Onestaff North Island PPE Checklist

• Document No.

• Onestaff North Island PPE Checklist

Client Information

• Company Name

• Client location
  Address

Auditor Details

• Checklist Completed By

  Select Matt Groucott Steve Mulcahy Neisha Groucott Tessa Key Steve Humphrey Jodie Gummer Jon Braniff Jon Ives Troy Thurston Logan Fui Okert Brits Spencer Shaw Bryn Hudson Megan Nicholson Anneke Pepping Russell Kopu Rebecca Quinn-Nicol

  • Matt Groucott
  • Steve Mulcahy
  • Neisha Groucott
  • Tessa Key
  • Steve Humphrey
  • Jodie Gummer
  • Jon Braniff
  • Jon Ives
  • Troy Thurston
  • Logan Fui
  • Okert Brits
  • Spencer Shaw
  • Bryn Hudson
  • Megan Nicholson
  • Anneke Pepping
  • Russell Kopu
  • Rebecca Quinn-Nicol

• North Island Branch

  Select Palmerston North Wellington Auckland Hawkes Bay New Plymouth

  • Palmerston North
  • Wellington
  • Auckland
  • Hawkes Bay
  • New Plymouth

• Conducted on

  Date

Employee Information

• Employee Name

• Length of Assignment

  Select Less than 3 Months Less than 6 Months Less than 1 Year 1Year +

  • Less than 3 Months
  • Less than 6 Months
  • Less than 1 Year
  • 1Year +

PPE is fit for purpose and worn correctly

• Hard hat

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Steel Cap Boots

  Yes

  No

  N/A

• Welding Helmet

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Hi Viz Clothing

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Wet Weather Gear

  Yes

  No

  N/A

• Respirator/Dust Mask

  Yes

  No

  N/A

• Overalls

  Yes

  No

  N/A

• Additional PPE

• Is replacement PPE Required?

  Yes

  No

  N/A

• Date of Replacement

  Date

Employee Safety Culture Survey

• Health & Safety information is communicated in simple to understand ways and is openly discussed?

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Managers enforce safety rules & stop work if unsafe

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• It is known how to correctly report all incidents/near misses and is carried out when applicable

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Employees receive a full induction that includes H&S

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Managers communicate the importance of working safely and encourage employees to say something when they see unsafe behaviour

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Employees are invited to participate in safety discussions

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Hazards are adequately safeguarded and the ID of hazards welcomes employee participation

  Select 1 - Never 2 - Rarely 3 - Occasionally 4 - Often 5 - Always

  • 1 - Never
  • 2 - Rarely
  • 3 - Occasionally
  • 4 - Often
  • 5 - Always

• Additional comments/concerns

Sign off

• Employee Signature

  Sign

• Assessor Signature

  Sign