QCD SVR-D001

• Document No.

• Client

• Conducted on

  Date

• Prepared by

• Site
  Address

• Staff Number (s)

Uniform Presentation

• Site Type

  Construction Site

  White Collar

  Door Supervision

  Event

• Select Applicable Uniform (as presented)

  Select White Collar Shirt Black Polo Shirt Black Combats Black Trousers Tie Hat / Cap

  • White Collar Shirt
  • Black Polo Shirt
  • Black Combats
  • Black Trousers
  • Tie
  • Hat / Cap

• Photographic Evidence of Uniform

  Media

PPE

• PPE Required? Check Applicable Items

  Select Hard Hat Safety Boots Ear Defenders Hi Vis Vest Torch 4 in 1 Gas Monitor

  • Hard Hat
  • Safety Boots
  • Ear Defenders
  • Hi Vis Vest
  • Torch
  • 4 in 1 Gas Monitor

• Correct PPE being used as specified?

Overall

• Overall Appearance Score

Timesheets

• Timesheet present?

• Elements completed correctly?

  Select Name / Employee Number Date SIA number & Expiry Sign In Time Sign Out Time Total Hours Signature Site Manager Sign Off

  • Name / Employee Number
  • Date
  • SIA number & Expiry
  • Sign In Time
  • Sign Out Time
  • Total Hours
  • Signature
  • Site Manager Sign Off

• Photographic Evidence of Timesheets

  Media

Occurence Logs

• Occurence Logs present?

• Sufficient supply of Occurrence Logs?

• Element completed correctly?

  Select Dates correctly entered, accounting for date change at midnight where on night shifts? Times correctly entered in a 24 hour format? Sudficient detail included in log entries? Log numbers correctly generated in continual ascending order? Initials / Staff Numbers correctly entered? Site Manager signed off at the end of each shift?

  • Dates correctly entered, accounting for date change at midnight where on night shifts?
  • Times correctly entered in a 24 hour format?
  • Sudficient detail included in log entries?
  • Log numbers correctly generated in continual ascending order?
  • Initials / Staff Numbers correctly entered?
  • Site Manager signed off at the end of each shift?

• Photographic Evidence of Occurence Logs

  Media

Incident Reporting

• Are Incident Reports being correctly completed?

  Yes

  No

  N/A

• Photographic Evidence of Incident Reports (if applicable)

  Media

SIA Licensing

• ORIGINAL SIA License on display?

  Armband

  Lanyard

  No

• Photographic Evidence of SIA License

  Media

• SIA License Number:

• SIA Expiry date:

• Register of SIA License Holders
  http://www.sia.homeoffice.gov.uk/Pages/licensing-rolh.aspx

• License verified as valid?

  Verified

  NOT VALID