Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Are all employees signing on the debriefing?

  • Does the JSA have the required general information?

  • Are human performance tools being discussed during the JSA/debriefing process?

  • Are crews turning in near miss lessons learned during debriefing and attaching forms to the JSA?

  • Are actions to be taken assigned during debriefings?

  • Did the Safety Lead involve the entire crew when filling out the JSA?

  • Is the PM just reading the questions from the debriefing or is he "mixing it up" to keep crew attention? Opportunity for coaching.

  • Did the crew acknowledge that they understand the JSA job steps, hazards, and mitigation steps prior to signing onto the JSA?

  • Are employees interactive with debriefing?

  • Does the JSA identify all the required PPE to preform the job?

  • Does the JSA identify all the jobs steps?

  • Does then JSA identify all the hazards associated with the job steps?

  • Does the JSA identify all actions to mitigate each hazard listed?

  • Is the JSA filled out neatly?

  • Is the JSA specific to the job being performed?

  • Are all personnel signed on the JSA that are in the safe work permit?

  • Copy of JSA

  • Signature of Auditor

  • Signature of Auditee

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