Weekly Checklist

• Site address

• Conducted on

  Date

• Document No.

• Prepared by

Work Areas

• Do you wish to examine work areas on this safety walk?

  Yes

  No

  N/A

• Walkways (free of debris and obstructions)

  Safe

  At Risk

  N/A

• Work Surfaces (clear of clutter and dust)

  Safe

  At Risk

  N/A

• Sides or Holes (safety guards or covered)

  Safe

  At Risk

  N/A

• Impalement Hazards (none present, or adequately marked)

  Safe

  At Risk

  N/A

• Material Storage/Lay Down (neat and tidy)

  Safe

  At Risk

  N/A

Personal Protective Equipment (PPE)

• Do you wish to examine PPE on this safety walk?

  Yes

  No

  N/A

• Hard Hats (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Safety Glasses with Side Shields (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Face Shield / Goggles (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Respiratory Protection (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Hearing Protection (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Appropriate Clothing (in safe condition)

  Safe

  At Risk

  N/A

• Gloves (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Foot Protection (fit for task, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

Fall Protection Equipment

• Do you wish to examine fall protection equipment on this safety walk?

  Yes

  No

  N/A

• Fall protection equipment inspected inspected regularly and before use

  Safe

  At Risk

  N/A

• Appropriate for task and used properly by crew where applicable

  Safe

  At Risk

  N/A

• Suitable Anchorage Points

  Safe

  At Risk

  N/A

Ladders

• Do you wish to examine ladders on this safety walk?

  Yes

  No

  N/A

• Ladders are well maintained and in satisfactory condition

  Safe

  At Risk

  N/A

• Ladder base, footing and set up is to standard

  Safe

  At Risk

  N/A

• Proper Ladder for Task

  Safe

  At Risk

  N/A

Tools and Equipment

• Do you wish to examine tools and equipment on this safety walk?

  Yes

  No

  N/A

• General condition of tools

  Safe

  At Risk

  N/A

• Tools and Equipment inspections take place and are recorded

  Safe

  At Risk

  N/A

• Right tools are being used for tasks

  Safe

  At Risk

  N/A

• Crew members are trained to be competent in the tools appropriate for their work tasks

  Safe

  At Risk

  N/A

Excavations

• Do you wish to examine excavations on this safety walk?

  Yes

  No

  N/A

• Access/Egress is safe and frequency of egress is acceptable

  Safe

  At Risk

  N/A

• Shoring/Shielding/Sloping is safe

  Safe

  At Risk

  N/A

• Barricades are in place as required

  Safe

  At Risk

  N/A

• Spoil Pile

  Safe

  At Risk

  N/A

Electrical Safety

• Do you wish to examine electrical safety on this safety walk?

  Yes

  No

  N/A

• Ground fault circuit interrupters in use

  Safe

  At Risk

  N/A

• Extension Cords are not causing trip hazards or used inappropriately

  Safe

  At Risk

  N/A

• Power Tools are undamaged and being used fit for purpose

  Safe

  At Risk

  N/A

Personnel

• Do you wish to check personnel and this safety walk?

  Yes

  No

  N/A

• Behavior is orderly and professional

  Safe

  At Risk

  N/A

• Clear communication is possible without needing to shout

  Safe

  At Risk

  N/A

• Proper lifting technique demonstrated

  Safe

  At Risk

  N/A

People Safety

• Do you wish to check work crew safety knowledge at this inspection?

  Yes

  No

  N/A

• Approach at least one team member and record their responses to the following. Make clear this is not an assessment of the team member themselves, but rather the safety procedures on site.

Team Member

• Has the team member attended a pre-start meeting or toolbox talk within the last week?

  Yes

  No

  N/A

• Is the team member able to describe the correct process to follow in an emergency situation?

  Yes

  No

  N/A

• Is the worker able to identify three hazards they may encounter in their tasks today?

  Yes

  No

  N/A

• Team member signature (to verify this interview took place NOT to assess their safety knowledge)

  Sign

General Comments

• Any further comments or recommendations arising from this inspection?

• Any additional photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign

• Name & Signature of Site Supervisor / Foreman

  Sign