Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

JSA Audit Requirements

  • Reviewed by workers, signed, posted

  • Does it follow the work? Is it applicable?

  • Updated: being followed

  • Required documents on control board

Environment / Site Conditions

  • First Aid Kit: stocked, eye wash, accessible

  • Sanitation: toilets clean, stocked

  • Noise below 85dba, protection used

  • Lighting: general, task

  • Ventilation: heat, odors

  • Dust control

PPE

  • Standard hard hat, glasses, high vis clothing, steel toes

  • Other: correct for area, task, department

Fire Protection

  • Extinguishers: sized for task, inspected

  • Flammable loquids controlled, stored properly

  • Fuel: stored correctly (propane, oxygen)

Signs, Barricades

  • Proper barricades: placement

  • Signs: correct, posted, phone #, red , yellow

Material/ Handling / Storage / 5S

  • Mat, tools, equip: Stored properly, neatly stacked

  • Trip Hazards: cords neatly run, areas clean

  • Liquids on floor: spill kit available

  • Rigging for material handling correct, stored properly

Tools: Hand and Power

  • Condition: handles on, cords not cut

  • Guarding: used, adjusted correctly

  • Proper Usage: correct tool for the job

  • Identification on gang boxes, tools, equipment

Welding, Cutting, Grinding

  • Hot work requirements met: issued

  • Proper PPE non flammable clothing

  • Shields barriers equipment area protected

  • Gas equip: proper storage flash arresters used

Electrical

  • GFCI Protection: tested

  • Ext. cords: condition, protected, inspected

Scaffolds

  • No missing planking, bracing, guardrails

  • Inspected:tagged, hazards noted

  • Falling Object Protection: toe boards

  • Rolling Scaffolds: wheels locked

  • Workers tied off in Aerial Lifts, Prop fall protection

  • Basket: floor cleaned, materials loaded properly

Fall Protection

  • PFAS: inspected, good condition, worn properly

  • Proper anchorage: clamps, straps, lines

  • Workers tied off in scissor lifts

  • Double lanyard used for free climbing

  • Leading edges identified, protected

  • Warning Lines: Used, proper distance

  • Floor openings: permit issued, followed

  • Roof work: permitted, weather conditions

Motor Vehicles / Mechanized Equipment

  • Daily Inspections, equipment Identified

  • Safety Devices: seatbelts, lights, alarms

  • Operators: certified, authorized, licensed

  • Forklift operated correctly

Excavations

  • Over 5ft: sloped, benched, shored

  • Over 4ft: ladder access, every 25ft

  • Spoils: back 3ft

  • Water Intrusion: rain, seepage

  • Excavations protected, workers, equipment

Concrete and masonry construction

  • Rebar/ rods capped, protected

  • Masonry walls support, Limited access zones

Steel Erection, Equipment Placement

  • Area protected from overhead lifts

  • Site specific erection plan in place

  • Area will support load and equipment

Demolition

  • Engineer survey by competent person made

  • All sev. Shut off capped, disc, removed

Power transmission / distribution / LO

  • Energy sources: identified, isolated locked out

  • Sign in sign out sheet: used and correct

  • Group lockout: key box used key inside

  • Locks labeled, contain required info

  • Arc Flash: proper PPE, workers trained

Ladders

  • Secured used properly right type for work

  • Non conductive no metal side rails

  • Good condition rungs rails bracing

Toxic /hazardous substances

  • Chemicals: identified, labeled

  • Stored Properly: correct containment

  • MSDS sheets available, correct

  • Proper PPE being used

Cranes and Derricks

  • Crane operator certified card checked

  • Crane inspection certifications current

  • Rigging condition, inspected, rating tag

  • Rigger qualified: checked

  • Signal Person: qualified, checked

Confined space

  • Air quality tested

  • Permit/ checklist Posted

  • Workers trained / rescue notified

Other

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.