Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Ensure that the workplace is safe in the following areas:

  • Have there been any injuries or incidents since the previous walkthrough inspection?<br>

  • Summarize the incident, results of the investigation and any corrective actions that were implemented:

  • Any examples of best practices, or pro-active safety efforts observed during the site visit (ergonomic improvements, pre-task planning, near miss reporting, safety suggestion system, perception surveys, incentive program, return to work program, etc.)?<br>

  • Summarize the observation:

  • Any Claims Data to review prior to onsite visit? - WC Trending? eMod Discussion or considerations?

  • What, If Any, KPI's are related to Safety? TRIR? DART? Days without an injury? (obtain these #'s for tracking purposes):

  • AWAIR Safety Program Contains 5 elements; updated annually with goals and objectives.

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Injury & Illness Record Keeping: OSHA 300 Log Accurate? Log posted (February 1 - April 30)? Posters?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Safety Committee MN: Regular Meetings? Documented Meetings? Management & employee equally represented?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Bloodborne Pathogens Exposures: Training? BBP clean up kits?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Compressed Air Use: Not used for cleaning personnel/clothing, For cleaning equipment nozzle pressure reduced to 30 psi if dead ended (regulated or relief ports on nozzle), chip guarding/PPE in place.

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Confined Space: Permits? Signs? Training? Rescue plan?<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Electrical Wiring & Equipment: Cords not used for permanent wiring? Damaged Cords? 3 feet clearance in front of panels? Missing Grounding Pin?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Emergency Action Plan: Notification system, Maps developed/posted? Drills?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Ergonomics: Proper workstation setups, computers etc.?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Eyewash Station: Plumbed in Units - Checked Weekly Other inspected Monthly?; Not Blocked?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Fall Protection & Elevated Surfaces: Fall protection available and in use above 4'? Guardrails in place where appropriate (mezzanine and other elevated surfaces)? PFAS in use when appropriate (order pickers, etc.)? Training? Equipment Inspections?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Fire Extinguishers: Training? Monthly inspection? Labeled? Not Blocked/Obstructed? Mounted properly?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • First Aid & CPR: Trained personnel if no EMS Response within "Near Proximity" (4 minutes); Training every 2 years?<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Hazardous Substances / Chemicals (Employee Right To Know): Employees trained annually, Bottles properly labeled, Stored properly (25+ gallons flammable liquid inside cabinet), SDS readily available, PPE in use as required?

  • MMA Recommendation:

  • Potential OSHA Citation

  • Housekeeping / Cleanliness of Work Space: Cluttered, Disorganized, or Dirty?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Ladders: Trained on proper use, in good condition, labels are legible, being used properly (Extension Ladder - secured, set up at a 4:1 ratio, and extends 3' above access point. Step Ladder - spreader bars locked, personnel not standing above the second step from the top).

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Lock Out Tag Out: Procedures developed for equipment? Authorized/Affected training? Procedures evaluated?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Machine Guarding: Bench Grinders Guards? AUTO Interlocks? Light curtains? Two hand controls?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Material Storage / Racking: Open Shelving, Damaged Racking, Materials Stored in a safe manner?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Overhead Cranes: Documented Inspections? Safety latch? Controls labeled? Limit switches tested?<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Personal Protective Equipment: Trained, Proper Use, Hazard Assessments

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Power Tools: In good condition, cords not damaged, guards/shields in use, proper PPE?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Powered Industrial Trucks (Forklifts): Classroom Training? Written Test? Hands on evaluation, every 3 years? Quarterly Monitoring for CO?

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Respiratory Protection: Required Use (Trained, Medically Qualified, Fit Tested) Voluntary Use (Signed Form, Medically Qualified for Elastomeric APR)<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Rigging (Chains & Slings): Inspected? Rated? Good condition?<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Walking & Working Surfaces: Personnel exposed to a fall hazard are protected (4' trigger height, guardrail system, personal fall arrest system or safety net system). <br><br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Woodworking Machines: Guards in place? Push Sticks? Anti restart?<br>

  • MMA Recommendation:

  • Potential OSHA Citation:

  • Additional observations:
  • Observation finding:

  • MMA Recommendation:

  • Potential OSHA Citation:

STANDARD OF CARE:

  • The services performed by Marsh & McLennan Agency (MMA) on this project have been conducted with that level of care or skill ordinarily exercised by reputable members of the profession, practicing in the same locality under similar budget and time constraints. No other warranty is expressed or implied.

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