Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Emergency & First Aid

  • 1.1 Is the evacuation plan up to date and clearly displayed?

  • 1.2 Are entrance exits and evacuation routes kept clear

  • 1.3 Where emergency lights are installed are they in working order

  • 1.4 Are the emergency telephone numbers displayed

  • 1.5 Is there a 2-3 (min) fire extinguisher located in an appropriate place and tagged as current for testing

  • 1.5 Is there a 1.2 x 1.2 fire blanket located in an appropriate place

  • 1.6 Are smoke alarms installed in appropriate location

  • 1.7 Did the smoke alarms operate correctly when tested

  • 1.8 Is there appropriate equipment and PPE in place for cleaning bodily fluid spills and are there hand washing facilities

  • 1.9 Are there WIRF forms available

  • 1.10 Is there a well stocked first aid kit and appropriate signage displayed

  • 1.11 Has a fire evacuation drill been conducted and the assessment sheet completed (including recommendations for frequency of evacuation drill)?

Electrical

  • 2.1 Is there an electrical safety switch installed at this property

  • 2.2 Did the safety switch operate correctly during the push button test

  • 2.3 Are all lights and fittings, power points and switches in a safe working condition

  • 2.4 Are all fixed and portable electrical equipment in a safe working condition

  • 2.4 Is there any hazardous extension cords and piggy back double adaptors

  • 2.5 Are floors walkways or other areas clear of any temporary leads or cords that would cause a hazard

  • 2.6 Have all observable hazards been addressed

Chemicals

  • 3.1 Is there a copy of the safety assessment for the storage and use of potentially hazardous substances in AS&RS households in the household information folder

  • 3.2 Has the safety assessment been reviewed in the last 12 months?

  • 3.3 Has the safety assessment been updated with the introduction of new chemicals into the household ?

  • 3.4 Are chemicals stored according to the recommendation of the safety assessment

  • 3.5 Are all chemical contained in undamaged original containers with reliable labels

  • 3.6 Are material safety data sheets available for hazardous substances

  • 3.7 Is the poison information centre number in the household information folder?

  • 3.8 Have all observable hazards been addressed

  • 3.9 Are the appropriate products being used on floors

General

  • 4.1 Are floors walls and ceilings in a safe condition?

  • 4.2 Are all doors and windows in a safe condition?

  • 4.3 Can access and egress be done safely

  • 4.4 Are all benches,shelves and fixtures secured firmly and in a safe condition?

  • 4.5 Is there suitable and efficient storage space

  • 4.6 Is all furniture and bedding in a safe condition

  • 4.7 Are all baths, showers, sinks and wash trough in a safe condition?

  • 4.8 Is there sufficient ventilation ?

  • 4.9 Is there appropriate lighting?

  • 4.10 Are all rails, landing, verandas and steps in a safe condition?

  • 4.11 Is the house free of vermin?

  • 4.12 Noise- At the time of the audit are noise levels acceptable / work areas have been assessed for risk associated with excessive noise?

  • 4.13 The cleanliness of ventilation equipment (air conditioners) and clothes driers is maintained

  • 4.14 Have all other observable hazards been addressed

Ergonomics / Manual Handling

  • 5.1 Has the manual handling involving people and equipment checklist been completed in the last 12 months?

  • 5.2 Are mopping duties performed in a safe manner?

  • 5.3 Are laundering facilities safely located?

  • 5.4 Are laundering duties performed in a safe manner?

  • 5.6 Are all tasks that include the lifting or carrying of loads optioned into light, manageable loads?

  • 5.7 Are frequently accessed items stored at a safe working height?

  • 5.8 Are staff using environmental resources to support safe working postures when performing domestic activities?

Medication

  • 6.1 Is the medication stored in an appropriate cupboard, which is lockable if required( as per client risk assessment)

  • 6.2 Is all medication required and within it expiry date?

Behavior Management

  • 7.1 Are all behavior intervention, management and travel plans signed and up to date?

Motor Vehicle

  • 8.1 Have motor vehicles been serviced regularly and is there a system for recording past and due service dates?

Water temperature

  • 9.1 Is the temperature regulation device used in the household and the required temperature recorded in the household information folder ?

  • 9.2 Was the temperature of the water consistent with the requirements recorded in the household information folder?

Outside of residence

  • 10.1 Is there sufficient lighting to access vehicles and outdoor areas?

  • 10.2 Is access and egress appropriate for the residence?

  • 10.3 Are stairs, handrails and landings in a safe useable condition and free of hazards?

  • 10.4 Are all fences in good repair and free of fire hazards?

  • 10.5 Are all garden beds and grass well maintained and is the yard hazard free?

  • 10.6 Are garden sheds and other out buildings in a clean and safe condition, free of hazards and vermin?

  • 10.7 Are items in the shed stored appropriately and in accordance with client risk assessment?

  • 10.8 Has all rubbish or unused items been removed or disposed?

  • 10.9 Are BBQ's well maintained and has gas bottles been tested and stamped in the last ten years?

  • 10.10 Is all playground equipment, Garden furniture in a safe working condition and free of hazards?

  • 10.11 Have all observable hazards been dealt with?

WHS Consultation arrangements

  • 11.1 Are staff aware of the WHS consultation arrangements?

Psychological Health

  • 12.1 Is the staff members on shift aware of EAS, employee support program and how to access it?

  • 12.2 Is the employee on shift aware of the process for managing critical incidents?

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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.