Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Opening Conference

1: Transportation: 29 CFR 1910.178

  • 1.1 Are gladhand locks being used?

  • 1.2 Straight truck/box truck securement (air brake locks)?

  • 1.3 Are wheel chocks being used?

  • 1.4 Training Documentation?

2: Lockout/Tagout (Hazardous Energy): 29 CFR 1910.147, 29 CFR 1910.332

  • 2.1 Does the location have a Lockout/Tagout Written Program?

  • 2.2 Was there a list of Authorized Employees (FSB Online Training (MFG006), Employee Training Packet /Training Quiz & Annual Certification records); Are all maintenance employees accounted for?

  • 2.3 Is there training documentation for authorized/affected/other employees (NEOP Packet)? Please provide 3 examples.

  • 2.4 Are there records of Periodic Inspections being completed?

  • 2.5 Could the company provide a table of contents for all LOTO procedures?

  • 2.6 Are specific procedures put in place for each piece of equipment?

  • 2.7 Does the facility have an LOTO station?

  • 2.8 Did the location provide their corrective action policy for when employees don't follow standard protocol?

3: Fall Protection: 29 CFR 1910.27, 29 CFR 1910.23, 29 CFR 1910.140 (c)(21)

  • 3.1 Does the location have a Fall Protection Written Program?

  • 3.2 Was there a list of Authorized Employees?

  • 3.3 Is there training documentation for authorized employees?

  • 3.4 Are there inspection reports for harnesses and lanyards?

  • 3.5 Did the location provide their corrective action policy for when employees don't follow standard protocol?

  • 3.6 Did the location provide a fall protection rescue plan?

  • 3.7 Are there inspection reports for Gantry/Bridge cranes?

4: Forklifts/Powered Industrial Trucks: 29 CFR 1910.178

  • 4.1 Does the location have a Forklift Written Program?

  • 4.2 Did the location provide a list of certified drivers?

  • 4.3 Did the location provide a list of certified trainers?

  • 4.4 Are there inspection reports for forklifts?

  • 4.5 Did the location provide their corrective action policy for when employees don't follow standard protocol?

  • 4.6 Is there proof of employees completing the online portion of forklift training?

  • 4.7 20-hour behind the wheel documentation?

  • 4.8 Did the location provide forklift driver certification records?

5: Forklift (objectives): 29 CFR 1910.178

  • 5.1 If an incident occurs, what is the disciplinary action that takes place? (E.g: points taken off, re-training or possible termination)

  • 5.2 Obvious damage

  • 5.3 Seatbelt; Equipped with interlocks?

  • 5.4 Horn

  • 5.5 Tires

  • 5.6 Leaks

  • 5.7 Forks

  • 5.8 Do all forklifts maintain blue lights and lights are facing the floor?

  • 5.9 Are all powered industrial trucks governed to 5 mph operating speed?

6: Other Documents

  • 6.1 Does the location have a visitor sign-in sheet?

  • 6.2 Is the location utilizing the visitor online safety video?

  • 6.3 Did the location provide injury reports for the current year?

  • 6.4 Did the location provide safety committee meeting minutes for the current year?

  • 6.5 Is the New Employee 90 day review being conducted?

7: Contractor Safety: 29 CFR 1926.16

  • 7.1 What type of contractor did the location show?

  • 7.2 Did location provide contractor acknowledgement form?

  • 7.3 Did location provide liability insurance proof?

Leadership Questions

Safety Committee

  • 8.1 How often are your team leads conducting Toolbox Talks?

  • 8.2 Do you have a Safety Committee?

  • 8.3 How many members are on your Safety Committee?

  • 8.4 How often does the Safety Committee meet?

  • 8.5 Is someone represented from each department?

  • 8.6 What departments are not represented?

  • 8.7 Provide all Safety Committee meeting minutes for the current year?

Job Safety Analysis (JSA) and Job Safety Observations (JSO)

  • 9.0 Are you familiar with JSA's and JSO's?

  • 9.1 Are your team leads understanding of the JSO process?

  • 9.2 How often are the team leads conducting JSO's right now?

  • 9.3 Did the location provide two JSA's and the corresponding JSO?

  • 9.4 If the location provided JSA/JSO documentation, were they created correctly?

  • 9.5 Did the company provide completed JSO's for the current quarter?

  • 9.6 JSO duration meets 3-minute minimum time limit?

  • 9.7 Do affected JSA's indicate weight restrictions?

  • 9.8 Can the location provide non-routine JSA's? (Provide at least 2 examples).

  • JSA Specific Discovery
  • Item Description:

  • Piece of equipment:

  • Was there a signed JSA for the employee working on the piece of equipment?

  • Can location provide proof of revision dates on JSA within the last year?

Near Miss Forms

  • 10.1 Does the location use Near Miss forms?

  • 10.2 How many Near Miss forms did the location have last month?

  • 10.3 How many Near Miss forms did the location have two months ago?

  • 10.4 How many Near Miss forms did the location have three months ago?

  • 10.5 Does the location have an active Near Miss program?

  • 10.6 Does the Safety Committee go over Near Miss Forms that were filled out since the last Safety Committee Meeting?

Injury Review and Analysis

11: Injury Review

  • Department with the highest number of injuries?

  • How many injuries in this department:

  • Department with the second highest number of injuries?

  • How many injuries in this department:

  • Department with the third highest number of injuries?

  • How many injuries in this department:

  • How did the location review and communication injury investigations across the departments and leadership?

Injury Progression

  • Has the HUB shown improvement over the last five years with regards to reducing injuries?

Employee/Lead Interviews

    Employee/Lead Interviews by Location
  • Location/Department?

  • Does your lead conduct Toolbox Talks? If so, how often?

  • Do you know what a JSA or JSO are? How does management conduct these?

  • Have you ever filled out a Near Miss Form? Do you know what these are?

  • Team lead behavior toward safety?

  • What is good with our safety program?

  • What needs improvement with our safety program?

  • Does your supervisor talk to you about safety?

  • Do you know we have a safety committee?

  • Are expectations to high or manageable to keep a safe environment?

Discovery Phase

12: Building safety: 29 CFR 1910.22, 1910.23, 1910.29, 1910.178

  • 12.1 Are floors safe and even?

  • 12.2 Are railings all in place?

  • 12.3 Are ramps and ledges protected properly?

  • 12.4 Are walkways kept clear?

13: Confined space: 29 CFR 1910.146

  • 13.1 Does the facility have a written program and procedures for entering permit-required confined spaces as indicated in 1910.146?

  • 13.2 Are all confined spaces clearly marked?

  • 13.3 Are all confined spaces closed off and secured?

14: Conveyors: 29 CFR 1910.28, 1910.212, 1926.555

  • 14.1 Is the location's conveyor fall protection in order?

  • 14.2 Are all facility conveyors within 7' of the walking surface/working platform completely guarded?

  • 14.3 Crossovers/passageways provided to pass over conveyors?

15: Personal Protection Equipment (PPE)

  • 15.1 Are forklift drivers wearing safety toe shoes/boots?

  • 15.2 Are at risk employees using appropriate PPE?

  • 15.3 Eye protection?

  • 15.4 Hearing protection?

  • 15.5 Appropriate clothing?

16: Emergency preparedness: 29 CFR 1910.36, 1910.37, 1910.157, 1910.165

  • 16.1 Is an emergency action plan in place and communicated to all employees?

  • 16.2 Do the employees have an alarm method?

  • 16.3 Is there a floor plan with escape routes and emergency information?

  • 16.4 Are all fire extinguishers regularly maintained?

  • 16.5 All extinguishers free of obstructions?

  • 16.6 Are all exit signs located properly?

  • 16.7 Exits clear of obstructions?

  • 16.8 Is the location conducting annual emergency/fire drills?

  • 16.9 Are OSHA labor law posters posted in a conspicuous location?

17: First Aid and Blood Spill Kits: 29 CFR 1910.151, 1910.1030

  • 17.1 Are first aid kits stocked and clean?

  • 17.2 Are blood-borne pathogen kits stocked and clean?

  • 17.3 Are first responder lists posted?

  • 17.4 Are first responder lists updated?

  • 17.5 Training certification provided for first responders? (Basic first aid, Blood borne pathogens, AED & CPR)

18: General lighting: 29 CFR 1910.305

  • 18.1 Good natural lighting?

  • 18.2 Light fittings clean and in good condition?

  • 18.3 Emergency lighting operable?

19: Hazardous communications: 29 CFR 1910.1200, 1910.253, 1926.252

  • 19.1 Are all containers properly labeled?

  • 19.2 Proper labeling/use of secondary chemical containers?

  • 19.3 Proper containment for chemicals?

  • 19.4 Does the location have an emergency spill clean-up team and/or kit if needed?

  • 19.5 Proper waste disposal? (E.g: fire resistant waste bins)

20: Electrical equipment requirements: 29 CFR 1910.303, 1910.304

  • 20.1 Are all breaker box doors closed?

  • 20.2 Are there openings located in breaker boxes?

  • 20.3 Are all extension cords up to compliance? (Ends, electrical tape, etc.)

  • 20.4 Are all electrical outlets within 6 feet of water GFCI outlets?

  • 20.5 Do all electrical panels maintain 36" of clearance in front of them, and an unobstructed path of access?

21: Hot work permit: 29 CFR 1910.252, 1910.253

  • 21.1 Method of site review.

  • 21.2 Permit process.

  • 21.3 Does permit require a fire watch?

22: Housekeeping: 29 CFR 1910.22, 1910.28, 1910.176(b), 1926.250

  • 22.1 Frequency and method of reducing the accumulation?

  • 22.2 Is the location maintaining the 6s program?

  • 22.3 Rod and Strut material securement?

  • 22.4 Racking Storage Securement?

  • 22.5 Surface load limits indicated?

23: Ladders: 29 CFR 1910.23

  • 23.1 Are ladders industrial strength?

  • 23.2 In good condition?

  • 23.3 Are cages put in place where needed?

  • 23.4 Are all work platforms guarded with a swing gate to protect employees from fall hazards?

  • 23.5 Are all ladders in storage chained properly?

  • 23.6 Are ladder inspections performed and documented?

24: Machine guarding: 29 CFR 1910.212

  • 24.1 Are all machines properly guarded?

  • 24.2 Are all machine interlocks working properly?

  • 24.3 Are all grinders/sanders properly guarded?

  • 24.4 Are all belts, pulleys, etc. guarded correctly?

  • 24.5 Are all pinch points effectively guarded?

  • 24.6 Exposed sharp edges?

25: Safety Knives

  • 25.1 Is the location using the correct safety knives?

26: Other Items Found during Initial Discovery Phase.

    Area of Concern
  • Item Number (i.e. 26.1)

  • Where was Item Located?

  • Potential Hazard/Violation

  • What scope does it fall under?

  • Was Item mitigated immediately

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