Site Team Monitoring Record

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Team details

• Department name

• Department service

• Technician name(s)

• Task carried out at the time of inspection?

Client details

• Client name

• Client contact name(s)

• Site location
  Address

Health and safety

• If at any time the answer 'No' is given, please add comments to the 'Notes' section stating any corrective action that followed.

• Risk assessment and method statement and permit to work (where relevant) available?

  Yes

  No

  N/A

• Is the technician/engineer familiar with the risk and method statement / permit to work?

  Yes

  No

  N/A

• Are the procedures and control measures as stated in the risk and method statement / permit to work being followed?

  Yes

  No

  N/A

• Please ask the engineer to follow them and ensure that they are before allowing work to continue.

• Please ensure that the engineer fully understands the risk and method statement, follows the safe system of work and risk assessment control measures, then allow them to continue with works.

• Can the engineer / technician give an explanation as to why?

  Yes

  No

  N/A

• Please add the explanation below and if proof can be given that the identified control measures are now understood and are being followed, allow the engineer to continue.

• Please ask the engineer to temporarily stop works and provide proof of training and communication of risk and method statement.
  - If training and communication can be given ensure safe procedures are followed and allow engineer to continue.
  - If training and communication can not be given, stop works and ask engineer to rearrange and return.

• Overall safety score

  Select Poor - Urgent action needed Satisfactory - Improvements needed Good - Operating safely Excellent - Best practice applied

  • Poor - Urgent action needed
  • Satisfactory - Improvements needed
  • Good - Operating safely
  • Excellent - Best practice applied

• Observations and any additional control measures recommended?

• Evidence of inspection and safe procedures.

  Media

Sign-off information

• I can confirm that I believe that the information given during the time of this inspection is accurate and true.

• Inspector name and signature.

  Sign

• Select date

  Date