Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Observations
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Did the person being observed attend the daily pre start meeting?
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Is the task being conducted covered by a TSA or Procedure? which is being followed adequatly
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Has the person being observed signed the TSA or Procedure?
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Are all site management rules being complied with during the task? (PPE requirements, working alone, etc)
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Does the person being observed have the appropriate competencies required for the task?
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Has a Pre Start Check been completed for the items of plant being used?
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Is all plant being used for the task fit for purpose and in a safe and serviceable condition?
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Is the working environment safe to complete the task? (noise, air contaminants, weather conditions, etc)
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Is adequate communication being used between workers completing the task? (two way radios, visual, etc?)
Instructions or Advice Provided to Person Being Observed?
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Instructions Provided
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Advice Provided
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Positive Feedback to Observed Person
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Opportunities for Improvement
Signatures
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Person Conducting Observation
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Person being Observed