Safety Performance Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Venue profile

• The scope of works is identified in our proposal

• Date and time of audit

  Date

• Auditor

  Sign

• Receiver

  Sign

Policy communication

• Does the workplace have a written work and health safe policy?

  Safe

  At Risk

  N/A

• Has the work health and safety policy been developed in consultation with workers?

  Safe

  At Risk

  N/A

• Does the policy state the workplaces commitment to work health and safety?

  Safe

  At Risk

  N/A

• Does the work health and safety policy outline the work health and safety responsibilities?

  Safe

  At Risk

  N/A

• Does the policy have clear objectives to protect the work health and safety of the workers and others?

  Safe

  At Risk

  N/A

• Is the work health and safety policy signed and dated by the PCBU/general manager?

  Safe

  At Risk

  N/A

• Is the work health and safety policy displayed in a prominent place at the workplace?

  Safe

  At Risk

  N/A

• Is the work health and safety policy included in the worker instructions?

  Safe

  At Risk

  N/A

• Is the work health and safety policy reviewed and re-issued at least every two years?

  Safe

  At Risk

  N/A

Due Diligence

• Hdfakndajgbsdvinadivn adviser gods raginrsg srgistgjotsgojgrs rhisthnngtsnstitd