Southern District Health Board - Project Site Visit

• Project Location:

• Project Name:

• Conducted on

  Date

• Prepared by

• Contractors on site:

• Have all workers used the sign-in book?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Have all workers been SDHB inducted, are they displaying SDHB contractor ID cards?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Have all contractors undergone the site specific induction?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is the site adequately secured?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is signage suitable for the activities on site?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are workers utilising the correct P.P.E, as identified on the site hazard board?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is there adequate lighting on site?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are ladders and step ladders in good condition and being used correctly?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are tools, and equipment, being stored securely?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is construction dust being sufficiently controlled?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are all electrical tags on cords and equipment up to date?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is there evidence of regular housekeeping?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is emergency equipment readily accessible on site?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are emergency exits free from any obstructions?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are there current permits to work for high risk activities being undertaken on site? (Hot works, Confined space, Asbestos work area)

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is scaffolding set up on site? - this includes mobile, edge protection, standing, special etc

  Yes

  No

• Are scaffold tags present and up to date?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is Mobile Scaffolding equipment correctly assembled?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• If Mobile Scaffolding is currently in use are all wheels in correct position and securely locked?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are scaffold platforms set at a safe working height?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Is scaffold within the safe working load limits?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Are working platforms in good condition, secure, and free from tripping hazards?

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Visual inspection - Is the scaffolding structurally secure, debris netting in place etc.? ( check for damage, defects, missing parts, non-certified modifications, environmental risks that maybe present)

  Compliant

  Non-Compliant

  Partially Compliant

  N/A

• Were there any Health and Safety concerns identified that required immediate action?

  Yes

  No

• Are there any Health and Safety concerns that require follow up action and monitoring?

  Yes

  No

Notes

Recommendations

• Completed

  Date

• Site Visit Completed

  Sign