Pacifica Appliance Services - Field Safety Overview v5

• Date Of Inspection

  Date

• Inspector

• Engineer Name

• Employment Type (PAS/BG/Partner)

  PAS Direct Employed

  PAS Partner

  BG Employed

  BG Partner
• Location
  Address

• Select weather conditions at the time of inspection

  Select Clear Sky Cloudy Raining Windy Hazy Snow/Hail Sunny

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

• To ensure that all engineers have the correct tools, equipment and PPE to perform their job safely

  I Understood the objectives

  Further information required

• To ensure that all engineers can perform all mandatory electrical safety tests and understand the sequence of tests as well as the reasons for the safety procedures. This is achieved by monitoring, coaching and training. Photos of the engineer performing the tests are required

  I Understood the objectives

  Further information required

• Please refer to Pacifica Appliance Services - Safe Isolation Process located on LearnUpon

  Yes

  No

  N/A

• To confirm that the engineer is competent and safe to work

  I Understood the objectives

  Further information required

Resident Inspection Authorisation & COVID 19 Questions

• 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)? Please photograph items

  Yes

  No

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?

  Good

  Fair

  Poor

  N/A

• Is the works vehicle tidy? Photos of vehicle required (inside & out)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• RAMS

• 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, work zone locations and able to carry out a dynamic risk assessment?

  Yes

  No

  N/A

Electrical Equipment Checklist (Please photograph the serial number & Calibration date)

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

  Media

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

  Media

• 2-Pole Indicator condition

  Media

• Personal RCD

  Media

• All Lock Off Equipment & Devices Condition

  Media

Electrical - Safe Isolation Process (Please photograph the engineer performing each test)

• REQUIRED - Engineer MUST Demonstrate Safe Electrical Isolation Process

• Can the Operative make correct use of the non-contact Volt Detector (Volt Stick x2 available)? Photos of the engineer carrying out the test required.

  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)? Photos of the engineer carrying out the test required.

  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? Photos of the engineer carrying out the test required.

  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? Photos of the engineer carrying out the test required.

  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? Photos of the engineer carrying out the test required.

  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

• Personal RCD available

  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

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

  Yes

  No

  N/A

Sign Off

• Auditor Feedback (Please detail your observations and any coaching provided to engineer)

• Auditor Sign

  Sign

• Engineer Sign

  Sign