Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Cover all findings and assigned actions with the person in charge prior to leaving the site. Forward this checklist to Safety Manager daily. Perform this checklist on every site visited.
BASIC MACHINE MAINTENANCE
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50% of all equipment and/or vehicles on site inspected? List equipment inspected. Basic Machine Maintenance etc.
PAPERWORK
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Inspected all paperwork on the equipment and/or vehicles checked in question 1? Forward in abnormal findings to Safety Manager by COB.
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Pre And Post Trip?
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Permits?
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Registration/cab card?
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Insurance?
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Inspection tags, inspection card?
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Driving JSA and trip report?
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Three Ring binder for all mandated items? Traffic control scenarios, laminated Matt weight chart, log exemption form etc.?
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Inspect all JSA's on site. Assure personnel are following outlined work steps and associated hazard mitigations. Note at least 2 observations.
COACHING OPPORTUNITIES AND/OR BRIEFINGS
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Attended and actively participated in tailboard or debriefing session? Note any Near Miss Lessons Learned here and assure they are turned in.
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Talked to at least two employees' and identified any issue with being fit for duty? Examples: Quiz them on what shifts they have worked, when their last day off was etc..Note at least one observation here.
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Coached at least 2 employees on a topic applicable to the operation and related to the weekly safety report? Record what is discussed and with whom.
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Asked all employees spoken with if they were aware of any injuries, equipment damage or issues with safety leadership? Note at least one observation here
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Visited with the PM or person in charge to discuss any findings and/or issues they may have? Note accordingly.
PPE
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Inspected all personnel Power Safe Cards and company assigned cards? Assure they are on person. (Heat stress card, spotter card, NM/LL book etc.)
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Inspected 100% use of all needed PPE? <br>Note a minimum of two observations here.
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Glove clips in place?
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Radio holster in place?
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Hard Hat
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Proper Footwear
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Gloves
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Hearing Protection
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Safety Glasses
SITE SAFETY
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Walked through and/or drove site to identify any issues with traffic control? Note at least one observation here.
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Observed and noted any ergonomic hazards? Note at least one observation here.
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Observed and noted any issues with 3 points of contact or fall protection? Perform 360 walk around 50% of site equipment to identify any needed hand/foot hold needs.
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Observed and inspected proper equipment set up and evaluated risks? Note a minimum of one observation here.
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Performed 360 degree walk down of site to identify issues with such items as housekeeping, slip trip fall hazards, flagging etc.? Note at least one observation here.
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Visited with any clients on site? Discussed and noted any issues we might be of assistance with?
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Inspected any hazards associated with OSHA’s focus four: Caught between hazards, fall hazards, electrical hazards and struck by hazards. Assure they are captured on JSA. Note at least one observation here.
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Observed and noted 100% of all spotter operations? Radio use, position etc. Note all here.
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Inspected 100% of all lifting and rigging operations/equipment? Note at least one observation here.
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100% inspection on the use of barricades and flagging? 10’ rule etc. Note at least one observation here.
PRODUCTION
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Observed any deficiencies with site production? Report to PM or person in charge prior to leaving the site. Record at least one observation here.
DRIVING
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Observed and noted all deficiencies with safe driving? Note at least one observation here. Check at least one cell phone against sage quest each week. Note findings here.
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Coached at least one employee on proper driving techniques. Note item coached here.
SUMMARY
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Add any additional Pictures here. Describe what the focus is.
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Inspectors signature here
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Person in charge of site sign here
