The RCG Safety Assessments Leadership visit

• Site conducted

  Select

• Site Code

• Site Name

• Prepared by

• Other personnel on site

• Date

  Date
• Location
  Address

Site Information

• Is the site access information correct and up to date?

  Yes

  No

• Please insert correct site access information.

• Is there safe parking while working on the site?

  Yes

  No

• Picture of site layout displaying parking concern.

  Media

• Is the area around site free of hazards?

  Safe

  At Risk

  N/A

• Does the area around the site require any maintenance? Weeds, Fences, Rubbish, etc.

  Yes

  No

  N/A

• Please describe to best of your knowledge what maintenance is required.

• Are steps and ramps in good condition with a firmly fixed handrail if steps above 1m?

  Safe

  At Risk

  Fail

  N/A

• please photograph area

  Media

• Site safety signage?

  Compliant

  Non-compliant

• Is the site area clean, tidy, free from - water damage, slip and trip hazards? Any overhead hazards?

  Safe

  At Risk

  Fail

  N/A

• please describe.

• Site access & additional site hazard photos.(Photo of road leading to site + any other access info)

  Media

• All contractors (including sub-contractors) have been provided with information relating to health and safety for the work they are undertaking?

  Safe

  At Risk

  Fail

  N/A

Safety Gear

• Personal Protective Equipment/Safety Gear appropriate to the task is in being worn and is in good condition?

  Safe

  At Risk

  Fail

  N/A

• PPE inspected before use?

  Yes

  No

  N/A

Emergency planning and equipment

• Is the site able to call for emergency assistance - Fire, Police Ambulance?

  Safe

  At Risk

  Fail

  N/A

• Are appropriate Fire Extinguishers and First Aid kits on site?

  Safe

  At risk

  N/A

• Emergency assembly point identified?

  Safe

  At risk

  N/A

Environmental

• All site areas are kept tidy with litter removed from site appropriately?

  Safe

  At risk

  N/A

General

• Have all visitors signed the visitor log and are hazards, risks and controls discussed with visitors prior to entering the site??

  Safe

  At Risk

  Fail

  N/A

• Is lighting adequate for carrying out tasks and and/or safe access?

  Safe

  At risk

  N/A

RF

• Are there RF hazards on site?

  Yes

  No

• RF warning signs are in place at access points?

  Safe

  At Risk

  Fail

  N/A

• Are persons trained/competent/certified in RF Awareness

  Safe

  At Risk

  Fail

  N/A

• Are appropriate RF monitors available and being used?

  Safe

  At Risk

  Fail

  N/A

• Are RF monitors calibrated?

  Safe

  At Risk

  Fail

  N/A

Machinery for working at Heights on Towers, Roofs and Structures

• MEWP, Crane, Scaffold or Guardrails being used on Site?

  Yes

  No

• Move to the next section

• Are workers on the ground wearing appropriate PPE e.g. Safety Helmets, Safety Boots, High Viz Vests and Eye Protection?

  Safe

  At Risk

  Fail

  N/A

• Have exclusion zones been implemented and sufficient for the tasks being carried out?

  Safe

  At Risk

  Fail

  N/A

• Assess any of the following equipment on site

• Mobile Elevated Work Platfrom

  Yes

  No

• Has the operator carried out a carried out a pre start inspection of the MEWP that includes functional and visual tests (required each day)?

  Safe

  At Risk

  Fail

  N/A

• Is the MEWP clearly marked with the rated lifting capacity

  Safe

  At Risk

  Fail

  N/A

• Weight of lift?

• Essential operating and maintenance instructions permanently displayed or stored in a conspicuous place on the MEWP?

  Safe

  At Risk

  Fail

  N/A

• Is the six monthly inspection certificate displayed?

  Safe

  At Risk

  Fail

  N/A

• Operator is trained and competent (US 23966 v1) and the corresponding unit for the type of MEWP being used?

  Safe

  At Risk

  Fail

  N/A

• Hazards associated with power lines are appropriately controlled (no closer than 6.4 metres, or between 4 - 6.4 metres with appropriate controls in place. No work can be carried out within 4 metres of a power line without the written consent of line owner and this consent must remain on site at all times?

  Safe

  At Risk

  Fail

  N/A

• Weather conditions are suitable for using the MEWP?

  Safe

  At Risk

  Fail

  N/A

• Are harnesses, lanyard and attachment points available to all workers undertaking tasks from the MEWP?

  Safe

  At Risk

  Fail

  N/A

• Is the MEWP set up on firm and level ground?

  Yes

  No

  N/A

• Crane

  Yes

  No

• Is the plan and information provided by the crane supplier signed and accepted by the contractor on site?

  Safe

  At Risk

  Fail

  N/A

• Is the crane set up on firm, level ground with barriers in place?

  Safe

  At Risk

  Fail

  N/A

• Safe working distances are maintained from overhead power lines?

  Safe

  At Risk

  Fail

  N/A

• No persons are standing under suspended loads?

  Safe

  At Risk

  Fail

  N/A

• Tag lines are used where there could be load spin?

  Safe

  At Risk

  Fail

  N/A

• The load does not exceed the lifting capacity of the crane

  Safe

  At Risk

  Fail

  N/A

• Lifting capacity of the crane

• Weight of lift

• Clear lines of communication exist between the dogman/persons in bucket and the crane operator?

  Safe

  At Risk

  Fail

  N/A

• Weather conditions suitable for the use of a crane?

  Safe

  At Risk

  Fail

  N/A

• Scaffold or Mobile Scaffold

  Yes

  No

• Are the surface conditions suitable for scaffold access and stability - e.g level and safe to work on?

  Safe

  At Risk

  Fail

  N/A

• Is there a health and safety management plan on site that clearly identifies those responsible for implementing control measures for the scaffold?

  Safe

  At Risk

  Fail

  N/A

• Are site specific hazards e.g proximity to power lines and control measures included in the Safe Work Method Statement or JSA?

  Safe

  At Risk

  Fail

  N/A

• The scaffold was erected, altered or dismantled by a person(s) who have been trained and have suitable experience with the type of scaffold being used?

  Safe

  At Risk

  Fail

  N/A

• Are the wheels locked and turned out on mobile scaffolds?

  Safe

  At Risk

  Fail

  N/A

• If a portion of the scaffold is above 5 metres above the ground the following conditions must be met

  Yes

  No

  N/A

• The person assembling, altering or dismantling the scaffold have a certificate of competence

• Scaffold inspection card/register (Safety Tag) clearly visible in place by the access ladder and checked weekly?

• Notification has been sent to WorkSafe NZ

• Edge protection provided where a person could fall 2 or more metres

• Scaffold protected from passing vehicles or plant

• Ladders are secured top and bottom.

• Ladder extended 900-1000 mm above the landing platform.

• Planks are in good condition, 3 planks minimum and butted and secured.

• Edge Protection?

  Yes

  No

• Designed and constructed to by a competent person?

  Safe

  At Risk

  Fail

  N/A

• Positioned appropriately?

  Safe

  At Risk

  Fail

  N/A

• Will barriers and guard rails be regularly inspected

  Safe

  At Risk

  Fail

  N/A

• Includes a toe board or mesh infill to prevent tools, materials and debris falling from the roof?

  Safe

  At Risk

  Fail

  N/A

• Not used on a roof with greater than 35 degree slope (In this instance a MEWP, or Fall Restraint/Arrest system must be used)

  Safe

  At Risk

  Fail

  N/A

Fall restraint and fall arrest systems

• Are fall restraint or fall arrest systems being used on site?

  Yes

  No

• Move to the next section

• All personnel trained and certified for working at height?

  Safe

  At Risk

  Fail

  N/A

• Has the rigger undertaken a visual inspection of the structure, pole etc prior to work commencing?

  Safe

  At Risk

  Fail

  N/A

• Is each person familiar with the work plan?

  Safe

  At Risk

  Fail

  N/A

• Are personnel attached at all times while working at height?

  Safe

  At Risk

  Fail

  N/A

• Has a drop zone been implemented and sufficient for the tasks being carried out?

  Safe

  At Risk

  Fail

  N/A

• Is all equipment secure to prevent a fall from height?

  Safe

  At Risk

  Fail

  N/A

• Does each member of the team have the required PPE?

  Yes

  No

  N/A

• Two certified rescue climbers are on site at all times?

  Safe

  At Risk

  Fail

  N/A

• Notification has been sent to WorkSafe NZ of the work?

  Safe

  At Risk

  Fail

  N/A

• Has a SWMS or JSA been prepared for height work on site?

  Safe

  At Risk

  Fail

  N/A

• Are there established safe access pathways to the anchor points?

  Safe

  At Risk

  Fail

  N/A

• Is a certified fall restraint system available for use?

  Safe

  At Risk

  Fail

  N/A

• If using a fall arrest system are suitable certified anchor points being used?

  Yes

  No

• Date anchor points certified to?

  Date

• Certified load?

• If certified anchor points are not available a Temporary Anchor Point Permit must be completed and a copy held on site

• The temporary anchor point permit has been signed by a competent rigger?

  Yes

  No

• Rope access work must cease until the permit is completed

• The temporary anchor point permit has been signed by the rescue climber?

  Yes

  No

• Rope access work must cease until the permit is completed

• For this assessment the following applies
  
  Safe -
  At Risk -
  Fail -

Pedestrian and Public Safety

• Are members of the public/pedestrians passing the site?

  Yes

  No

• Is a spotter required on site?

  Safe

  At Risk

  Fail

  N/A

• Is safe pedestrian access maintained on site at all times?

  Safe

  At Risk

  Fail

  N/A

• Work vehicles are parked safely?

  Safe

  At Risk

  Fail

  N/A

• Pedestrian and public safety

  Safe

  At Risk

  Fail

  N/A

Electrical Safety

• Is electrical (230 v and over) work being undertaken on site?

  Yes

  No

• Procedures are in place for ensuring electrical equipment is de-energised before electrical work is carried out and methods in place to ensure that it cannot <br>be inadvertently re-energised (isolation, tagging and lockout)?

  Safe

  At Risk

  Fail

  N/A

• Persons conducting work on electrical equipment are appropriately trained, registered and hold a practising license for the type of work being undertaken?

  Safe

  At Risk

  Fail

  N/A

• Proven to be de-energised before work commences?

  Safe

  At Risk

  Fail

  N/A

• Only ladders constructed of timber or fibreglass are to be used for work on or near electrical apparatus?

  Safe

  At Risk

  Fail

  N/A

• All electrical equipment, extension leads and portable power tools are in good condition and regularly inspected, tested and tagged?

  Safe

  At Risk

  Fail

  N/A

• Undertaken a CPR course (within the last 12 months) and Basic First Aid course (within the last 2 years)?

  Safe

  At Risk

  Fail

  N/A

Live electrical work

• Is live electrical work being undertaken on site?

  Yes

  No

• A risk assessment and safe work method statement has been prepared before any live work is undertaken?

  Safe

  At Risk

  Fail

  N/A

• When working on or near live electrical apparatus the following Safety Gear (PPE) is being worn

  Yes

  No

• Clothing covers the body from neck to wrist to ankle, (cotton)

• Sleeves rolled down and shirts tucked into trousers (protecting against entanglement and arc flash)

• Non metallic fasteners (or fasteners are protected by a layer of the same material as that of the garment)?

• Suitable eye protection?

Traffic Management

• Is the worksite in the road corridor or subject to frequent vehicle movements?

  Yes

  No

• Copy of the traffic management plan signed by the contractor and maintained on site?

  Safe

  At Risk

  Fail

  N/A

• Traffic management setup is correct and according to the TMP?

  Safe

  At Risk

  Fail

  N/A

• STMS contact number listed?

  Safe

  At Risk

  Fail

  N/A

• Is there an escape route for the traffic controller?

  Safe

  At Risk

  Fail

  N/A

• Comes and barriers in good condition?

  Safe

  At Risk

  Fail

  N/A

• After hours TMP in place if necessary?

  Safe

  At Risk

  Fail

  N/A

• Site Photographs

  Media

Agreement

• Are any other hazards present on site, list below

  Yes

  No

• Are these hazards and risks being appropriately controlled?

  Yes

  No

• Were any unsafe work practices observed at the time of the assessment

  Yes

  No

• Please describe the unsafe practice observed below

• undefined

• Required corrective actions

  Yes

  No

  N/A

• undefined

• Agreed date for completion of corrective actions

  Date

• Assessor

  Sign

• undefined

  Select Spark Connect 8 Skycomms Broadspectrum Downers Other

  • Spark
  • Connect 8
  • Skycomms
  • Broadspectrum
  • Downers
  • Other

• Site representative

  Sign

• undefined

  Select Spark Connect 8 Skycomms Broadspectrum Downers Other

  • Spark
  • Connect 8
  • Skycomms
  • Broadspectrum
  • Downers
  • Other

• Additional people

Person