all situation confirm S &T form required on all validation work?
Near miss incidents ( target 1 per week)
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Does the engineer understand the importance of reporting near misses?
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Answered No: Explain
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Has the engineer reported any near miss situations in the last week?
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Answered No: Explain
High Risk Areas:-
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Did the engineer use the appropriate measures to minimise the risk and / or use the correct equipment provided in areas listed below?
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Electrical safety general
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Answered No: Explain
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Electrical safe isolation
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Answered no: Explain
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Voltstick
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Answered No: Explain
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P.P.E
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Answered No: Explain
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Manual handling
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Answered No: Explain
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Slips, trips & falls.
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Answered No: Explain
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Asbestos awareness
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Did the engineer work in a safe and methodical manner?
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Answered No: Explain
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Answered No: Explain
Safe working
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Did the engineer work in a safe and methodical manner?
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Answered No: Explain
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Overall safety assessment
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Action / improvement agreed with engineer:-
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Letter to engineer
- No
- Yes
- Letter A
- Letter B
- Letter C
- Letter D
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Engineers name and signature
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Asessors name and signature
