Pacifica Appliance Services - Field Safety Overview v3 - duplicate

• Site conducted

  Select

• Conducted on

  Date

• Inspector

• Location
  Address

Resident Inspection Authorisation & COVID 19 Questions

• Engineer Name

• Does the Operative have COVID RAMS, present, signed and in-date?

  Yes

  No

• Can the Operative clearly outline the procedure to prevent the spread of COVID?

  Yes

  No

• Is the Operative aware of the COVID symptoms?

  Yes

  No

• Does the Operative have all COVID PPE available as supplied by the Company (Sanitizer, wipes, disposable gloves, face visor, masks)?

  Yes

  No

• Select weather conditions at time of inspection..

  Select Clear Sky Cloudy Raining Windy Hazy Snow/Hail Sunny

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow/Hail
  • Sunny

Site Safety and Customer Service

• Do Operatives carry valid ID Cards [I.E Company ID, Gas Safe, OFTEC, NICEIC]

  Yes

  No

  N/A

• Is the works vehicle parked safely?

  Yes

  No

  N/A

• Is the works vehicle tidy?

  Yes

  No

  N/A

• Does the Operative have access to current RAMS? (LearnUpon)

  Yes

  No

  N/A

• Evidence Site Safety Set-Up: Have Operatives set up the work area in an orderly fashion, keeping access/ egress routes free from obstruction?

  Yes

  No

  N/A

• Are the Operatives using the correct floor protection?

  Yes

  No

  N/A

• Has the customer been suitably advised on the repair process and potential hazards associated, including the safe zone and work zone locations?

  Yes

  No

  N/A

Electrical Equipment Checklist

• Earth Loop Impedance Meter / Capture serial number & calibration date

  Media

• Insulation Resistance & Continuity / Capture serial number & calibration date

  Media

• RCD Response Time Test Meter (BG Only) / Capture serial number & calibration date

  Media

• 2-Pole Indicator Condition

  Media

• Personal RCD

  Media

• Any / All Lock Off Equipment & Devices Condition

  Media

Electrical - Safe Isolation Process

• REQUIRED - Engineer MUST Demonstrate Safe Electrical Isolation Process

• Can the Operative make correct use of the non-contact Volt Detector (Volt Stick x2 available)?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

• Yes

  No

  N/A

• Can the Operative perform an Earth Loop Impedance Test (ELI)?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

• Can the Operative perform an RCD Response Time Test (BG Only)?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

• Can the Operative perform an Earth Continuity Test?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

• Can the Operative perform an Insulation Resistance Test?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

• Can the Operative make use of the 2-Pole Indicator to prove dead?

  Pass

  Fail

• Inspector - refer to attached Electrical Safety Training Presentation & Provide Training

• Following training given, I "The Operative" can confirm I have read, received and will adhere to all information provided

  Sign

PPE & Work Equipment

• Picture of full PPE [Empty Contents and Check Equipment Stock Levels]

  Media

• Does the Operative have the correct PPE /Work Equipment in order to undertake the work safely? [Including COVID PPE]

  Yes

  No

  N/A

• Does the Operative have a fully stocked, in date First Aid Kit including eyewash?

  Yes

  No

  N/A

• PPE / Equipment Checklist

  Select Test Socket Adaptor FFP3 Face Masks Socket & See [Earth Loop Tester] Voltage Detector / Volt Pen Surface Protection Mats RCD PPE Storage Kit Bag Electrical Lock Off Equipment Cable Ties Padlocks Safety Glasses Bump Cap First Aid Kit Including Eyewash Dustsheets / Floor Protection Cut 3 Gloves Cut 5 Gloves Non-slip Overshoe Hi-Viz Safety Footwear Socket and See (RCD Tester) Kevlar Sleeves PPE / Equipment Storage Bag

  • Test Socket Adaptor
  • FFP3 Face Masks
  • Socket & See [Earth Loop Tester]
  • Voltage Detector / Volt Pen
  • Surface Protection Mats
  • RCD
  • PPE Storage Kit Bag
  • Electrical Lock Off Equipment
  • Cable Ties
  • Padlocks
  • Safety Glasses
  • Bump Cap
  • First Aid Kit Including Eyewash
  • Dustsheets / Floor Protection
  • Cut 3 Gloves
  • Cut 5 Gloves
  • Non-slip Overshoe
  • Hi-Viz
  • Safety Footwear
  • Socket and See (RCD Tester)
  • Kevlar Sleeves
  • PPE / Equipment Storage Bag

• Any equipment damaged or missing - arrange replacement

• Work being carried out in a safe manner using appropriate, serviceable PPE?

  Pass

  Low Risk Defect

  High Risk Defect

  Severe Risk Defect

• Operatives Gloves & Work Clothing

  Media

• Is all hand tools / field equipment free from damage?<br>(if at risk, remove from use immediately and replace)

  Safe

  At Risk

  N/A

• Has the defective equipment been immediately removed from site?

  Yes

  No

  N/A

• Personal RCD available

  Yes

  No

  N/A

• Does the engineer understand the correct method of use

  Yes

  No

  N/A

• Does the Operative have X1 1KG Powder Fire Extinguisher Available? [Fully Pressurised and Maintained]

  Yes

  No

  N/A

• Extinguisher Condition

  Media

• Is safety footwear in good condition and of the correct type?

  Yes

  No

  N/A

• Are staff aware of the correct PPE for the tasks they are trained to perform?

  Yes

  No

  N/A

• Access Equipment / Lifting Equipment in good condition and free from any defects? (Check feet, platforms **where applicable)

  Yes

  No

  N/A

• Remove from use immediately and arrange replacements

• Oven Table

  Safe

  At Risk

  N/A

• Cooker table

  Safe

  At Risk

  N/A

• Hop-Up

  Safe

  At Risk

  N/A

• Does the Operative have correct paperwork [Warning Labels, Electrical and Gas]

  Yes

  No

  N/A

Sign Off

• Auditor Feedback

• Auditor Sign

  Sign

• Operative Sign

  Sign