Information
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Date
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Branch
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Job Site
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Location
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Safety Professional
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Foreman
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Superintendent
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Consultant/GC/Architect
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Crew Member Attending
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Reported on Site With
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Last Evaluation Date
Job Details & Specific Details Of The Job At Time Of Evaluation
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Details
Distribution
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Doug Flynn
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Regional VP
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Branch Manager
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Department Manager
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Superintendent
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Health & Safety Department
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Foreman & Crew
Fire Prevention/ Fire Safety
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Fire Extinguishers on Walls visible and clearly marked.<br>
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Workers Trained in Extinguisher Use.
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Extinguishers maintained and tested this year.<br>
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Emergency routes clearly marked.<br>
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Emergency exits clear.<br>
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Combustibles stored properly.<br><br>
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Other
Safety Response
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First Aid Trained Persons On Site.
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First Aid Kits.
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Emergency Plan.
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Worker Aware Of Emergency Plan.
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Evacuation Muster Point.
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Emergency Phone List.
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First Aid and accident reports available and used.<br>
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Other
Equipment & Machinery
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Workers trained to use properly.
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Lock Out Procedure in Place.
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Safe Work Procedure used.
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Emergency stops clearly marked and working properly.
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Perimeter Warning System in Place.
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Openings Guarded or Secured Properly.
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Guards and safety devices maintained and working properly.
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Inspected before each use.
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Noise controlled.<br>
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Workplace adequate.
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Fumes and Exhaust controlled.
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Other
Site Access
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Adequate Entrances.
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Clean Level Ground.
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Adequate Ladders, stairs where required.
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Other
Housekeeping
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Are aisles kept free of Obstructions.
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Areas well lit.
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Garbage Bins available and in suitable locations.
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Other
Personal Protective Equipment
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Maintained and clean.
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Foot Protection.
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Eye & Face Protection.
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Hearing Protection
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Hand Protection.
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Hi-Vis Outerwear.
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Other
Ladders
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Properly Secured Top & Bottom.
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Proper Angle 1:4.
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Proper Size & And Type.
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Safe Usable Condition.
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Properly Used.
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Other
Power Hand Tools & Equipment
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General Condition.
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Proper Guards.
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Use Defective Tags.
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Other
Electrical
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Plug, Cords, and sockets in good condition.
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Extension cords minimized.<br>
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Access to plugs and sockets clear.
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Proper cords and plugs used.
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Electrical tools in good repair.
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Are power disconnects and switches for machines clearly marked.
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Other
Worker Equipment Training
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Machine Training ( Press Brake, Punch Press, Saws etc).
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Welding/Cutting Training.
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Forklift Training
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Other Equipment.
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Other
Lighting
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Is Lighting adequate in all areas.
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Is task Lighting provided in areas of low light or high glare.
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Does the work area emergency lighting work and is it adequate.
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Is glare and contrast minimized.
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Are workers eyes protected from welding and cutting processes.
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Other
Material Storage
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Safely Stacked and Secured
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Properly Bundled or Containerized
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Properly Located
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Properly Labeled (WHMIS)
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Other
Worker Education
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WHMIS Trained
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Oriented in company Safety Policy.
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Aware Of H&S Committee And Worker Representative
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Orientated With Injury/Hazard Reporting
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Orientated On Provincial Construction Regulations
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Other
Site Collateral Material
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Provincial Construction Regulations
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MSDS Sheets On Site/Worker Access
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Safety Manual On Site
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Warning Signs.
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Injury Passport
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Washroom/Lunch Area Cleanliness
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Weekly Safety Talk
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PLRA Completed
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Other
Storage
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Are items stored on shelves properly.
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Is Lifting/ Moving equipment used whenever possible instead of manual lifting.
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Are floors around shelves clear.
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Are racks and shelves maintained.
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Are floors dry and clean.
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Other
First Aid Requirements
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Adequate First Aiders On Site
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Adequate Number of First Aid Kits
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Adequate Contents in Kits & Reports
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Other
Safety Board
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Information up-to-date and available for all workers to view.
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Other
Totals
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Red Category - Major Issue
- 1
- 2
- 3
- 4
- 5
- 6
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Yellow Category - Moderate Issue
- 1
- 2
- 3
- 4
- 5
- 6
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Blue Category - Minor Issue
- 1
- 2
- 3
- 4
- 5
- 6
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Follow-up Required
Review
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Site Supervisor/Forman
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Health & Safety
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Superintendent
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