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