Title Page

  • Site

  • Conducted on

  • Prepared by

  • Shift

Safety Checklist

Safety Checks

  • All scoring questions use the Number response type:
    0 = Fail, 1 = Needs Attention, 2 = Pass

  • Scaffolding is properly secured

  • Fall protection is used

  • Electrical hazards are addressed

  • Walkways are clear of debris

  • PPE compliance observed

  • Equipment is maintained

  • First aid kit is accessible

  • Safety signage is visible

  • Compliance Score (%)

  • Risk Factor Score

  • This penalizes lower average scores exponentially, resulting in a higher risk score for non-compliance.

  • Compliance Variation

  • Measures inconsistency across safety checkpoints.

  • Consistency Score

  • A lower average deviation increases the consistency score, which reflects operational discipline.

Evidence & Corrective Actions

    Supporting Evidence
  • Upload Photos of Issues

  • Notes or Observations

  • Area of Concern

  • Action Items
  • Were any issues found? If yes, create a corrective action.

  • Inspector signature

Approval

  • Date and time of approval

  • Approver's signature

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.