Title Page
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Site / Project Name
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Site / Project Address
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Principal Contractor
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Person in Charge of Site / Project
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Conducted On
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Completed By
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Company Contact on Site
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Brief Description of the Works
Health & Safety Inspection
CDM Role & Responsibilities
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Are we the Principal Contractor (yes) or sub-contractor (no)?
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Is the required documentation on site such as: Policy, Insurances, HSE Poster, F10, CPP?
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Is there welfare on site?
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Is the welfare clean and tidy?
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Is there hot running water?
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Is there drinking water available?
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Is the welfare connected to an electrical supply?
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Are the relevant documents (insurance, H&S policy, HSE poster) on display?
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What can be improved if anything?
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Has the site been secured to prevent unauthorised access?
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Is there suitable signage in place advising others of the construction work?
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Is there a site emergency plan?
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Is there a muster point sign on site in a suitable location?
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Irrespective of CDM role, are all employees inducted for the site?
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If Principal Contractor, are there induction records available?
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Have Tool Box Talks been carried out?
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What was the last topic and date the TBT was completed?
Safe System of work - H&S documentation
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Is there RAMS on site (electronic or hard copy)?
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Are the RAMS signed by those working under them?
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Are the RAMS relevant to the work?
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Is a permit to work required for the work (issued by Principal Contractor)
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What work being under taken requires a permit>
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Are hazardous substances being used on site?
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Are COSHH assessments in place for each substance?
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Are the COSHH assessments signed by those using the hazardous substances?
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Have you 'dip sampled' 2 substances to ensure there are COSHH assessments in place?
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What was the names of the 2 substances?
Plant & Equipment
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Have daily pre use checks been completed and recorded for any fork lift/ telehandler on site?
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Have daily pre use checks been completed and recorded for any MEWPS on site?
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Are all electrically powered tools 110V (yellow cable)?
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Are all 110V tools PAT tested within the last 3 months?
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Are all cables and extensions in good condition?
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Are all battery powered tools in good condition?
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How are the batteries being charged?
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Are all hand tools in good condition?
Temporary Works
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Is there temporary works on site?
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What is/ are the temporary works?
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Has the temporary works been entered onto a register?
PPE
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What is the minimum PPE requirements for site?
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Are all operatives wearing the required PPE?
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Is their PPE in good condition?
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Are FFP3 dust masks accessible?
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Is hearing protection available?
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Is eye protection available?
House keeping and material storage
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Is the site tidy?
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What can be improved?
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Is there a storage container on site?
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Is the container tidy?
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What can be improved?
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Are materials stored neatly and are easily accessible?
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What can be improved?
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Are works vans on site?
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Are the inside of the vans tidy?
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What can be improved (and driver of the van)?
Work at height
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Are MEWPS (scissor lifts/ cherry pickers) being used?
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Are the operators trained?
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Has a daily pre use check been carried out and recorded for the MEWP?
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Is the MEWP housed on suitable ground?
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Are the operators hooked to a suitable anchor point in the basket (cherry picker)?
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Is there suitable barriers around the base of the MEWP?
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Is scaffolding being used?
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Is the scaffold safe with no isues?
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Are all Operatives aware not to alter, amend or dismantle any part of the scaffold?
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Are step ladders being used?
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Is/are the step ladder(s) in good condition?
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Is/ are the step ladder(s) housed on firm level ground?
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Is/ are the step ladder(s) being used correctly?
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Are ladders being used?
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Is/ are the ladder(s) in good condition?
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Is/ are the ladder(s) being footed or tied off at the top?
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Is/ are the ladder(s) extend past the area they are accessing by 1 meter or more (2-3 rungs)?
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Do the client allow use of ladders on site?
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Is the ladder at a suitable angle to the wall it is up against (1m out to 4m up)?
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Is safety nets being installed?
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Is there suitable RAMS on site for the erection, checking and dismantling of the nets?
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Have the RAMs been read and signed?
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Have pre use checks of the MEWP(S) been carried out and recorded?
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If the nets are erected is there proof that they have been inspected in the last 7 days?
Lifting operations
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Is lifting of materials taking place on site?
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Has a pre use check of the crane been recorded by the operator?
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Is there a lift plan on site (electronic or hard copy)?
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Has the lift plan been signed by all those under taking the lift?
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Are all lifting accessories in good condition?
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Do all lifting accessories have an in date thorough examination certificate?
Noise, dust, vibration & manual handling
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Is hearing protection being worn when using powered tools that exceed 85dB (states on the tools/ manufactures guidance)?
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Is cutting of materials such as timber taking place or handing insulation?
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Are FFP 3 dust masks being worn?
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Is welding taking place on site?
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Are air fed welders hood being worn or welders hood and suitable FFP3 mask?
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Are vibrating tools being used on site?
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What is in place to prevent over exposure to vibration on site?
Asbestos
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Is there known to be asbestos on site?
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Has an Asbestos survey been completed? (If NO stop work and notify management)
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Have you read the survey? (if NO stop work and read the survey)
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Having read the survey does the asbestos impact your work? (if it does STOP work)
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Are all Operatives asbestos awareness trained?
Accidents, incidents, near misses & improvements
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Has there been any incidents, accidents or near misses?
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Is there any improvements those on site feel that can be made?
Other
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Any other good practice or areas for improvement?
Summary
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What is the over all finding for the site (include explanation in the notes)?
- Meeting Industry Standard
- Advice
- Hygiene Concern
- Non-Conformance
- Potential for injury
- Serious Breach
- Not Seen at the Time of Visit
- Not Applicable
- Principal Contractor
Completion
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Completed by (Name and Signature)