Rocky Mountain Drywall Site Safety Assessment

• Supervisor

• Address

• Conducted on

  Date

• Prepared by

• Subdiv
  Address

• Crew Leader

1. Working at Heights

• 1.1. Fall risks of 6' or more?

  Safe

  At Risk

  N/A

• 1.2. Lack of edge protection? (Guard rails installed?)

  Safe

  At Risk

  N/A

• 1.3. Personal fall arrest system (PFAS) meets requirements?

  Safe

  At Risk

  N/A

2. Scaffolds

• 2.1. Wheels or base plates used?

  Safe

  At Risk

  N/A

• 2.2. Cross braces used?

  Safe

  At Risk

  N/A

• 2.3. Scaffold fully planked?

  Safe

  At Risk

  N/A

• 2.4. Fall protection used?

  Safe

  At Risk

  N/A

3. Ladders, Walk-ups, and Stilts

• 3.1. Unsafe or damaged ladder or walk-up?

  Safe

  At Risk

  N/A

• 3.2. Unsafe positioning of ladder or walk-up?

  Safe

  At Risk

  N/A

• 3.4. Ladder or walk-up unsuitable for job?

  Safe

  At Risk

  N/A

• 3.5. Stilts in good working condition?

  Yes

  No

  N/A

4. Personal Protection Equipment

• 4.1. Safety glasses needed and used?

  Yes

  No

  N/A

• 4.2. Hard hats needed and used?

  Safe

  At Risk

  N/A

• 4.3. PPE in good working condition?

  Safe

  At Risk

  N/A

5. Work Environment

• 5.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  Safe

  At Risk

  N/A

• 5.2. Insufficient lighting?

  Safe

  At Risk

  N/A

• 5.3. Inadequate housekeeping?

  Safe

  At Risk

  N/A

• 5.4. Home access is within 19"?

  Safe

  At Risk

  N/A

• 5.5. Floor openings?

  Safe

  At Risk

  N/A

6. Electrical Hazards

• 6.1. Cords rated for heavy duty and free of breaks?

  Safe

  At Risk

  N/A

• 6.2. Temporary panels is grounded and in good shape?

  Safe

  At Risk

  N/A

• 6.3. Overloading outlets?

  Safe

  At Risk

  N/A

• 6.4. Electrical equipment near water?

  Safe

  At Risk

  N/A

• 6.5. Electrical is GFI protected?

  Safe

  At Risk

  N/A

• 6.6. Electrical cover plate installed?

  Safe

  At Risk

  N/A

7. Administrative Procedures

• 7.1. No quality and Safety checklist on site.

  Safe

  At Risk

  N/A

• 7.2. Inadequate or improperly completed Quality and Safety checklist.

  Safe

  At Risk

  N/A

• 7.3. Lack or, or inadequate, supervisory arrangements?

  Safe

  At Risk

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign