NMC NOMENCA - duplicate - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Questions

• Do you think Health and Safety is given the correct amount of importance at site

  Not enough

  About Right

  Too Much

• Are you encouraged to talk openly and honestly about Health and Safety issues?

  Yes

  No

  N/A

• Do you feel that you can influence Health and Safety at your site?

  Yes

  No

  N/A

• Do you know what a positive intervention is?

  Yes

  No

  N/A

• Have you attended a site induction?

  Yes

  No

  N/A

• Do you know where the fire assembly point is located?

  Yes

  No

  N/A

• If you found a better way of doing your job what would you do?

  Just do it

  Tell you mates

  Talk to super'

• Do you know what is meant by RAMS?

  Yes

  No

  N/A

• You find the RAMS are different to the task you are presently working on. Would you?

  Speak to him

  Tell your Supervisor

  Do Nothing

• What do you know about COSHH?

  Nothing

  Some Idea

  Compliant

• Do you receive a Tool Box Talk at least once a week?

  Yes

  Sometimes

  Not had one

• Do you know what is meant by the initials KSAW? (Keep Safe and Well)

  Yes

  No

  N/A

• If yes to the last question are you encouraged to discuss Health and Safety matters?

  Yes

  No

  N/A

• Do you know how to report a positive intervention?

  Yes

  No

  N/A

• Have you ever reported a positive intervention?

  Yes

  No

  N/A

• Did you get any feed back from your actions?

  Yes

  No

  N/A

• Do you know what a permit to work is?

  Yes

  No

  N/A

• 

• Do you know what the above sign means?

  Yes

  No

  N/A

• Do you know how to report an accident?

  Yes

  No

  N/A

• If you saw one of your workmates working in an unsafe manor what would you do?

  Speak to him

  Tell your Supervisor

  Do Nothing

General observations

• Is operator wearing the required PPE to do the task (Hi-Viz, Safety Boots, Gloves, Task Specific)?

  Yes

  No

  N/A

• Prior to the audit was the operator working in a safe manor?

  Yes

  No

  N/A

• Was the operator cooperative with the audit?

  Yes

  No

  N/A

• Was the initial contact with the operator?

  Positive

  Suspicious

  Negative