Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

  • The nine step approach to completing VFL's
    1, Stop and observe.
    2, Introduce yourself (unless you already know the person).
    3, Tell them what you're doing.
    4, The job and its stages.
    5, Give praise for safe behaviour.
    6, Ask about the worst thing that can happen, etc.
    7, Find the root cause of any unsafe behaviour or condition.
    8, Get solutions to the unsafe behaviour or condition
    9, Get commitment to act

  • Do you have your own personal locks and do they only have on key?

  • Are there any duplicate keys in a cabinet or managers office?

  • How have you locked off the equipment you are working on and where?

  • Have you had a toolbox talk on LOTOTO?

  • Can you show me the lock off point?

  • Do you know how to try out on this piece of equipment?

  • Do you know when a permit to work is required?

  • Have you ever had to cut a lock off, do you know the correct procedure?

  • Have you identified all hazardous energies that might allow this equipment to move?

  • Do you know the procedure for working on equipment that has no isolator

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.