Information

  • Audit Title (Company/Contractor/Work Area)

  • Specific Site Location
  • Contractors Viewed

  • Conducted on

  • Team Members Present

1. Working at Heights

  • Team members in the area working are working from elevated surfaces?

  • 1.1. Team members in the area are safely working at heights.

  • 1.2. Employees are properly protected from fall risks of 6 feet or more.

  • 1.3. Sharp edges are protected in case they contact fall protection devices.

  • 1.4. Guard rails are installed properly.

  • 1.5. Warning lines/barricades are complete and installed properly.

  • 1.6. Personal fall arrest equipment is appropriate for exposure and is being used properly.

  • 1.7. Fall exposure and mitigation is appropriately addressed on JSA.

  • 1.8. Fall protection/ arrest components are stored/stowed properly.

2. Equipment

  • Team members are using tools, or other equipment to complete the job (grinders, LOTO, aerial work platforms)

  • 2.1. Tools, equipment, and accessories are safe to use (guards, grinding discs, cutting blades, etc.).

  • 2.2. Operators are trained in safe operation, clean-up and maintenance.

  • 2.3. LOTO procedures are followed for cleaning, servicing and maintenance of tools/equipment and is conducted per policy and is verified.

  • 2.4. Aerial work platform/scissor lift is being used properly / per manufacturer requirements.

  • 2.4.1. Fall protection is in place (lanyards, gates, etc.).

  • 2.4.2. Aerial work platform was inspected before use and was documented.

3. Scaffolds

  • Are scaffolds being used?

  • 3.1. Scaffolds viewed in the area appear to be safe and in good condition.

  • 3.2. Competent persons are erecting, altering, and inspecting scaffold (inspection documented).

  • 3.3. Scaffolds viewed appear to be be properly erected and as complete as possible.

  • 3.4. Safe Work Load (SWL) was provided and not exceeded.

  • 3.5. Scaffold viewed is erected properly to include proper bracing and tie-back.

  • 3.6.. Scaffold viewed has suitable access, to include swing gate and retractable when exposure exceeds 24".

4. Lifting/Rigging Equipment

  • Lifting/ rigging is being performed.

  • 4.1. Lifting/Rigging equipment in the area appears to be in good condition and safe to use.

  • 4.2. Crane and devices are safe to use.

  • 4.3. Loads are lifted to safely clear power lines, people, hazardous materials storage, etc.

  • 4.4. Maintenance, testing and inspection completed as required prior to use.

  • 4.5. Lift plan was completed prior to lift.

  • 4.6. Lifting equipment, including ropes, slings, chains, hooks etc. are in good condition.

  • 4.7. Lifting equipment has proper manufacturer labeling.

  • 4.8. Rigging is used per manufacturer requirements.

  • 4.9. Operator/Rigger is properly trained/certified.

  • 4.10. Safe rigging practices are being followed.

6. Ladders

  • Ladders are being used to complete task.

  • 6.1. Ladder viewed are safe to use (inspected before use, proper labeling, not damaged, etc.).

  • 6.2. Ladders viewed are correctly positioned, secured, etc.

  • 6.3. Ladders viewed are suitable for the task (eg. metal ladder not used for electrical work, scissor lift better for the job, etc).

  • 6.4. Ladders viewed are proper tool for job.

7. Hazardous Manual Tasks

  • Manual lifting hazards are present.

  • 7.1. Manual lifting hazards have been addressed.

  • 7.2. Stretching was completed before shift.

  • 7.3. Manual lifting risks are properly controlled (examples: job rotations, lighter loads, trolleys, lifting equipment, etc).

  • 7.4. Team members are trained to safely lift items.

  • 7.5. Material handling is evaluated on JSA.

8. Hazardous Chemical (including fuel and oil)

  • Hazardous chemicals are being used and/or are stored in the immediate area.

  • 8.1. Hazardous chemical risks are being controlled in the area.

  • 8.2. Hazardous materials are properly stored (flammables distance to ignition source, storm water controls, location to compatible materials, labeled, out of traffic, etc).

  • 8.3. Spill containment procedures and equipment are adequate for exposure present.

  • 8.4. Safety Data Sheets are accessible and on site.

  • 8.5. PPE is adequate for the exposure present.

9. Confined space entry

  • Confined space risks are viewed in the immediate area.

  • 9.1. Confined space related work is being performed.

  • 9.2. Procedures are being followed (permit).

  • 9.3. Emergency rescue is available.

  • 9.4. Atmospheric testing is conducted and documented.

11. Personal Protective Equipment (PPE)

  • 11.1. Required PPE is available, properly used, in use, and in good condition (safety glasses, sun protection, face shield, etc.).

  • 11.2. PPE is made available.

  • 11.3. PPE is in good condition.

  • 11.4. Team members have been trained in safe use, clean-up, and inspection of PPE.

12. Work Environment

  • 12.1. Amenities are adequate (toilets, wash areas, lunch rooms, lighting, site security, overhead protection, etc).

  • 12.2. Lighting is sufficient.

  • 12.3. Housekeeping is adequate.

  • 12.4. Noises and vibration are controlled.

  • 12.5. Site security and signage is in place and clearly visible.

  • 12.6. Suitable overhead protection is in place.

13. Electrical Hazards

  • Electrical hazards are present in the immediate area.

  • 13.1. Electrical related hazards in the immediate area are controlled.

  • 13.2. Electrical leads are in safe/good condition (damaged, out of test date or untested).

  • 13.3. Assured grounding requirements followed and up to date.

  • 13.4. Underground utilities were located and uncovered by hand prior to excavating.

  • 13.5. Minimum distances have been designated from overhead electrical lines delineated and maintained.

  • 13.6. Temporary electrical panels are safe (no voids, labeled, and GFCI protected).

  • 13.7. Leads and cords are properly suspended.

  • 13.8. Electrical equipment is protected from wet conditions/ GFCI in place.

  • 13.9. Electrical leads grounded directly to work?

14. Administrative Procedures

  • 14.1. JSA is completed and fully addresses exposures.

  • 14.2. Permits are approved and up to date (Council, EPA, Hot Works, Confined Space etc).

  • 14.3. Suitable orientation for workers, contractors, visitors?

  • 14.4. Supervisory arrangements are adequate.

  • 14.5. Weekly safety meetings and OSHA required training is conducted.

15. Items Not Addressed Above

  • 15.1. Other items not addressed above...

Risk Improvement Notes

  • Risk Improvement Action Items

  • Risk Improvement Action
  • General Notes

  • General Notes

  • General Notes

  • General Notes

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.