Information

  • Location
  • Work being monitored:

  • Team / Person checked:

  • Company monitored

  • Select date

  • Safety Document

  • Is available and held in safe custody, the work activity complies with requirements of any safety document. Risk assessments and method statements are being complied with.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • RAMS, POWRA and/or SARA

  • Available and held in safe custody, suitable for task.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Demarcation

  • Remains as constructed and is an effective control from the system hazards e.g. cones all standing and correctly positioned, chain suspended, access point provided and notice up to date, hazard signs warning of adjacent equipment outside work area.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Provision of safe access / egress

  • Established both to / from work area and within the work area

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Work area / space

  • Is tidy and free from obvious hazards

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Environmental controls

  • Are being effectively applied e.g. no spill or leaks, correct storage and labelling of materials, bunds used, waste segregated and managed, emissions controlled etc.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Lighting

  • Adequate for task, provision of additional lighting if required and, it works / is being used correctly.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Lifting and Handling

  • Hazards identified, controls adequate and correctly applied

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Work at Height or Confined Space

  • Hazards identified, controls used and correctly applied e.g. safe access provided, equipment used, no work over / under, no lone working, rescue / emergency arrangements in place

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Tripping / Falling

  • Hazards identified, controls adequate and correctly applied

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Tools / Work Equipment

  • Appropriate for the task and being used safely, are inspected, PAT tested etc, any inspection records in date

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • COSHH

  • Substances appropriately selected, controls adequate and correctly applied, clear labelling, stored properly

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Noise

  • Hazards identified, controls adequate and correctly applied

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • PPE

  • Available, appropriate for the task, is being used, is in good condition, compliance with applicable safety line policy

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • CDM and Temporary Works Management

  • Adequate provision is made to manage CDM or temporary work

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Competence

  • Safety Rules (Person/BESC), applicable NSIs, and equipment (MEWPS, ETC)

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Communication, Co-ordination and Control of the work

  • Talk to those involved in the work and establish if they are aware of: what work is taking place, who is in control, site induction requirements, hazards and controls, arrangements in place to keep everyone safe, emergency arrangements etc. Use the areas above on this form as topics of conversation.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

  • Others

  • Notes, actions, comments, additional areas of monitoring.

  • Satisfactory?

  • Record comments and actions

  • Add Photo

Completion

  • Audit completion

  • Completed by

  • Signed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.