Romane SH AUDIT

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Add location
  Address

• Select date

  Date

• Add media

  Media

Recommendations are either IMMEDIATE — HIGH — MEDIUM — LOW

IMMEDIATE

• Action Immediately — Where a hazard presents serious and imminent danger to the safety of employers, residents and visitors.

HIGH

• Action within 5 working days — Where a hazard presents a serious danger to the well being of employees, residents and visitors.

Medium

• Action within 3 months — where a hazard is considered to present a risk to employees, residents or visitors.

Low

• Action within 6 months — where a hazard is perceived that could lead to a non conformance occurring.

Premises Coordinator

• Is there a premises coordinator

  Select Yes No

  • Yes
  • No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Policy, Posters and Documents

• Do employees know how to access employers health and safety policy?<br>

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is a Health and Safety law poster prominently displayed?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Accident Reporting and Investigation

• Are employees aware of accident reporting procedures?<br>

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are employees aware of RIDDOR reporting procedures?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there evidence of accidents being reported?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are risk assessments and safe systems of work reviewed following an accident?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Lone Working

• Do any employees undertake lone working?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are employees aware of lone working procedures?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Risk Assessment

• Is there clear evidence that risk assessments have been undertaken for the premises and activities?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the risk assessments considered to be suitable and sufficient?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the risk assessments regularly reviewed, signed and dated?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the risk assessments communicated to employees?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Safe System of Work

• Are there safe systems of work in place for all tasks which require one?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the systems being followed?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Training and briefings

• Have new staff received a health and safety briefing/induction?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Fire

• Is there a named person responsible for fire safety and maintaining the premises fire log book?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there an in date fire risk assessment?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Has a clear fire action plan been developed following on from the fire risk assessments?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Has a general fire evacuation plan been developed?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are weekly fire alarm tests being carried out?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is portable fire fighting equipment (fire extinguisher, etc) being serviced annually?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is emergency lighting regularly serviced?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Do the premises display simple fire action notices in key locations?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the information in the fire action notices accurate?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Do the fire exit signs meet current standard ( pictograms)?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are fire exits, alarms points and fire fighting equipment free from obstruction?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the building/area under control free from rubbish and poorly stored combustible materials?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

First Aid

• Is there an in date first aider?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the first aid kit correctly stocked?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Legionella

• Is there someone who has legionella management awareness for the site, even remote support?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there an up to date and signed legionella risk assessment in place?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are all risk assessment actions carried out?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are all test records available for inspection, temperature, bacteriological and flushing?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

COSHH

• Is there a nominated person that can demonstrate an understanding of the requirements under COSHH.

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Buildings

• Are all fire doors in good order and do they close correctly?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are there records of portable appliance testing?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the fabric of the building in good condition?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Do doors which require door closers preventing slamming have them in place?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Housekeeping

• Is the general standard of cleaning acceptable?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are steps, stairwells or stairs free from obstruction or unsafe storage?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is storage tidy and accessible?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is area free from slip/trip hazards?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are sufficient bins available?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is lighting suitable and sufficient?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Work equipment

• Is equipment suitable for purpose?

  Yes

  No

  N/A

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is equipment used for intended purpose?

  Yes

  No

  N/A

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Standing Instructions

• Are up to date instructions available for Fire Evacuation?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are up to date instructions available for bomb threats or suspect packages?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are up to date instructions available for emergency planning.

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Has this information been communicated to staff.

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Premise documentation

• Is the responsible person's premises log available?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are visitors procedures followed for signing in/badges?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there a contractor signing book available?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there a permit to work system in place as appropriate?

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Asbestos Management

• Does the responsible person have access to the AsbestosManagement Systems

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there a Hard copy or readily available software version of Asbestos Register?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there a nominated trained person to manage asbestos? <br>

  Yes

  No

  N/A

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the Asbestos management plan available? - Answer = Yes<br>

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is there access to the Asbestos Policy?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are contact numbers of asbestos team available?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

General Inspection

• Are all the exits readily available and not covered by curtains or obstructed by equipment or tripping hazards?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are exits appropriately signed? - Answer = Yes<br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are any stores tidy and safe? - Answer = Yes<br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the entrance secured (if appropriate)?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are appropriate (relevant to client base) visitor control measures in place: signing in/badges/waiting area

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are other potential entrances in the vicinity of the Reception kept locked or clearly state they are not for use?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are entrance/exit routes free from obstructions & other slip/trip hazards? <br>

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are routes clear from a build up of leaves/moss/mud that can make the entrances/exits slippery?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are floors free from raised or curled up carpet edges, raised floors or tiles ?<br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are sunken mat wells with mats below the edges?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are there mats at entrances to prevent corridor floors becoming wet during wet and snowy weather?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are windows in good condition?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Do doors open/close freely?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Anything in corridors reducing width, making it insufficient for emergency?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Cloakroom/toilets

• Are there doors on all of the cubicles? - Answer = Yes<br>Is the area free from any signs of smoking or matches being used in the area? - Answer = Yes<br>Are the toilets clean and well maintained? - Answer = Yes<br>Is the flooring anti-slip in areas that may become wet where necessary? - Answer = Yes<br>Is hot water at a suitable temperature i.e. not too hot - Answer = Yes<br>Is soap and hand towels/dryers provided? - Answer = Yes<br>Are toilets accessible for people with disabilities? - Answer = Yes<br>Are there any disabled toilets? Do they have alarms fitted? - Answer = Yes

  Yes

  No

  N/A

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the area free from any signs of smoking or matches being used in the area? <br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the toilets clean and well maintained? <br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is the flooring anti-slip in areas that may become wet where necessary? <br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is hot water at a suitable temperature i.e. not too hot?<br>

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Is soap and hand towels/dryers provided?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are toilets accessible for people with disabilities?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are there any disabled toilets? Do they have alarms fitted?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Stairs

• Are stairs free from any gaps in the stairs' handrail to enable a child to bypass it?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the stair treads in good condition?<br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are the stair nosing's in good condition? <br>

  Yes

  No

  N/A

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are hand rails in good condition? <br>

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are stairs free from any raised tiles or damaged flooring?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Lifts

• Is the lift regularly maintained?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Boilers

• Is the boiler house secure?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Kitchen

• Is equipment clean?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Are emergency systems in place, fire blanket etc?

  Yes

  No

• Add media

  Media

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

Roof/working at heights

• Is there safe access to the roof for maintenance?

  Yes

  No

• Recommendation

  Select Immediate High Medium Low

  • Immediate
  • High
  • Medium
  • Low

• Auditor

  Sign

• Select date

  Date

• Auditee

  Sign

• Select date

  Date