Title Page

  • Client Name (Site)

  • Conducted on

  • Location
  • Prepared by

  • In Consultation With:

  • General Comments (optional)

  • Add media

Work Environment

  • Is there adequate space to move freely about the workplace?

  • Are floors clean and dry?

  • Are floors free from cracks and holes that might cause trips?

  • Are pedestrian walkways clearly marked?

  • Are walkways and exits clear?

  • Are bins provided and not overflowing?

  • Is lighting bright enough?

  • Is the work area adequately ventilated?

  • Will all work be performed in temperatures between 10°C and 40°C?

  • If working in cold temperatures, do workers have access to warm clothing?

  • Can workers take a break away from the extreme temperatures?

  • Is noise low enough to easily hear a normal conversation?

  • Is hearing protection readily available?

  • Are hearing protection signs displayed?

  • Are work areas free from dust?

  • Is respiratory protection readily available?

  • Are respiratory protection signs displayed?

  • Is eye protection readily available?

  • Are eye protection signs displayed?

Fire & Emergency

  • Is an Emergency Evacuation Plan displayed?

  • Are emergency contacts and numbers displayed?

  • Are fire extinguishers and fire hoses available?

  • Do all observed fire extinguishers and fire hoses have a current inspection tag?

  • Is an illuminated green running man sign fitted above emergency exits?

  • Are emergency exits clear?

  • Is a first aid kit easily accessible?

  • Is there evidence the first aid kit has been inspected or restocked within the last 12 months?

  • If working outside, is there a 10cm wide crepe bandage in the first aid kit for treating snake bites?

  • Can trained first aiders attend within a few minutes?

Amenities

  • Is there a separate meal room or area?

  • Is the meal room or area clean and hygienic?

  • Is cool drinking water available?

  • Are toilets readily accessible?

  • Are toilets clean and hygienic?

  • Is there water and soap for washing hands?

Storage

  • Are materials not currently in use, stored off the floor?

  • Are bins, crates and pallets stacked so they are unlikely to fall over?

  • Is storage racking used?

  • Are racks in good condition?

  • Is the safe working load displayed?

  • Are loads stored so they are unlikely to fall?

Manual Handling

  • Are forklifts, pallet jacks or trolleys available?

  • Do items that need to be lifted manually, weigh less than 15kg?

  • Are items that need to be lifted manually, kept above knee height and below shoulder height?

Ergonomics

  • Are work benches about waste height?

  • Do workers have to stand in one place for long periods?

  • Is anti-fatigue matting provided?

  • Do workers perform repetitive tasks for long periods without the opportunity for micro-breaks?

  • Do workers move between different tasks during a shift?

Electricity

  • Are all observed electrical outlets, leads and appliances free from damage?

  • Is a current test & tag attached to all observed electrical leads and appliances?

  • Are extension leads kept off the floor?

  • Are electrical circuits fitted with a Safety Switch?

  • Is there evidence Safety Switches have been tested in the last 12 months?

Traffic Management - Outdoors

  • Are roads clearly marked?

  • Are roads in good condition?

  • Are parking locations clearly marked?

  • Are physical barriers used to separate pedestrians and vehicles?

  • Are speed limits displayed?

  • Were the vehicles you observed, travelling within the speed limit?

  • Are traffic rules displayed?

Traffic Management - Indoors

  • Are forklifts or other vehicles used inside?

  • Are physical barriers used to separate pedestrians and vehicles?

  • Are no-go areas used to separate pedestrians and vehicles?

  • Are speed limits displayed?

  • Were the vehicles you observed operating indoors, travelling within the speed limit?

  • Are traffic rules or a traffic management plan displayed?

  • Are workers wearing hi-visibility clothing?

Passenger Vehicles

  • Do Agri Labour workers drive or ride in a passenger vehicle at work?

  • Vehicle
  • What is the make, model and rego number of the vehicle?

  • Does the vehicle appear to be road worthy?

  • Are pre-start inspections conducted?

  • Is there evidence of a recent service?

  • Do lights and indicators work?

  • Are windows clean and free from cracks?

  • Are seat belts fitted?

  • Do tyres have at least 2mm of tread?

Forklifts

  • Are forklifts operated by, or near Agri Labour workers?

  • Forklift
  • What is the make and model of the forklift?

  • Does the forklift appear to be in a serviceable condition?

  • Can the forklift operator produce their licence?

  • Are seat belts fitted?

  • Is overhead protection fitted to the forklift?

  • Are controls clearly labelled?

  • Do lights and indicators work?

  • Is the reversing alarm working?

  • Does the horn work?

  • Is the Safe Working Load clearly marked on the data plate?

  • Are pre-start inspections conducted?

  • Are forklift warning signs displayed about the workplace?

Loaders, Tractors and Other Mobile Plant

  • Is mobile plant (other than forklifts or passenger vehicles) operated by, or near Agri Labour workers?

  • Mobile plant
  • What is the type, make and model of the mobile plant?

  • Does the machine appear to be in a serviceable condition?

  • Are pre-start inspections conducted?

  • Are seat belts fitted?

  • Are windows and mirrors clean and free from cracks?

  • Do lights and indicators work?

  • Is there an exclusion zone around the plant, when in operation?

Hazardous Substances

  • Do Agri Labour workers need to use chemicals at work?

  • What chemicals do they use?

  • Are chemical containers clearly labelled?

  • Are Safety Data Sheets available?

  • Is the PPE described by Safety Data Sheets, readily available?

  • Does signage on dangerous goods stores indicate the class of dangerous good?

Confined Spaces

  • Are there confined spaces in or near the work area?

  • Has a confined space sign been placed at the entry point of confined spaces?

  • Do Agri Labour workers have to enter a confined space?

  • Has a procedure or safe work method statement available for working in confined spaces?

  • Is the atmosphere confirmed as safe, prior to entry?

  • Is an observer located immediately outside the confined space while workers are inside?

  • Is there a plan in place to rescue workers inside the confined space?

Cool Rooms

  • Do Agri Labour workers have to enter a cool room?

  • Cool room
  • Is there a method for exiting the cool room if the main door is jammed close?

  • Is there an alarm or bell activated from inside the room and audible outside?

  • Is lighting inside the cool room adequate?

  • Is the cool room clean and free from mould?

Hand Tools

  • Are power tools used by Agri Labour workers?

  • Are they appropriate for the job?

  • Do they appear to be in good condition?

  • Has a current electrical test & tag been attached to power tools?

Machinery

  • Is fixed plant or machinery used by Agri Labour workers?

  • Machinery
  • What is the type, make and model of the machine?

  • Does the machine appear to be in a serviceable condition?

  • Are moving parts guarded to prevent them being touched?

  • Is there an Emergency Stop near the operator?

  • Is there evidence of Emergency Stops being tested regularly?

  • Is there an operating procedure readily available?

Working at Heights

  • Do Agri Labour workers use ladders?

  • Are ladders rated for commercial use?

  • Are ladders in good condition?

  • Do Agri Labour workers work with their feet more than one meter from the ground (apart from on ladders)?

  • Work at height location
  • Name or description of location

  • Is a stable and securely fenced work area provided?

  • Do elevated work areas have handrails, mid rails and toe boards?

  • Do stair treads to elevated work areas have a non-slip surface?

  • Is a fall prevention or work positioning system in place?

  • Is a fall arrest system in place?

  • Please call Nigel to discuss.

  • Is there evidence of a recent inspection of all harnesses and ropes?

  • Are all workers certified for Working At Heights?

  • Is there evidence that all harnesses and ropes have had a recent inspection?

  • Are all workers certified for Working At Heights?

Working Alone

  • Do Agri Labour workers need to work alone?

  • Are all tasks low or medium risk, when working alone?

  • Do they have a radio or phone that works in all areas?

  • Does someone check on them regularly?

Working Outside

  • Are Agri Labour workers required to work outside?

  • Is shade available?

  • Are broad brimmed hats worn?

  • Is sunscreen provided?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.