SPOT AUDIT: Respiratory Protective Equipment (RPE)

• Conducted on

  Date

• Prepared by

• Location
  Address

Area Audited

• Area / Team Audited

• Shift Supervisor / Responsible Manager

• Number of Personnel who require RPE

• List of Names

• Are all of the above Face-Fit Tested?<br>[Check Records]

  Pass

  Fail

  N/A

• Have all of the above been provided with RPE<br>[Confirm all produce RPE]

  Compliant

  Non-Compliant

  N/A

• Has all RPE been subject to recorded inspection and maintenance, including filters changed, within the last month?

  Compliant

  Non-Compliant

  N/A

• Do any individuals report issues (damage; wear; blocked filters; etc.)?

  Safe

  At Risk

  N/A

• Are all of the above individuals conversant with WHEN and WHERE the RPE must be used?

  Good

  Fair

  Poor

  N/A

• Are the requirements for WHEN and WHERE RPE is required clearly stated in Site Rules?

  Compliant

  Non-Compliant

  N/A

• Are there suitable stock of spare filters for the RPE?

  Good

  Fair

  Poor

  N/A

• Are personnel conversant with how & when to replace RPE filters?

  Good

  Fair

  Poor

  N/A

• Feedback provided to the Shift Supervisor:

• Acceptance of Feedback

  Sign

• Feedback provided to Relevant Manager:

• Acceptance of Feedback

  Sign