Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Does the workplace have an JASANZ safety management system (WHSMS)?

  • YES - Take photograph, sign and finalise assessment.

    NO - complete assessment as directed. do not sign

  • Photographic evidence

  • Validation evidence?

  • Host employer signature

  • Field officer signature

Organsiation

  • 1.1 Is there a WHS policy?

  • How often is the policy reviewed?

  • Review date?

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 1.2 Is this communicated to the workers?

  • Guide: The policy is communicated to workers by the following methods?
    (displayed, at induction,toolbox meetings, employee hand book nor accessed electronically)

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

Planning:

  • 2.1 Does the Host Employer have a formal process in place to manage WHS within the business?

  • Guide: Does the host use any of the following to manage WHS?
    (Must have safety management plans or a schedule (program) of WHS activities and corrective action plans and risk assessments for full compliance), Partial for Safe Work Method Statements (SWMS) or Job site Analysis (JSA's), worksite inspection checklists only and/or objectives/ targets or WHS goals are set.

  • Validation notes?

  • Photographic evidence?

  • Level of Compliance?

  • 2.2 Is there a risk assessment and planning process for off site work?

  • Guide: Does the host have a formal procedure & forms in place to conduct job site risk assessments (job site analysis (JSA's), job quotation forms etc.)?

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 2.3 Are there any Safe Work Method Statement (SWMS)/Job Safety Analysis (JSA's) available?

  • If so, Are they job specific? Is there a list of safe work method statements (SWMS) or job safety analysis (JSA's) for key tasks performed by the business?

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 2.4 Does the host keep up to date with current legislation?

  • Guide: This can be achieved by subscriptions to the government agency, SMART kit, WHS training, Associations, Affiliations or Client)

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

3.0 Implementation:

  • 3.1 Do officers and workers know their WHS roles and responsibilities?

  • Guide: The following are used to inform officers and workers of their responsibilities. (WHS procedure, Job descriptions, WHS training outlines, organisational chart)

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.2 Does the Safety Management System (SMS) have procedures to address the host's key risk or hazard exposures?

  • Guide: The host may have a list of documents or contents page of a manual, or supporting procedures ie. confined spaces, working at heights, manual handling, electrical, use SMART kit.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.3 Are there any Safe Operating Procedures (SOPs) in place?

  • Guide: SOPs are a 1or 2 pages on how to safely use dangerous plant/equipment ie. angle grinders, jack hammers, hydrojets, commercial dishwashers, ovens & drill press.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.4 Do documents have appropriate document control?

  • Guide: Does the document control include a document name, numbering system, version control and review date?

  • Validation Notes?

  • Photographic Evidence?

  • Level of Compliance?

  • 3.5 Are workers consulted regarding WHS?

  • Guide: Determined by a formal consultation procedure, toolbox meeting/minutes, management meetings/minutes or health and safety committee (HSC)/minutes or health and safety representatives (HSRs).

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.6. Are there formal arrangements in place to resolve WHS issues?

  • Guide: Is there a formal issue resolution procedures

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.7 Does WHS information get communicated to workers?

  • Guide: WHS is communicated by formal communication procedure, news letters, SMS, memos, notice boards, committee minutes.

  • Validation notes?

  • Photographic evidence?

  • Level of Compliance?

  • 3.8 Do workers receive necessary safety training?

  • Guide: business training plans, training register, training records, training certificates , toolbox minutes, GTO for apprentices.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.9 Is there an induction process?

  • Guide: Does the host have the following induction procedure, induction checklist, site inductions, workers files or informal walkthru's/discussion.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.10 Are hazards and risks controlled?

  • Guide: The host uses the following to control risks/hazard eg. hazard management procedure, hazard reports, corrective action register, worksite inspections, contractor management documentation and site audits/visit.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.11 Are there first aid arrangements in place?

  • Guide: Host has first aid procedure, trained first aiders, first aid kits ( in vehicle, office,workshop), first aid kits regularly stocked

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 3.12 Are potential emergencies identified and planned for?

  • Guide: Emergency procedure, Emergency scenarios are risk assessed. Emergency plan, Evacuation plan, Emergency test results, Permit to work or in SWMS/JSA

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

4.0 Measuring Performance:

  • 4.1 Is all testing and tagging of flexible cords, Fixed Residual Current Devices (RCDs) (safety switches in switchboards), portable ( RCDs) up to date?

  • Guide: How is this demonstrated eg. test & tagging, registers or certificates of compliance provided.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 4.2 Are accidents and incidents investigated?

  • Guide: Accidents are investigated by a documented investigation procedure & forms, completed forms or evidence of statutory reporting (notification of incidents)

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 4.3 Are environmental or health monitoring requirements needed a for workers?

  • Guide: Do they do Hep A or B vaccinations, Medical assessments with asbestos exposure, audiometric testing for workers exposed to high noise levels or workplace/site inspections.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

  • 4.4 Is there a formal process in place to manage WorkCover claims and return to work?

  • Guide: Where applicable Workcover claims are discussed and monitored. The following is required: A Process in place to inform workers of their rights, roles, responsibilities and claims forms etc. Hosts with more than 30 workers must have a Return To Work (RTW) Co-ordinator.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

5.0 Review performance:

  • 5.1. How does the host review it's performance and overall safety management system?

  • Guide: Performance is reviewed by formal management meeting & minutes, review of targets and objectives, development of action plans for the next 12 months.

  • Validation notes?

  • Photographic evidence?

  • Level of compliance?

Office use only:

  • Date of audit?

  • Host signature

  • Assessor signature

  • Version: safety cloud/ iauditor V5.4
    Created: May 2014 - Modified: August 05 - Review: August 2015

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.