Worksite Safety Audit

• Job Site/Unit/Name/Foreman

• Conducted on

  Date

• Prepared by

General Work Environment

• Permit and JSA at work site and easy accessible for inspection?

  Yes

  No

  N/A

• Permit filled out and signed by ALL EMPLOYEES at work site?

  Yes

  No

  N/A

• JSA filled out and signed by ALL EMPLOYEES at work site?

  Yes

  No

  N/A

• Are all work areas clean?

  Yes

  No

  N/A

• Are aisles, walkways, doorways, and exit routes kept clear and unobstructed?

  Yes

  No

  N/A

• Is material piled, stacked, or racked in a manner to prevent it from tipping, falling, collapsing, rolling, or spreading?

  Yes

  No

  N/A

First Aid and Emergency Equipment

• Is there at least one person on site trained in first aid and CPR?

  Yes

  No

  N/A

• Are first aid kits easily accessible?

  Yes

  No

  N/A

Fire Protection and Prevention

• Are fire extinguishers clearly visible and unobstructed at all times?

  Yes

  No

  N/A

• Are fire extinguishers inspected monthly for proper tags, pins, hoses not cracked or plugged, fully charged, and tags up to date?

  Yes

  No

  N/A

Fall Protection

• Are holes and other floor openings guarded by a grate, cover, guardrail, or equivalent on all sides (except at entrances to stairways or ladders)?

  Yes

  No

  N/A

• Are fall protection harnesses and lanyards used by every employee working 4 feet or higher?

  Yes

  No

  N/A

• Where a job site has protruding steel rebar or other protrusions below the work level, are they protected by covers to prevent impalement injuries?

  Yes

  No

  N/A

Portable Ladders

• Are ladders being used for their designed purpose only? (Step ladders/Extension ladders)

  Yes

  No

  N/A

• Do they have the appropriate labels?

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

Personal Protective Equipment

• Is the appropriate PPE worn by employees?

  Yes

  No

  N/A

Materials - Handling, Storage, Use, and Disposal

• Chemicals being stored and labeled correctly?

  Yes

  No

  N/A

Scaffolding

• Was the scaffold inspected prior to use and scaffold tag properly filled out?

  Yes

  No

  N/A

• Are scaffolds in good working condition with no damage or missing parts?

  Yes

  No

  N/A

• Have toeboards been installed to prevent falling objects?

  Yes

  No

  N/A

Electrical

• Are all cord-connected, electrically-operated tools and equipment double insulated or effectively grounded?

  Yes

  No

  N/A

• Are ground-fault circuit interrupters provided on all temporary electrical circuits?

  Yes

  No

  N/A

• Are all electrical rooms/panels secured and have proper signage?

  Yes

  No

  N/A

• Are all electrical cords inspected, protected from damage and in good working condition (i.e. no splices, frays, or the ground prong is removed)?

  Yes

  No

  N/A

• LOTO in place?

  Yes

  No

  N/A

Power-Actuated Tools / Hand and Power Tools

• Are employees who operate power actuated tools properly trained and carry a valid operator's card?

  Yes

  No

  N/A

• Are grinders, saws, and other tools with moving parts, equipped with appropriate safety guards to prevent physical contact with moving parts?

  Yes

  No

  N/A

Traffic Control

• Have flaggers been properly trained and carry their flagger certification card?

  Yes

  No

  N/A

Equipment Operator

• Has operator been trained?

  Yes

  No

  N/A

• Has equipment been inspected?

  Yes

  No

  N/A

• Has JSA been filled out for the use of equipment?

  Yes

  No

  N/A