Information

  • Audit Title

  • Client / Site

  • Conducted on

  • General Description of Task

  • Prepared by

Housekeeping and Basic PPE

  • Are all employees wearing Hardhats?

  • Are all employees wearing Safety Glasses?

  • Are all employees wearing appropriate Footwear?

  • Are all employees wearing Gloves?

  • What task(s) is being performed without Gloves?

  • Is the area noisy?

  • A common "Rule of Thumb" is...if you need to raise your voice to speak to a person standing next to you than there is risk of hearing damage.

  • Try using the "Decibel 10th" App. It's Free! Hearing protection should be worn when area is louder than 85 dB

  • Are employees wearing Hearing Protection?

  • What is creating noise in the area?

  • Type of Hearing Protection

  • Describe hearing protection

  • Are Hi-Viz Clothing or Safety Vests required on this project or for this task?

  • Are employees complying with Safety Vest / Hi-Viz clothing requirements?

  • Ensure employees are wearing appropriate Safety Vest / Hi-Viz clothing before leaving the area.

  • If employees are exposed to vehicle or equipment traffic or are working as a spotter then they should be wearing safety vests or Hi-Viz clothing.

Job Hazard Analysis

  • Is there a JHA posted for this task?

  • Take a picture of the posted JHA

  • Does the JHA address the Hazards of the work?

  • Was a JHA Meeting held to review this work?

  • Have all employees involved in the work signed onto the JHA?

  • Who completed the JHA?

  • Comments or Concerns regarding the JHA:

Working at Elevation

  • Are all employees performing work from grade level?

  • Is one or more A-Frame Ladder Being used?

  • Is the ladder being used in the locked open position?

  • A-Frame Ladder Inspection

  • A-Frame
  • Ladder ID

  • Are the steps and supports free from cracks?

  • Steps and supports are not bent or dented

  • Warning Labels are present and undamaged

  • If all boxes are not checked the ladder must be removed from service and labeled or tagged N/G

  • Is the area at the base of the ladder free of debris and/or tripping hazards

  • Are employees standing on the top or top rung of the ladder?

  • It is incorrect and risky to stand on the top or the top rung of an A-Frame ladder. Correct the situation immediately. A verbal warning should be issued to any employee standing on the top or top rung of an A-Frame ladder

  • Is this ladder the correct tool for the job?

  • This is a dangerous situation. Work must be stopped until the situation is remedied.

  • Is one or more Straight Ladder being used for this task?

  • Straight Ladder Inspection

  • Ladder
  • Warning Labels are present and undamaged

  • If all boxes are not checked the ladder must be removed from service and labeled or tagged N/G

  • Ladder ID

  • Are the steps and supports free from cracks?

  • Steps and supports are not bent or dented

  • Is the ladder secured?

  • Does the Ladder Extend 3' above the level that it is being used to access?

  • Is the ladder setup at a 4:1 ratio (rise:run)

  • A good way to check if a Straight ladder is setup correctly is to place your feet at the base of the ladder and extend your arms. Your hands should touch the rails of the ladder. If your hands extend past the ladder, it is too steep. If you cannot reach the ladder, it is too shallow.

  • Correct the situation immediately. Improperly setup ladders can cause serious falls.

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.