Title Page
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Date of Site Visit
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Prepared by
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Audit Participants:
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Primary Contact:
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Email Address:
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Phone Number
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Location
Safety And Loss Control Location Audit
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INSTRUCTIONS
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1. Answer "Compliant" "Partially Compliant"and "Non-Compliant" on the questions below.
2. Add photos and notes by clicking on the paperclip icon
3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link
INCIDENT TRENDING/ LOSS EXPOSURES
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List all trending incident/loss exposure. Click "Add incident" to begin.
Incident
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Please specify incident trending/loss exposures
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Compliance Level
MANAGEMENT CONTROLS
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Hiring Process, Best Practices
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Documentation/OSHA Logs/Safety Manual/Employee Sign
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Recordkeeping
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RTW
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Drug Testing - Pre/Post/Random
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Occ-med Clinic
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Safety Committee
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Accident Investigation
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EAP - Available/Numbers/Routes/Alert
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Hazcom
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First Aid / AED / CPR
Observed Behaviors/Site Conditions
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List all Observed Behaviors/Site Conditions
Observation
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Please specify Observed Behaviors/Site Conditions
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Compliance Level
Key Considerations / Meeting Notes
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Specify/Provide Key Considerations/Meeting Notes
Health And Safety Location Audit
Exposures and Controls
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STF - ladder work, work from heights
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Scaffolds, aerial lifts, walkways, working surfaces
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Fall protection needed?
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Material handling - mechanical aids
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Lighting
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Machines / equipment / tools - LOTO / Compressed gas / Infestation
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Training / proper lifting
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Security, locked doors, cameras etc.
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Electrical-wires, panels
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Chemicals/ SDS/ eyewash / labels etc.
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Fire etc. extiguishers / hot work permit / sprinklers
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Observable Deficiency on Ergonomics
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List other Observable deficiency on Ergonomics . Click "Add Deficiency" to begin.
Deficiency
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Please specify Observable Deficiency on Ergonomics
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Compliance Level
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Observable Deficiency on Occupational Exposures
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List other Observable deficiency on Occupational Exposures . Click "Add Deficiency" to begin.
Deficiency
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Please specify Observable Deficiency on Occupational Exposures
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Compliance Level
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Respirator use?
Fleet/Vehicles
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Driver policies / cell phone / distracted driving etc.
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MVR
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DD training / course /
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Ride alongs
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Forklifts/Gold Carts etc
Training
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New hire
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Re-occuring
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Cover exposures
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HR, BBP, etc.
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Newsletters
Housekeeping
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Storage-flammable / combustible
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Egress-fire exits, blocked, signs
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Containers
Observed Behavior
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PPE
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Work practices, pace, attitude
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Safety knowledge
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Uniforms
Building and Exterior Location Audit
Doors
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Damaged Frames/Threshold/Lintels/Trim
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Damaged Hardware / Locks
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Damage Surface (Holes/Paint/Rusting/Security Doors
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Damage/ Missing Screen / Storm / Security Door
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Deteriorated/Missing Caulk/Seals
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Missing Doors
Fire Escapes
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Blocked Egress / Ladders
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Visibly Missing Components
Foundations
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Cracks/Gaps
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Spalling/Exposed Rebar
Lighting
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Broker Fixtures / Bulbs
Roofs
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Damaged Soffits/Fascia
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Damaged Vents
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Damaged/Clogged Drains
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Damaged/Torn Membrane/Missing Ballast
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Missing / Damaged Components from Downspout/Gutter
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Missing / Damaged Shingles
Walls
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Cracks/Gaps
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Damaged Chimney
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Missing/Damaged Caulking/Mortar
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Missing Pieces/Holes/Spalling
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Stained/Peeling/Needs Paint
Windows
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Broken/Missing/Cracked Pains
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Damaged Sills/Frames/Lintels/Trim
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Damaged/Missing Screens
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Missing/Deteriorating Caulk/Seals/Glazing
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Peeling/Needs Paint
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Security Bars Prevent Egress
Fencing & Retaining Walls
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Damaged/Falling/Leaning
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Holes
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Missing Sections
Grounds
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Erosion/Rutting Areas
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Overgrown/Penetrating Vegetation
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Ponding/Site Drainage
Market Appeal
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Signs Damaged
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Graffiti
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Litter
Parking Lots
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Cracks/Gaps
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Ponding/Site Drainage
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Potholes / Loose Material
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Settlement/Heaving
Play Areas & Equipment
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Damaged / Broken Equipment
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Damaged / Falling Leaning
Storm Drainage
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Damaged/Obstructed
Walkways & Steps
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Broken/Missing Handrail
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Cracks/Settlement/Heaving
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Spalling
COMPLETION
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Audited by
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Other Audit Participants
Participant
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Name & Signature
