Title Page
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Conducted on
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Prepared by
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Project Name & Address
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Description of works on site today
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Contractor & sub contractors
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Did you get out of your car?
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Did you view the COVID Safe Plan?
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Did you view their SWMS?
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Number of people on site
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Trades on site (concreters/engineers/traffic management etc.,)
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Was everyone wearing masks?
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Was everyone social distancing?
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Was anyone sharing tools?
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general hygiene observations (eg, cleaning equipment, wash stations, separate facilities etc.,)
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Other observations
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Action taken to rectify issues
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Further action/escalation required
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Include photos of practices observed
