QHSE + FM Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Housekeeping

• General Housekeeping Issues & Observations

  Safe

  At Risk

  N/A

Personal Protective Equipment (PPE)

• Foot protection

  Yes

  No

  N/A

• Hands protection

  Yes

  No

  N/A

• Head protection

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Respiratory protection

  Yes

  No

  N/A

• Safety harness / Safety belt

  Yes

  No

  N/A

Ladders

• Safe / usable condition

  Yes

  No

  N/A

Scaffold

• Properly erected (all parts used)

  Yes

  No

  N/A

• Properly secured

  Yes

  No

  N/A

• Properly planked

  Yes

  No

  N/A

• Proper guard rails and toe board

  Yes

  No

  N/A

• Proper ladder access to platform

  Yes

  No

  N/A

Power tools & Equipments

• General condition

  Yes

  No

  N/A

• Proper guards, cords & PPE

  Yes

  No

  N/A

• Equipments and Machines PAT Tested

  Yes

  No

  N/A

• Tagging or labelled as defective

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Emergency Exit Staircase & Door

• Adequate lighting on staircase

  Yes

  No

  N/A

• No crack and damage to stircse

  Yes

  No

  N/A

• Proper handrail and guards

  Yes

  No

  N/A

• Emergency exit Door is accessible (not locked or obstructed)

  Yes

  No

  N/A

Cradle

• 3rd party certificate valid

  Yes

  No

  N/A

• Operators are trained with valid certificate

  Yes

  No

  N/A

• Is cradle check list filled

  Yes

  No

  N/A

• Are all slings ok?

  Yes

  No

  N/A

• Are all operators using PPE

  Yes

  No

  N/A

Gas Cylinders

• Properly located and secured

  Yes

  No

  N/A

• Properly moved and lifted

  Yes

  No

  N/A

• Properly stored

  Yes

  No

  N/A

First Aid Kit

• First aid kit available

  Yes

  No

  N/A

• First aider available

  Yes

  No

  N/A

• Adequate contents inside first aid kit

  Yes

  No

  N/A

Material Storage room

• Properly located

  Yes

  No

  N/A

• Safely piled, stacked , bundled or organized

  Yes

  No

  N/A

• Properly moved or lifted

  Yes

  No

  N/A

• Store room locked or authorized access only

  Yes

  No

  N/A

• Heavy items stored below

  Yes

  No

  N/A

• Chemicals stored as per COSHH standards

  Yes

  No

  N/A

• Properly labelled

  Yes

  No

  N/A

Signs

• Assembly points

  Yes

  No

  N/A

• Site HSE board

  Yes

  No

  N/A

• Emergency phone list

  Yes

  No

  N/A

• Warning signs at site

  Yes

  No

  N/A

Workers education & uniform

• HSE Induction training

  Yes

  No

  N/A

• How to report hazards and injuries (interview)

  Yes

  No

  N/A

• Personal health and safety responsibilities (interview)

  Yes

  No

  N/A

• Employees wearing appropriate uniform

  Yes

  No

  N/A

• Weekly toolbox talk

  Yes

  No

  N/A

Hygiene and welfare facilities

• Washroom facilities Available

  Yes

  No

  N/A

• Cleanliness of facilities

  Yes

  No

  N/A

• Drinking water available

  Yes

  No

  N/A

Fire protection

• Fire extinguishers present where required

  Yes

  No

  N/A

• Fully charged serviced and inspected

  Yes

  No

  N/A

• Fire alarm panel without faults

  Yes

  No

  N/A

FM - Mechanical

• FM - Mechanical issues at site

  Safe

  At Risk

  N/A

FM - Electrical

• FM - Electrical Issues

  Safe

  At Risk

  N/A

FM - Plumbing

• FM - Plumbing Issues

  Safe

  At Risk

  N/A

FM - Civil

• FM - Civil issues

  Safe

  At Risk

  N/A

FM - General

• FM - General Issues

  Safe

  At Risk

  N/A

Signatures

• HSEQ Officer

  Sign

• Site Incharge

  Sign