MONTHLY SITE ASSIGNMENT VISIT FORM

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Employee Liability Insurance.

• Employee Liability Insurance Certificate displayed<br>(Renewed annually) on display onsite?<br><br>

  Yes

  No

  N/A

Environmental and Quality Policy.

• Cleanall Environmental Policy <br>(Reviewed annually) on display onsite? <br><br>

  Yes

  No

  N/A

Health and Safety

• Health and Safety Handbook. <br>All staff fully conversant with the contents? (Available onsite?)<br><br>

  Yes

  No

  N/A

• Health & Safety Manual Sign Off.<br>Signed by all staff?<br><br>

  Yes

  No

  N/A

• Site First Aid Box.<br>Available on site?<br><br>

  Yes

  No

  N/A

• Fire Fighting Equipment.<br>Available on site?<br><br>

  Yes

  No

  N/A

• Health and Safety Induction and Training Record. <br>To be completed by managers for all staff, records available?<br><br>

  Yes

  No

  N/A

• Procedure for use of Injury Incident Report Form. <br>Available on site.<br><br>

  Yes

  No

  N/A

• Injury Incident Investigation Report form.<br>All incidents reported (check DOB against recorded incidents)?<br>

  Yes

  No

  N/A

• Incident Corrective Action Form.<br>Completed for all recorded incidents and forwarded to the Security Dropbox and to Colin@cleanall.co.uk and Peterw@cleanall.co.uk <br>

  Yes

  No

  N/A

• HSE Poster. <br>Displayed in the work place?<br>

  Yes

  No

  N/A

Risk Assessments

• Site Specific Risk Assessments.<br>Available onsite and in date?<br>

  Yes

  No

  N/A

• Risk Assessment Sign Off Form.<br>Signed off by all staff?<br>

  Yes

  No

  N/A

• DSE Workstation Assessment Checklist.<br>Completed for all staff (Staff defined as “User’s”) <br>

  Yes

  No

  N/A

Assignment Instructions.

• Site Specific Assignment Instructions.<br>Are reviews in date and signed off as completed?<br>All site staff have read and signed off as understood? <br>Document Amendment record completed and signed off? Version control issue 1<br>Client Agreement, Signature and date?<br>Next review date………………………….?<br>

  Yes

  No

  N/A

• Site Specific Assignment Instructions.<br>Location & description of site? <br>Agreed means of access?<br>Emergency procedures & lines of communication?<br>Method and frequency of check calls?<br>Equipment supplied (Asset list)?<br>Individual duties and responsibilities<br>1. Work hours and handover procedures<br>2. Patrol routes<br>3. CCTV management<br>4. Access control and searching procedures<br>5. Record keeping<br><br>

  Yes

  No

  N/A

• Temporary Security Guard AI Instruction.<br>Are all temporary staff signed off?<br>

  Yes

  No

  N/A

CCTV Guidelines and Procedures.

• Guidelines and procedure on the administration and management of CCTV and personal information. <br>Available in the site file? Are the staff fully conversant with the content of the document?<br>

  Yes

  No

  N/A

• CCTV ICO Code of Practice.<br>Available in the site file? Are the staff fully conversant with the content of the document?<br>

  Yes

  No

  N/A

CCTV Administration Documentation.

• CCTV viewing request Log.<br>Available records fully completed, authorised and signed?<br><br>

  Yes

  No

  N/A

• CCTV Receipt for footage.<br>Available records fully completed, authorised and signed?<br>

  Yes

  No

  N/A

• CCTV fault log.<br>Available records fully completed, defects rectified?<br>

  Yes

  No

  N/A

• CCTV Room Sign In Log.<br>Available records fully completed and signed (in and out)?<br>

  Yes

  No

  N/A

• CCTV Incident Log.<br>Available records fully completed?<br>

  Yes

  No

  N/A

• CCTV Request for footage.<br>Available records fully completed, authorised and signed?<br>

  Yes

  No

  N/A

• CCTV Subject Access Application Form.<br>Available records fully completed, authorised and signed?<br>

  Yes

  No

  N/A

• CCTV Data Protection Log.<br>Available records fully completed, authorised and signed?<br>

  Yes

  No

  N/A

• CCTV Confidentiality Agreement.<br>Signed and witness for all staff?<br>

  Yes

  No

  N/A

• CCTV Disc Destruction Log.<br>Available records fully completed, full traceability?<br>

  Yes

  No

  N/A

• CCTV Monthly Audit Log.<br>Available records fully completed and authorised?<br>

  Yes

  No

  N/A

• CCTV Daily Audit Log.<br>Available records fully completed?<br>

  Yes

  No

  N/A

• Master Media Register (Electronic File).<br>Password Protected & fully completed?<br>Cross reference CCTV Data Protection Log, all entries match?<br>

  Yes

  No

  N/A

• Security and integrity of Media.<br>All recorded media fully secure?<br>Evidence bags sealed?<br>DVD’s sequentially numbered?<br>Records kept separate from media storage?<br>Master Media CD’s (Must be kept) records correct?<br>Copy of masters, records correct?<br>Third party copies, records correct?<br>

  Yes

  No

  N/A

Key Security.

• Key Holding Register.<br>Is the key register on the correct issue?<br>Are all keys accounted for? (Signed in and out)?<br>Is the records of keys being handed over between shifts<br>Are the keys secure?<br>Available records of Monthly Key audits conducted by independent managers/supervisors any anomalies to be reported to the site manager <br>

  Yes

  No

  N/A

Cleanall Security Documentation.

• Personal Training Record.<br>Completed by the managers with signatures and dates of trainee and training provider?<br>

  Yes

  No

  N/A

• Staff Licences and Cleanall ID.<br>Staff licences checked? <br>***PHOTOS TO BE TAKEN OF ALL SITE LICENECES*** <br>Staff ID cards checked?<br>Licence database up-to-date?<br>

  Yes

  No

  N/A

• Notification of training carried out.<br>Fully completed with the trainee(s) signatures and dates of trainee and training provider?<br>

  Yes

  No

  N/A

• Toolbox Talks Sign Off.<br>Signed by all staff, regular tool box talks to completed (subject matter at the manager’s discretion)?<br>

  Yes

  No

  N/A

• Site Inventory and PAT record.<br>Fully completed (Cleanall and Client supply equipment) Assignment Instructions should indicate both Client and Cleanall supplied equipment listings.<br>Records of maintenance and calibration for all CCTV equipment<br>Portable Appliance Testing (PAT) in date for all equipment<br>

  Yes

  No

  N/A

• Competency Assessment Form.<br>Available records fully completed (Annually) signed and dated?<br>Corrective actions completed?<br>

  Yes

  No

  N/A

• Monthly Site Assignment Visit Form.<br>Available records fully completed, where required corrective actions completed?<br>

  Yes

  No

  N/A

• Monthly Staff Welfare Visit Form.<br>Welfare checks conducted by the managers for all staff on a monthly basis, records available and maintained inclusive of: <br>1. Welfare<br>2. Familiarity with site AI’s<br>3. Performance<br>4. Training needs<br>(N.B. Over a 3 month period, a maximum of 2 checks conducted over verbally, at least once per quarter there shall be a face to face interview with the staff). <br>

  Yes

  No

  N/A

• Additional Comments, Corrective actions etc.

• Cleanall Managers Signature.

  Sign

• Clients Signature.

  Sign