Information

  • Front Elevation

  • Property Name

  • Site Address
  • Project Reference Number:

  • Contractor

  • Weather at time of visit

  • Visit Date

  • Who was on site?

  • Prepared by

CDM, Health and Safety

  • Were you able to gain safe access to the property?

  • Why could you not access the site?

  • Is the property clean, tidy & safe?

  • Contractor to make arrangements to clean down the site to ensure safe access during works.

Surveyor Safety

  • Instruction: Surveyor has received clear instructions, supervision and expert support received where necessary, relating to: – the work activities required – the operation of any equipment and – appropriate safe systems of work.

  • Supervision: Supporting staff with clearly defined lines of communication and personal protective equipment (PPE): providing individuals with appropriate personal protective equipment that meets appropriate specifications.

  • The attending surveyor has completed an individual risk assessment to confirm safe working access and correct PPE in place to complete their works.

  • Individual responsibilities include:

  • Performance: being competent to perform their work safely (including understanding the limits of their competence (skills, knowledge and experience)).

  • Control: being able and prepared to work within accepted or designated systems of work.

  • Adaptability: being able to recognise and adapt to changing circumstances at all times.

  • Vigilance: remaining vigilant, at all times, for their own safety and that of colleagues and others.

  • Awareness: being able to recognise their own abilities and limitations and teamwork: being an effective member of a team.

Site Control

  • Hazard board and signage up-to date

  • Contractor to make arrangements to update the hazard board and signage.

  • Safety inductions in place

  • Safety inductions to be applied by the principle contractor

  • Safety notice board current

Site Facilities

  • Office clean, adequate and good lighting

  • Contractor to make necessary arrangements to ensure that the site is clean with good lighting.

  • Smoking area / shed/ Agreed location

  • Smoking area to be adjusted in accordance with the pre contract meeting report.

  • Toilets clean with wash facilities

  • Principle contractor to ensure that the toilets are clean and suitable as wash facilities.

  • Tool / equipment sheds/ storage adequate

General Site Tidiness and Accessways

  • Clear, safe access to work areas

  • Stairways and accessways clear

  • Hoardings / fences and gates secure

  • Loose materials secure from wind

Personal Safety Equipment

  • Signage displayed and legible

  • Hard hats being worn

  • Correct footwear being worn

  • Task PPE worn

First Aid / Fire Prevention

  • First aid box available

  • Accident book on site

  • Fire points located

  • Evacuation procedures in place

  • Assembly point located

Additional site safety checks

  • Additional site safety checks to be included where necessary

  • Additional Health and Safety Checks

  • Cranes/ Hoists Lifting: Lift plan in place and communicated

  • Cranes/ Hoists Lifting: Crane certificate current

  • Cranes/ Hoists Lifting: Slings / chains certified

  • Cranes/ Hoists Lifting: Operator procedures in place

  • Cranes/ Hoists Lifting: Inspections in place

  • Cranes/ Hoists Lifting: Emergency plan in place

  • Plant & Equipment: In good condition

  • Plant & Equipment: Inspections in place

  • Plant & Equipment: Operator licence / certification in place

  • Excavations: Correctly shored and inspected

  • Permits to work: Hot work permit in place

  • Permits to work: Permit to dig in place

  • Permits to work: Electrical permit in place

  • Permits to work: Other permits

  • Electrical Equipment: Leads tested and damage free

  • Electrical Equipment: Leads safely placed

  • Electrical Equipment: Transformer located safely

  • Electrical Equipment: Equipment in good condition and tested

  • Electrical Equipment: Adequate lighting

  • COSHH: Correctly stored

  • COSHH: MDS and Coshh sheets on site

  • Tools: PAT tested

  • Tools: Operatives trained in use

  • Scaffolding: Handover certificate on site

  • Scaffolding: TG20 compliance sheet or design on site

  • Scaffolding: Scaf Tag displayed and checked weekly

  • Scaffolding: Scaffold entered onto the temp works schedule

  • Scaffolding: Scaffold checked by the SM

  • Ladders/ Steps: Good condition

  • Ladders/ Steps: Tagged / inspected

  • Ladders/ Steps: Used correctly

  • Fall Hazards: Edge protection in place

  • Temporary Works: Schedule up to date

  • Temporary Works: Items signed off by Temporary Works Co-ordinator

  • Temporary Works: Information attached to schedule

Site Report

Present Position

  • Progress / activity on site since previous report

  • Building Name/ Number
  • Name of Building/ No.

  • Working areas

  • Basement 1 photographs and site notes

  • photographs and site notes

  • Ground Floor photographs and site notes

  • First Floor photographs and site notes

  • Second Floor photographs and site notes

  • Third Floor photographs and site notes

  • Fourth Floor photographs and site notes

  • Fifth Floor photographs and site notes

  • Sixth Floor photographs and site notes

  • Seventh Floor photographs and site notes

  • Eighth Floor photographs and site notes

  • Ninth Floor photographs and site notes

  • Tenth Floor photographs and site notes

  • Eleventh Floor photographs and site notes

  • Twelfth Floor photographs and site notes

  • Thirteenth Floor photographs and site notes

  • Fourteenth Floor photographs and site notes

  • Fifteenth Floor photographs and site notes

  • Sixteenth Floor photographs and site notes

  • Seventeenth Floor photographs and site notes

  • Eighteenth Floor photographs and site notes

  • Additional Floor photographs and site notes

  • Roof photographs and site notes

  • Elevations photographs and site notes

  • Curtilage photographs and site notes

  • Other photographs and site notes

  • External Decorations/ Maintenance
  • External Works area

  • Front Elevation photographs

  • Rear Elevation photographs

  • Left hand side Elevation photographs

  • Right Hand side Elevation photographs

  • Other Elevation photographs

  • Individual Room
  • Room Name

  • Room Notes

  • Photographs

  • Apartment/ House
  • Name/ Number of house

  • Rooms

  • Kitchen Photographs

  • Bathroom 1 Photographs

  • Bathroom 2 Photographs

  • Bathroom 3 Photographs

  • En-suite 1 Photographs

  • En-suite 2 Photographs

  • En-suite 3 Photographs

  • En-suite 4 Photographs

  • Bedroom 1 Photographs

  • Bedroom 2 Photographs

  • bedroom 3 Photographs

  • Bedroom 4 Photographs

  • Bedroom 5 Photographs

  • Bedroom 6 Photographs

  • Bedroom 7 Photographs

  • Bedroom 8 Photographs

  • Bedroom 9 Photographs

  • Bedroom 10 Photographs

  • Bedroom 11 Photographs

  • Bedroom 12 Photographs

  • Living Room Photographs

  • Dining Room Photographs

  • Airing Cupboard Photographs

  • Closet 1

  • Closet 2 Photographs

  • Closet 3 Photographs

  • Closet 4 Photographs

  • Study Photographs

  • Balcony 1 Photographs

  • Balcony 2 Photographs

  • Balcony 3 Photographs

  • Toilet 1 Photographs

  • Toilet 2 Photographs

  • Toilet 3 Photographs

  • Toilet 4 Photographs

  • Room Name

  • Room Name

  • Room Name

  • External works
  • Working area

  • Photographs of working area

  • Driveway and Parking areas
  • Works update

  • Works Photographs

  • Garage Works
  • Garage (s) no/ location

  • Photographs of Garage (s)

  • Window Works required per development
  • Location of window (s)

  • Photographs of windows

  • Door works
  • Location of door (s)

  • Door Photographs

  • Roof Works
  • Roof work location

  • Works update

  • Roof photographs

On Site Progress

  • Is the project on plan?

  • Why have the works been delayed?

  • Has an Extension of time been requested by the contractor?

  • The contractor will need to issue an extension of time request to the contract administrator including the reason for delays, supporting evidence and and updated programme of works.

Planned activity

  • Overview of planned activity in next two weeks

  • Decisions / Choices req'd:

Variations

  • Is a variation to the contract required?

  • Variation Requested

  • The contractor will require official approval to proceed in the form of a contract instruction or formal email correspondence. The contract administrator will need to review all variation requests.

Valuations

  • Is a valuation required / requested by the contractor?

Valuation request

  • Percentage of works completed on site

  • The contract administrator will issue a payment certificate based on the works completed to date.

Action plan following this visit

  • Please provide details of any actions / choices that are required in order to progress the repairs, when this needs to be done and who needs to action this.

    If actions are required then tap on the "Add Action required" button. For each additional action either hit that button again or tap the "+ Add" button.

  • Action required
  • What needs to be done next in order to move this repair forward?

  • Specify the person / party responsible for this action

  • Person (s) responsible for the action.

  • When does action need to be taken by?

Any additional comments

  • Additional comments

Principle Contractor Review

  • Contractor performance review; scores based on 1 being very poor and 5 being very good/ excellent.

  • Quality and consistency

  • Progress of work

  • Health and safety

  • Communication

Sign Off

  • Add signature

Contract Administrator

  • Contract Administrator information

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number

  • Email Address:

  • Phone Number:

  • Email Address:

  • Phone Number:

  • Email Address

  • Phone Number:

  • Email Address:

  • Phone Number

  • Email Address

  • Phone Number:

  • Email Address:

  • Phone Number

  • Email Address

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.