QATC Take 5 - SAFETY CHECKLIST

• Conducted on

  Date

• Task or work area

• Task "actions to be included in file name"

• Location
  Address

• QATC Take 5 Checklist for the following activity type

  Select

STOP

• Is this task part of a audit safety check?

  Yes

  No

  N/A

• As part of our planning we have implemented the following additional controls .

  Select

THINK

• Have we thought through the tasks for today thoroughly?

  Yes

  No

  N/A

• Are supervisors trained, competent and authorised for these tasks ?

  Yes

  No

  N/A

• Does everyone have the correct PPE, enough water and equipment for todays tasks including a First Aid Kit

  Safe

  At Risk

  N/A

IDENTIFY

• Have I communicated with all work groups any hazards that may affect them or me?

  Yes

  No

  N/A

• Are we all fit to perform these tasks?

  Yes

  No

  N/A

• Have we considered the weather & environmental conditions for today’s tasks?

  Safe

  At Risk

  N/A

• What hazards are around me "here and now"? Select and make a list !

  Select

• What controls are in place for the identified hazards? Select and list all controls in place!

  Select

• What other actions have been taken to address todays tasks risks!

  Select

PLAN

• Have all been instructed in the task plan for this session?

  Yes

  No

  N/A

• Are these tasks correctly planned to protect the environment or cultural heritage?

  Yes

  No

  N/A

• Do we have the correct tools & equipment?

  Yes

  No

  N/A

• Is the work area prepared correctly, tidy and ready to work safely in?

  Safe

  At Risk

  N/A

• Take a photo of the work area where these tasks will occure today.

  Media

PROCEED

• Signature

  Sign

• Will the others involved be required to sign this Risk assessment

  Yes

  No

• Others that were present for this safety induction prior to work commencing

other people

• Name & Signature

  Sign

• Click on "+Add" to add more people to sign on