Information

  • Document No.

  • Assignment

  • Date

  • Time on Site

  • PSS Manager / Supervisor

  • Officer's Name

Red Amber Green

  • Appearance / In Full Uniform

  • Comments

  • Site Knowledge

  • Comments

  • SIA Licence Number

  • SIA Licence Expiry Date

  • Comments

  • ID Card Expiry Date

  • Comments

  • No ID Card? Take a photo

Checklist

  • Log book entries correctly completed?

  • Comments

  • All electrical equipment working? (eg Deister, hoover etc)

  • Comments

  • All fire equipment in position and in proper working order?

  • Comments

  • Are key controls in place and satisfactory?

  • Comments

  • Are all Health & Safety precautions in place?

  • Comments

  • Are all duties carried out on site to relevant Standards?

  • Comments

  • AI's / SDF

  • Was the operative fully conversant with and has signed the site AI's / SDF?

  • Comments

  • AI's / SDF kept in a place accessible to the operative

  • Comments

  • AI's / SDF review date

  • Comments

  • Risk Assessment Review Date

  • Comments

  • Operative Suggestions

  • Operations Manager signature

Performance Review

  • Overall timekeeping

  • Comments

  • Overall appearance

  • Comments

  • Professionalism and competency

  • Comments

  • Flexibility

  • Comments

  • Additional training required

  • Future Potential

  • Overall Performance

  • Overall Comments

  • Employee 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.