Title Page
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Site conducted
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Conducted on
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Job Number/Name
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General Contractor
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Floor Reviewed
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Area Reviewed
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Prepared by
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Location
PPE Usage
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COVID-19 Face Cover
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Proper Gloves
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Proper Safety Glasses
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Proper High Visibility Safety Vest
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Employee able to identify face shield
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Employee know when and why face shields are safety cans
Fall Protection Storage/Inspections
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Tie off points readily accessible and known
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Fall Protection PPE selected and being used appropriately
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Employee know how/why this fall protection was chosen for them to wear
Electrical Safety
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GFCI Usage
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Cords on electric tools in good working condition
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Power cords in good working condition
Equipment & Operators Training
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Equipment in good working condition
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Equipment Inspections being completed
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Equipment Operator Trained
Excavation Safety
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Excavation access/egress
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Equipment Sloping and/or shoring appropriate
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Equipment Daily inspection and/or after weather event
Hand Tools/Power Tools Safety
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Tools have guards in place and are operable
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Tools have deadman switch operable
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Employees been trained in Hand Tools/Power Tools safety
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Tools being used properly
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Describe how it was used
Heat Illness
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Adequate water supply available for manpower
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Shade available and appropriate
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Employee Interview - Does the employee know where the closest water is
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Has the foreman filled out his Site-Specific HIPP
Haz Com
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Employee Interview - Does the Employee know what an SDS is and how it can help them
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Flammable liquids are in approved safety cans
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Are all storage containers labeled properly
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Oxygen/Acetylene cylinders stored properly
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Oxygen/Acetylene torch units have flash back arrestors
Ladder Safety
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Ladders are safe and inspected as appropriate
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Ladders used properly
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Ladders selected properly
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Any observations for GC: are stairs and scaffolds safe
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Employee Interview - Can the employee identify the competent person for scaffolding
Material Handling
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Observe good body mechanics
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Carts/Material Trees in good working order
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Laydown area clean and organized?
Emergency / First Aid
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Is Grab and Go paperwork readily accessible
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Is on-site paperwork readily accessible
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Emergency eyewash and/or shower units accessible
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Appropriate number and size of first aid kits available
General Safety
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Fire extinguishers readily available
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Fire extinguishers inspected
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Floor holes are covered or guarded
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Trade Identified
Uncovered/Guarded Floor Hole Information
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Location
- NW
- NE
- SW
- SE
- Stair 1
- Stair 2
- Stair 3
- Stair 4
- Area A
- Area B
- Area C
- Area D
- Moat
- YHT
- YEV
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Floor Level
- Ground Level
- Parking Garage
- Roof
- Level 1
- Level 2
- Level 3
- Level 4
- Level 5
- Level 6
- Level 7
- Level 8
- Level 9
- Level 10
- Level 11
- Level 12
- Level 13
- Level 14
- Level 15
- Level 16
- Level 17
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Pictures of Area
Uncovered/Guarded Floor Hole Information
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Location
- NW
- NE
- SW
- SE
- Stair 1
- Stair 2
- Stair 3
- Stair 4
- Area A
- Area B
- Area C
- Area D
- Moat
- YHT
- YEV
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Floor Level
- Ground Level
- Parking Garage
- Roof
- Level 1
- Level 2
- Level 3
- Level 4
- Level 5
- Level 6
- Level 7
- Level 8
- Level 9
- Level 10
- Level 11
- Level 12
- Level 13
- Level 14
- Level 15
- Level 16
- Level 17
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Pictures of Area
Uncovered/Guarded Floor Hole Information
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Location
- NW
- NE
- SW
- SE
- Stair 1
- Stair 2
- Stair 3
- Stair 4
- Area A
- Area B
- Area C
- Area D
- Moat
- YHT
- YEV
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Floor Level
- Ground Level
- Parking Garage
- Roof
- Level 1
- Level 2
- Level 3
- Level 4
- Level 5
- Level 6
- Level 7
- Level 8
- Level 9
- Level 10
- Level 11
- Level 12
- Level 13
- Level 14
- Level 15
- Level 16
- Level 17
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Pictures of Area
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Overall cleanliness of the project
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Overall safe environment
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Illumination/task lighting adequate
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Does the foreman have OSHA 10 or 30
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Does the foreman have First Aid/CPR training
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Have you sent a copy of your guys certs to the office
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Employee Interview - Does employee know what the tool-box topic was this week
Any other observations?
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Observation
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Suggestion
