Information
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
Select date
-
Add location
Accident Prevention Program
-
Written Safety Policy?
-
Safety Health Manual?
-
Disciplinary Action Program?
-
Off-The-Job Injury Program set in place?
-
Safety Recognition Program?
-
OSHA 300 Log posted?
-
Emergency Plan in place?
Self-Audit Program
-
Written Plan or Procedure?
-
Documentation of Audits?
-
Documentation of Corrections?
-
Recorded Communication with employees?
-
Documented safe work practices training?
Confined Space Procedure
-
Written Program per standard?
-
Confined space awareness training, entrant, attendant, and entry Supervisor training completed?
-
Rescuer training annual drill and documented?
-
Retrieval system available? (harness, etc.)
-
Atmospheric monitoring up to date and calibrated up to date?
-
Ventilation available if needed per standard?
-
Permits adequate and filled out completely?
Safety Training and Education
-
Written New Hire Orientation and PowerPoint in place?
-
Safety Meeting set up for every week with team?
-
JSA forms available for Team Leaders?
-
Supervisor training available and documented?
-
OSHA classes given and documented?
-
Accident Investigation Training?
-
Media Release Policy?
RecordKeeping
-
OSHA Poster/Log?
-
First Aid Log?
-
Monthly Accident Summary?
-
Occupational Injury/Illness Report?
Medical Facilities
-
First Aid Kits, supplies, and disposal?
-
Medical Authorization
-
Injury Management setup?
-
Qualified First Aid attendant identified?
-
Bloodborne pathogens training and documented?
Accident Investigation
-
Near-Miss investigations conducted?
-
LTA Investigation Procedure?
-
Fatality/Catastrophe Procedure?
-
Third-Party liability investigation procedure?
Planned Safety Inspections
-
Inspection information competed in Job Safety Plan?
-
Inspection checklists in use?
-
Corrective actions documented?
Personal Protective Equipment
-
Head Protection use adequate?
-
Eye/Face Protection adequate?
-
Hearing Protection used when required?
-
Respiratory protection use adequate?
-
Fall Protection used?
-
Specialized PPE adequate for hazards?
Inspections
-
Portable Electrical Tools
-
Come-Alongs and Chainfalls?
-
Portable Welding Machine
-
Earth Moving Equipment
-
Crawler Cranes
-
Mobile Cranes
-
Overhead Hoists
-
Drum Hoists
-
Fall Protection Equipment
-
Suspension Scaffolds
-
Chokers, Slings, and Wire Rope
-
Ladders and Scaffolds
-
Cutting Rigs
-
Industrial Trucks
-
Aerial Lifts
-
Emergency Respirator Equipment
-
Fire Extinguishers
Work Permits
-
Safe Work/System Entry
-
Hot Work
-
Confined Space Entry
-
Lock-Out Tag Out
-
Excavation
Respiratory Protection Program
-
Written site-specific program in place?
-
Fit Testing?
-
Annual Training?
-
Maintenance and Storage Records?
-
Filter Cartridge Identification method?
-
Pulmonary function tests and Employee notification?
Emergency Evacuation and Response
-
Written plan identifying all elements?
-
Alarms and Signs/Signals posted?
-
Employee Training?
-
Media Release Policy training?
Hearing Conservation Program
-
Noise Survey of areas/operations?
-
Annual Training?
-
Hearing Protectors?
-
Audiometric test and employee notification
-
Warning signs and methods?
Fire Protection and Prevention
-
Written Program?
-
Fire Extinguisher adequate?
-
Fire Extinguishers inspected up to date?
-
Fire Extinguisher training completed and documented?
-
Warning Signs adequate?
-
Emergency Communication system adequate?
-
"EXIT" and "NOT AN EXIT" signs posted?
Signs, Signals, and Barricades
-
Warning Signs available and used?
-
Accident Prevention tags available and used?
-
Safety instruction signs posted?
-
Bulletin Board Maintained?
-
Adequate barricades used as needed?
Electrical Safety
-
Written Lock Out Tag Out Procedure/Program?
-
Annual Lock Out Tag Out Evaluation?
-
Lock Out Tag Out training completed and documented?
-
Written Assured Grounding Program?
-
Access to Electrical panels adequate?
-
Basic Electrical safety training and documented?
Hazard Communication Program
-
Written Program?
-
GHS for all Hazardous materials?
-
Chemical Specific training?
-
Container/Secondary container labeling?
-
Chemical inventory list and updates?
Asbestos Program
-
Written Program and Procedures?
-
Annual Awareness Training/Documented?
-
Competent Person assigned?
-
Protective Equipment?
-
Personal and Area monitoring?
-
Medical Surveillance records?
-
Signs and Labels?
-
Disposal responsibility?
-
EPA and State notification?
-
Decontamination facility?
-
RecordKeeping?
Powered Industrial Trucks
-
Operator training and authorization?
-
Inspections up to date and recorded?
-
Nameplates and Controls legible?
Aerial Lifts
-
Operator training and authorization?
-
Training Cards completed?
-
Inspections documented and completed?
-
Nameplates and Controls legible?
Mobile Cranes
-
Qualified/Competent Persons assigned?
-
Back alarms functioning?
-
Hand Signals posted?
-
Fire Extinguisher?
-
Inspections Completed and documented?
Power Actuated Tools
-
Operation Training and Authorization?
-
Proper Storage and Waste properly discarded?
-
Documentation of usage?
Abrasive Blasting
-
Protective Equipment?
-
Warning Signs and Barricades in place?
-
CO Monitoring and Records?
-
Air Purifying Filter and records?
-
Deadman release and Stand?
-
Personal and Area Monitoring and employee notification?
-
Safe Work Practices, PPE, and hazards training?
Flammable Liquids
-
Storage Available and adequate?
-
Warning Signs and Identification adequate?
-
Grounding and Bonding?
-
Drip Pans?
-
Auto Shut Valve and Drum Vent?
-
Spill Prevention Plan in place with Spill kits?
-
Fire Extinguishers available and at the correct distance away from flammables??
LPG/Compressed Gases
-
Storage racks?
-
Warning Signs in place with Identification?
-
Transporting and Field Use legal?
-
Flashback Arrestors attached?
-
Fire Extinguisher available?
Ventilation
-
Shops?
-
Paint Storage?
-
Welding Local Exhaust?
-
Paint Spraying area and booths?
Battery Charging
-
Warning Signs displayed?
-
Ventilation and Electrical?
-
Eyewash and safety shower in place?
-
Protective Clothing?
-
Fire Protection and Fire extinguishers
Excavation
-
Procedures?
-
Competent Person Inspection and Documented?
-
Employee Protection and Egress
-
Barricades set up?
-
Conditions?
Ladders
-
Safe Work Practices Training provided and documented?
-
Inspections up to date and documented?
Scaffolds
-
Safe Work Practices training?
-
Competent persons?
-
Qualified Builder?
-
Condition and Inspections documented?
Personnel Basket
-
Written Procedure in place?
-
Anti-Two Block System?
-
Training and Pre-Lift meeting?
-
Documented Load test and run?
-
Basket weight and capacity posted?
-
Engineering Design and stamp?
Housekeeping
-
Work areas, aisles and stairs free from clutter and debris (trash)?
-
Scrap and Debris removed regularly?
-
Trash and waster receptacles adequate?
Tools
-
Are they in a good safe working condition?
-
Supervisor Training on tools that require it and documented?
-
Stand Grinder Wheels, Rests and Guards in place?
-
Woodworking Tool guards in place?
-
Inspection and maintenance records up to date?
-
Documented tool box inspections?
Drug and Alcohol Program
-
Is there a Corporate manual?
-
Supervisor Training completed and documented?
-
Employee Training completed and documented?
-
Monthly report completed and documented?
-
Employee Asistance program?
Chemical-Specific Programs
-
Written Programs in place?
-
Benzene
-
Vinyl Chloride
-
Lead
-
Ethylene Oxide
-
Hazardous Waste
-
Other
-
Personal monitoring and notification in place?
-
Medical Suveillance and notification in place?
-
Training Offered and documented?
Safety and Health Committee
-
Written Charter and Procedure?
-
Responsibilities identified?
-
Documented Committee Inspections?
-
Documented Corrective actions?
-
Documented communication process?
Sanitation
-
Written Procedure for potable water cans?
-
Training on Procedure?
-
Non-Potable water labeled?
-
Vermin control?
-
Eating facilities in place?
-
Usable relief stations in place?
Transportation
-
Annual Vehicle inspection reports and decal in place?
-
Systematic vehicle Inspections completed and documented?
-
Cargo tank Inspections completed and documented?
-
Drivers log and Hours documented?
-
Pre Trip Logs and Post Trips Logs completed?
-
Add signature