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Use this template during a meeting about a site inspections. It helps to ensure the safety of your workers from the four deadly dangers. This template addresses the causes of falls, electric shock, impact and trapping of objects. The checklist includes helpful tips on how to prevent such incidents. Managers or any other responsible person can also use this template during a safety briefing to make recommendations to improve worker safety.
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Caught-in-between injuries: A person is squeezed, caught, crushed or compressed between multiple items.
Don't wear loose clothing.
Never overload any kind of equipment.
Always wear seatbelts when operating with machinery.
Turn off equipment whenever it is not in use and use LOTO when maintaining machines.
Do the trenching correctly.
Falls are the number one cause of fatal accidents in construction.
All workers wear safety gears when operating at heights
Use a proper type of structures
The ladders are used correctly
All employees use fall protection gear
Struck by object
A Struck is created by forcible contact/influence between a person and an object or a piece of equipment.
Mind rolling, falling or flying objects
Use catch platforms for tools.
Examine power tools for guards.
All workers wear appropriate Personal Protective Equiment
Electrocution are very dangerous and mostly caused by electic shocks or current passing through the body
No incorrect installed extension cord
Workers avoid contact with energised tools, live power lines or other sources
Tools are inspected regularly.
Electrical equipment is regularly reviewed
Regular site inspections.
Follow up questions
Did something dangerous happen during the shift?
Do you have any questions or comments about Fatal Four Hazards that need to be clarified?
Write down any recommendations/comments:
Full name and signature of a qualified Person:
I, the undersigned, confirm that I completely understood the above explained information.
Full name and signature of employee.
Please note that this checklist template is a hypothetical example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
Please, finish the registration to access the content of the checklist.