Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site Access

  • Access is clean, level ground

  • Adequate stairs and Ramps


  • Clear walkways

  • Clear office or work area

  • Clean common area

  • Clear emergency exit staircase

Personal Protective Equipment (PPE)

  • Foot protection

  • Hands protection

  • Head protection

  • Eye protection

  • Hearing protection

  • Respiratory protection

  • Safety harness / Safety belt


  • Secured

  • Proper size and type

  • Safe / usable condition

  • Non slip bases

  • Proper handrails and landing


  • Properly erected (all parts used)

  • Properly secured

  • Properly planked

  • Proper guard rails and toe board

  • Proper ladder access to platform

Power tools & Equipments

  • General condition

  • Proper guards, cords & PPE

  • Equipments and Machines PAT Tested

  • Tagging or labelled as defective

  • Other

Emergency Exit Staircase & Door

  • Adequate lighting on staircase

  • No crack and damage to stircse

  • Proper handrail and guards

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


  • 3rd party certificate valid

  • Operators are trained with valid certificate

  • Is cradle check list filled

  • Are all slings ok?

  • Are all operators using PPE

Gas Cylinders

  • Properly located and secured

  • Properly moved and lifted

  • Properly stored

First Aid Kit

  • First aid kit available

  • First aider available

  • Adequate contents inside first aid kit

Health Club

  • Main pool clean, water temperature at 28/ 29 degrees, chlorine & Ph in acceptable level

  • Pool heater working, circulation and standby pump working

  • Pool deck clean, chairs in good condition, warning signs in place, pool internal and external light working

Material Storage room

  • Properly located

  • Safely piled, stacked , bundled or organized

  • Properly moved or lifted

  • Store room locked or authorized access only

  • Heavy items stored below

  • Chemicals stored as per COSHH standards

  • Properly labelled


  • Assembly points

  • Site HSE board

  • Emergency phone list

  • Warning signs at site

Workers education & uniform

  • HSE Induction training

  • How to report hazards and injuries (interview)

  • Personal health and safety responsibilities (interview)

  • Employees wearing appropriate uniform

  • Weekly toolbox talk

Hygiene and welfare facilities

  • Washroom facilities Available

  • Cleanliness of facilities

  • Drinking water available

Fire protection

  • Emergency response Fire warden/ Fire Fighter available

  • Fire extinguishers present where required

  • Fully charged serviced and inspected

  • Fire alarm panel without faults


  • Emergency response drill conducted

  • Annual fire drill conducted

Diesel / Fuel on site

  • Diesel/Fuel safely stored at site under proper temperature and labelling

  • Appropriate Diesel level in Fire and Generator pump rooms etc


  • HSEQ Officer

  • Site Incharge

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.