Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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SUGGESTED AREA’S FOR REVIEW/FOCUS
1) PERSONAL PROTECTIVE EQUIPMENT (Eyes – Ears – Head – Hands – Feet/Legs – Respiratory system – Torso – Face – Arms) -
Monthly Focus Area 1
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Compliant or Area for Improvement (AFI)
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Comments
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SUGGESTED AREA’S FOR REVIEW/FOCUS 2) POSITION OF PEOPLE (Strike against? – Struck by? – Caught between? – Slip/Trip/Fall? – Hit from above? – Maintain clearances – Skin absorption? – Inhalation? – Ingestion?)
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Monthly Focus Area 2
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Compliant or Area for Improvement (AFI)
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Comments
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SUGGESTED AREA’S FOR REVIEW/FOCUS 3) ERGONOMICS (Postures – Repetitive task? – Lifting method – Work Area Design – Wrist position – Vibrations – Temperature – Lighting – Noise)
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Monthly Focus Area 3
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Compliant or Area for Improvement (AFI)
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Comments
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SUGGESTED AREA’S FOR REVIEW/FOCUS 4) TOOLS & EQUIPMENT (Fit for task? – Used correctly? – Rescue kit ready? – Appropriately stored – Scaffolding – Ladders secure? – Harness tight? – Signs in Place? – Test date valid?)
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Monthly Focus Area 4
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Compliant or Area for Improvement (AFI)
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Comments
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SUGGESTED AREA’S FOR REVIEW/FOCUS 5) PROCEDURES (Is Standard Procedure – Adequate for Task? – Being followed? – Available? – Isolations? – Correct use of Locks? – 3 points of contact? – Site Inducted? – Correct lifting techniques)
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Monthly Focus Area 5
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Compliant or Area for Improvement (AFI)
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Comments
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SUGGESTED AREA’S FOR REVIEW/FOCUS 6) WORK AREA (Is Workplace Clean? – Drop zone? – Good housekeeping? – Effective communication? – Equipment storage – Site layout – Accessibility / restricted access? – Traffic Management – Excavations Safe)
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Monthly Focus Area 6
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Compliant or Area for Improvement (AFI)
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Comments
Close out
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Follow up actions
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