Audit

Safety Performance Standard Key to use of scoring system

Ratings
5 = 80-100% Excellent
4 = 60-79% Good
3 = 40-59% Satisfactory
2 = 20-39% Poor
1 = 0-19% Unacceptable
0 = 0% Disaster

Activity
1 Safe Places of work

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

2 Steps and Ladders

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

3 Manual Handling

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

4 Protective Clothing/Equipment

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

5 Welfare

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

6 Protecting the Public

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

7 Plant & Machinery

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

8 Traffic & Vehicles

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

9 Fire & Emergency

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

10 Hazardous Substances

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

11 Noise

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

12 Hand Arm Vibration

Are there Health & Safety issues or concerns Identified:

Health & Safety issues Identified:

Comments & Actions Taken:

13 Any other issues identified

Health & Safety issues Identified:

Comments & Actions Taken:

Overall Health and safety Performance Standard
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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.