Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Personnel assisting with inspection
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Location/ Address
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What type of business is the work site?
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Describe the type of work site, e.g. Construction, farm, garage, hair salon, etc.
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Who is the main contact person at the work site? (provide names and contact numbers)
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Enter persons name
Person
- Contact number
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Does the employer have an age requirement?
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What is the minimum age required?
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Is a drivers license required?
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Who will provide on site supervision and job related training for the student? (provide name(s) of persons)
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Provide persons name
Person
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Will job related health and safety training and orientation be provided to the student? (list any courses that may be provided e.g. WHIMS, TDG)
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List courses
Training
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Courses
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Is the student expected to wear any personnel protective equipment?.
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Hearing protection
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Eye protection
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Footwear
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Headwear
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Gloves
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Coveralls/uniform
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Other
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Please specify other
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Is the student required to supply any of the personal protective equipment?
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Hearing protection
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Eye protection
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Footwear
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Head protection
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Gloves
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Coveralls/uniform
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Other
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Please specify other
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Is the arrangement for personal protective equipment acceptable?
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Is the employer familiar with the process for reporting a student injury? Does the employer know how to report an injury to Alberta Workplace Compensation?
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Are there emergency procedures in place; e.g. fire, spill?
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Are fire extinguishers, first aid kits maintained and readily available?
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Are emergency exits/signs clearly visible?
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Is emergency eyewash equipment (if necessary) maintained and readily available?
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List the most critical potential or danger of this job; chemical, biological, ergonomic, physical, psychological, other. Have these hazards been identified and controlled by the employer?
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Biological
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Describe:
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Chemical
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Ergonomic
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Physical
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Describe:
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Psychological/cultural factors e.g. bad language, negative attitude
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Describe:
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Other
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Describe:
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How will the students be made aware of these hazards/dangers?
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Describe how students will be made aware
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List the tools, materials and equipment the student will be expected to use or handle; hand tools, power tools, power lift equipment, heavy equipment, vehicle operation, chemical handling, deep fryer, welding, farm machinery, other.
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Hand tools
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Power tools
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Power lift equipment
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Heavy equipment
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Describe:
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Vehicle operation
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Describe:
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Chemical handling
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Deep fryer/ovens
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Farm equipment
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Describe:
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Other
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Describe:
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Does this work site appear to provide an orderly, well maintained safe caring work and learning environment?
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Inspector
