Information
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Client/Jobsite Name
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Conducted on
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Prepared by
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Location
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Personnel
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Job Status
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3 Largest/Upcoming Risk in the next 30 Days
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Job Number
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Region:
- 1
- 2
- 3
- 4
- 5
- 6
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Superintendent:
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Foreman 1
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Foreman 2
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Project Manager(s):
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Current Job Photos
Project Planning and Education
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B&G site specific safety plan, hazcom, msds present?
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Safety orientation being done and up to date?
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Bi-weekly PM/Supt safety walks up to date, and are issues being identified and corrected?
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Daily JSA's completed? Quality? Entire crew attending?
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Weekly safety meeting held/documented?
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Training - OSHA 10/30 hour and specific equipment
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Safety as a main topic in Schedule/Coordination meetings?
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Safety notebook current?
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Emergency action plan posted and communicated?
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Comments:
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Attachments
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Attachments
Subcontractor Management
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Startup meetings completed and documented?
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Safety documents current?
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Participation in regular safety walks as required?
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Sub supervision showing accountability for personnel in field?
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B&G holding sub supervision accountable?
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Following up on safety issues? Increasing accountability for repeat items?
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Training - Adequate for scope of work being performed, including specific equipment?
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Competent person, OSHA 10/30 for supervision is required?
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Comments:
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Attachments
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Attachments
Injury/Accident/Incident Management
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Reported in a timely manner?
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Accident/Incident report(s) complete?
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Root cause reports complete?
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Corrective actions implemented
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Actively managing employee return to work, modified duty provided
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Injury diary maintained for injured employee(s)
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Injury log maintained job wide
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Is the Team identifying and communicating near misses?
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Current Stats
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Number of recordables
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Number of lost time days
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Number of first aids
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Comments:
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Attachments
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Attachments
Current Site Conditions/Behaviors
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Jobsite posting & documentations
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Housekeeping/material storage/general appearance
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Building pad and surrounding areas
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Excavations
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Elevated floors
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Roof areas
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Personal protective equipment
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Fuel storage
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Equipment
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Electrical including weekly GFCI inspections
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Hand/power/powder actuated tools
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Fire protection and prevention in place?
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Rigging and signaling
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Foreman - performance in required level of supervision
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Foreman - superintendent expectations communicated
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Comments:
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Attachment
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Attachment
Presence of Safety Summary:
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Foreman 1 Score
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Foreman 2 Score
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Project Manager Signature:
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Superintendent Signature:
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Safety Manager Signature: