Title Page

  • Site conducted

  • Completed on:

  • Completed by:

  • Works location:
  • Contractors/workers present on site:

Administration and Control

  • Have all workers signed out/in and are they contactable by RT?

  • Do Main Contractors have SSSPs (or equivalent) in place and available on site?

  • Has an Authority to Work (ATW) been issued for the work activities?

  • Have any notifiable works been notified to WorkSafe by the Main Contractor?

  • Has high level hazard identification and risk management been carried out for the project?

  • Have Main Contractors provided hazard/risk registers for their works?

  • Has a Permit to Work been issued for required work activites?

  • Has a JSEA (or similar) been completed for all high-risk activities?

  • Have all workers completing high risk tasks had appropriate training?

  • Is there adequate/appropriate project signage in place across all work zones?

  • Is there a suitable hazard board displayed in each work zone?

  • Has a daily coordination meeting been held and attended by the required Main Contractors?

  • Has the Main Contractor completed a daily pre-start meeting (or pre-start at the commencement of new activities)?

  • Has the Main Contractor complete a toolbox talk for their work zone in the past week?

  • Has the Main Contractor complete health and safety inspections for their work zone in the past week?

  • Have work zone/site specific inductions been completed for all workers/stakeholders entering work zones?

  • Are there provisions to deal with workers or other stakeholders visiting the work zone?

Emergency Management

  • Is there a work zone emergency and evacuation plan in place?

  • Is emergency equipment on site and accessible?

  • Do all workers hold a current first aid certificate?

  • Are fire extinguishers available and checked/current?

  • Are first aid kits available and appropriately stocked?

  • Has emergency planning been completed for all high risk activities?

Incident Reporting and Investigation

  • Is there an incident register on site (for each work zone)?

  • Have any incidents/events occurred since the last assessment recorded?

  • Have any incidents been notified to the SBR project management team as required?

  • Have all incidents/events been investigated, the cause identified and preventative actions been agreed and actioned?

  • Have there been any notifiable events? If so, have these been notified to WorkSafe NZ?

Hazardous Substances and Materials

  • Is a current register of hazardous substances/materials held for each work zone?

  • Are all substances/materials used on site included in the register?

  • Are there any incompatible substances held on site?

  • Is there appropriate storage for any flammables?

  • Are Safety Data Sheets available and are they current?

Housekeeping

  • Are all accessways clear to work zones/areas?

  • Has delineation been set up around fixed work areas/zones and is it adequate?

  • Is all waste being managed as per the Environmental Management Plan?

  • Are all reinforcing steel bars capped?

  • Are nails in timber made safe?

  • Are slips and trips controlled?

  • Are loose materials secured from the wind?

Personal Protective Equipment (PPE) and Clothing (PPC)

  • Is information provided to workers to indicate the minimum PPE/PPC requirements for each work zone?

  • Are workers wearing appropriate cold weather clothing including gloves?

  • Is compliant safety footwear being worn

  • Are hi-visibility vests/cloting being worn?

  • Is hearing protection being worn?

  • Are safety glasses being worn?

  • Are respirators/dust makes being worn?

  • Are other items of task specific PPE/PPC being worn?

Machinery/Tools

  • Are nail guns being used in a safe manner?

  • Do grinders have guards in place, correct disc for task/tool, dead man's switch and observed being used in a safe manner?

  • Do table saws/power saws have guards in place, in good condition and observed being used in a safe manner?

  • Are all other tools in use (including hand tools) observed being safety and the correct tool for the job?

Power Actuated Tools

  • Do tools have current certification (6 monthly)?

  • Do operators hold certificates of competence relating to the make of tool being used?

  • Are barriers/signage in place to prevent unauthorised access to the firing zone?

Electrical

  • Are all electrical tools/leads/equipment tagged 3-monthly?

  • Is all electrical equipment beig used with an industrial rated RCD?

  • Are leads protected in high-traffic areas?

  • Are domestic splitter boxes and doubles adapters excluded from use?

  • Are leads clear of water?

  • Is equipment in good condition with appropriate guards in place?

  • Is adequate temporary lighting in place?

  • Have circuits been isolated (locked and tagged out)?

Ladders

  • Are ladders on site industrial rated to AS/NZS standard?

  • Are ladders in good condition?

  • Are ladders used for short term work only?

  • Are ladders being used safely?

  • Where used for access are ladders footed, tied off and installed with a 4:1 ratio?

Heights Work

  • Have all ground penetrations been covered, covers pinned and clearly marked when not being worked on?

  • Are fall hazards controlled, including the use of appropriate edge protection or fall arrest/restraint?

  • Are safety nets installed where required?

  • Have anchors and rope lines been designed/installed by a competent person?

  • Is work at heights being completed by trained and certified workers only?

  • Is all heights safety equipment checked, tagged and certified?

  • Is an appropriate rescue plan in place?

Scaffolding - Fixed

  • Are all toe boards, mid rails and to rails in place at the correct height?

  • Are all gates self-closing?

  • Is the scaffold the correct height/width for the roof pitch?

  • Are all planks tied down and secure?

  • Is the scaffold within 300mm of the workface?

  • Is the scaffold stable/on level footing?

  • Have scaffolds over 5m been notified to WorkSafe NZ?

  • Is the scaff-tag in place current?

  • When not in use, is the scaffold adequately isolated?

Scaffolding - Mobile

  • Are all toe boards, mid rails and top rails in place and at the correct height?

  • Is the mobile scaffold being used on a sound, clear and level surface?

  • Have the brakes been engaged and wheels turned out to prevent movement?

  • Is the hatch door closed (except during access and egress)?

  • Has the mobile scaffold been erected, maintained, altered and dismantled by the competent person (less than 5m) or a certified scaffolder (greater than 5m)?

Mobile Elevated Work Platforms (MEWP)

  • Is the ground/surface firm/level and suitable for MEWP use?

  • Is the MEWP rated for incline?

  • Are outriggers extended and on a flat surface/sole plates where available?

  • Are all guard rails/toe boards in place/anchor points in place and in good condition?

  • Has the MEWP been inspected prior to use and is there documented evidence of this?

  • Are maintenance records available and has the MEWP been inspected/tested in the last 6 months?

  • Is the loading weight of the MEWP suitable for the worker/tools/materials being used?

  • Is the operator wearing a harness/lanyard are they clipped into the anchor point?

  • Is a spotter in visual/audible contact range?

  • Is there an emergency rescue plan in place?

  • Is the operational area free from structures/hazards that may come into contact with the MEWP?

  • Is the operator appropriately trained/current and competent?

  • Is the MEWP being operated safely?

Cranes/Lifting Activities

  • Has a JSEA (or similar) or a lift plan been completed?

  • Is the safe work load displayed on crane/machine and lifting tackle, and not exceeded?

  • Is lifting equipment including tackle, lifting points and accessories fit for purpose, designed, installed, inspected, rated and certified?

  • Have overhead services been identified and controlled to prevent contact and is a spotter in place where there is a risk of striking overhead services?

  • Are exclusion zones in place?

  • Are lifts being executed to ensure no lifting is being completed over occupied areas and no work is being undertaken under a suspended load?

  • Have the ground conditions been assessed as suitable for the load and are stabilisers/outriggers fully deployed and locked in place?

Excavations

  • Are plant, spoil heaps and materials at least 1m clear from the edge of the excavation?

  • Are adequate exclusion zones in place?

  • Have underground/ground laid services been located/marked out?

  • Is the trench correctly shored, battered or benched?

Traffic Management

  • Are works areas separated from site traffic/plant movements or are adequate controls in place?

  • Are spotters being used for vehicle/plant positioning?

Transport and Mobile Plant

  • Have Main Contractors completed pre-start checks on plant and addressed any issues identified?

  • Are plant/vehicles well maintained and are log books (where applicable) and maintenance records present and up to date?

  • Are plant/vehicles operators licenced, trained and competent, and are manufaturers instructions followed?

  • Are all plant/vehicle and worker/pedestrian interactions adequately managed?

  • Are people kepy away from slewing plant?

  • Are spotters used for reversing plant/vehicles

  • Are loads properly secured

  • Are seatbelts worn?

  • Are securing pins in place on excavator quick hitches?

  • Are the appropriate ROPS/TOPS fitted?

General Observations

  • General health, safety and wellbeing observations for the work zones:

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