Information

  • Project Name / Raymond Job#

  • Client / Project Site

  • Conducted on

  • Prepared by

  • Project Location
  • On-site Personnel

Safety Assessment

1. PPE (Personal Protective Equipment)

  • 1.1 Lack of, or inadequate PPE (including sun protection)

  • 1.2 Respiratory protection/equipment?

2. Safety Documents/Postings

  • 2.1 OSHA posters/permits/workers comp postings?

  • 2.2 Lack of, or inadequate system to review SWP/IIPPas needed?

  • 2.3 Lack of/or inadequate Site Safety Plan?

  • 2.4 Lack of, or inadequate, routine inspections, monitoring, audits?

  • 2.5 Lack of/or inadequate Job Hazard Analysis (JHA) for high- risk work?

  • 2.6 Lack of/or inadequate training, licenses, skills, experience?

  • 2.7 P.A.T./LASER/Fireproofing signage posted?

3. Positions & Actions of People

  • 3.1 Lack of training in risk controls and safe lifting/team lifting techniques?

  • 3.2 Lack of identification/assessment of hazardous manual tasks?

  • 3.3 Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

4. Equipment (chop saws, drills, mixers, pumps, etc.)

  • 4.1 Lack of inspection regime?

  • 4.2 Unlicensed operators?

  • 4.3 Lack of safe work instructions?

  • 4.4 Unsafe or damaged equipment? (including missing or damaged guards, relief/safety devices)

  • 4.5 Incorrect equipment for job? (e.g. grinding discs for cutting)

  • 4.6 Unsafe or incompatible attachments used with equipment?

  • 4.7 Unsafe safe operation, clean-up and maintenance?

  • 4.8 Is Fire Protection available?

5. Slips, Trips & Falls

  • 5.1 Unprotected/unsecured/unmarked holes or depressions (>2" dia)?

  • 5.2 Trip Hazards?

6. Scaffolds

  • 6.1 Mobile scaffold wheels locked?

  • 6.2 Lack of inspection protocol for scaffold?

  • 6.3 Unsafe or incomplete scaffold (missing handrails, planks, etc.)?

  • 6.4 Incompatible scaffold components? Unlabelled or do not meet SAIA standards?

  • 6.5 Safe Work Load (SWL) exceeded? (tools, stored materials, number of persons)

7. Working at Heights

  • 7.1 Fall risks (6 ft. or more, including voids, pits, and trenches)?

  • 7.2 Unprotected change of elevation >18"?

  • 7.3 Unsafe or incomplete edge protection?

8. Fall Protection

  • 8.1 Lack of inspection protocol for equipment?

  • 8.2 Inadequate training for PFAS?

  • 8.3 Unsafe or damaged harness, lanyards, hooks or equipment?

  • 8.4 Unlabelled or does not meet Manufacturers standards?

  • 8.5 Unsafe or uncertified anchor points?

  • 8.6 Is PFAS stored properly?

9. Ladders

  • 9.1 Unsafe or damaged ladders?

  • 9.2 Unsafe positioning of ladders?

  • 9.3 Ladder not properly secured?

  • 9.4 Is all labeling attached and legible?

10. Lifting Equipment (scissor, boom, fork)

  • 10.1 Lack of daily inspection protocol?

  • 10.2 Unlicensed operators?

  • 10.3 Is Operators Manual on equipment?

  • 10.4 Does Forklift have a Fire Extinguisher attached?

  • 10.5 Unsafe operation observed?

11. Electrical Hazards

  • 11.1 Unsafe/damaged electrical cords? (damaged, cut, frayed, etc.)

  • 11.2 Lack of GFCI protection?

  • 11.3 Hazardous issues ( contact with overhead electrical lines, near water, overloaded, near hazardous chemicals)?

  • 11.4 Trip Hazard?

12. Work Environment

  • 12.1 Inadequate housekeeping?

  • 12.2 Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  • 12.3 Insufficient lighting?

  • 12.4 Lack of, or inadequate noise/ vibration control?

  • 12.5 Is there adequate & Safe Access & Egress?

  • 12.6 Air quality acceptable?

13. Emergency Response

  • 13.1 Lack of, or inadequate first aid kits aid equipment for site?

  • 13.2 Lack of drinking water available? (2 gallons, per person, per 8 hour shift)

  • 13.3 Emergency procedures, available, reviewed and displayed at site?

  • 13.4 Fire Extinguishers secured/available/functioning/inspected?

14. Traffic Management

  • 14.1 Inadequate controls and Traffic Management Plan (TMP) I place? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

15. Hazardous Chemical (including fuel and oil)?

  • 15.1 Inadequate spill containment equipment?

  • 15.2 Unsuitable/missing/damaged Fire protection (fire extinguisher)

  • 15.3 Safety Data Sheets not accessible on site?

  • 15.4 Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  • 15.5 Insufficient ventilation?

16. Environmental Hazards

  • 16.1 SWPPP

  • 16.2 PACM/PLCM-ACM/LCM (Asbestos/Lead)?

  • 16.3 Lack of/or inadequate, dust suppression system?

17. Miscellaneous

  • 17.1 Safe / At Risk?

Notes, Comments & Corrective Actions

Sign Off

  • On site representative

  • Auditor's signature KIRK WILLIAMSON, The RAYMOND Group Director of Safety

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