Lumiform / Templates / Workplace HS Inspection Template

Workplace HS Inspection Template

Use this workplace health and safety (HS) inspection template to conduct general audits of your workplace, to conduct systematic samplings of different dangerous activities, processes, or areas, all well incident inspections to be carried out after an accident causing a fatality, injury, or near miss. Report any injuries, deaths, or illnesses to the safety enforcing authority immediately.

Downloaded 4 times

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 4000 expert-proofed templates

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Workplace HS Inspection Template

Audit

Job Start

JHA on the job, in date and completed

CRM - Critical risks and critical controls identified on JHA and in place

Take 5'son the job, in date and completed

Work area demarked and sign posted

Clear access/egress to work area

Supervisor to crew ratio suitable (Span of Control)

Housekeeping

Materials neatly stacked

Work areas unobstructed

Suitable hose management

Correct signage in place and legible

Access ways throughout work area clear

Traffic Management

Segregation of LV and SME

Park up area correctly designed

Traffic management and/or control plans in place, publicized and followed

Speed limits posted correctly

Windrows correct height for traffic

Roadway design to standard for traffic

Lifting

Prestart, pre lift assessment and log book completed

Cranes set up correctly and suitable for task

Barricading in place for lift and slew zones

Loads tied off and/or secure

Pre lift assessment / lift study / calculation sheet in place and followed

Crane operator assessed as competent

Dogman / rigger following procedure

Lifting gear inspected, tagged and certified

Weather and ground conditions assessed

Working at Heights

(FIPS) Suitable mode (restraints/LLF) applied to task. FIPS secure and used correctly

FIPS inspected, tagged and certified

EWP operations following procedure

Spotters trained and in place

Electrical/Isolations

HV access permit

ECO barricading in place during erection and dismantling of scaffold

Drop zone barricading in place

Dropped objects prevention in place

WAH Permit valid for task

Equipment (portable, welders, lighting plant, etc) inspected and tagged

ELCB/RCD used for portable tools

Leads and plugs condition to standard

Suitable lead management (stands/hooks etc)

Isolations in place

Isolation points labelled and lockable

Isolation Permit in place and followed

Mechanical/Guarding

Grinder(s) fit for purpose and used to standard

Safety clips fitted to hoses

Discs used in grinders applicable to task

Guards fitted to machinery/tools

Power tools condition to standard and fitted with Deadman switch

Whip checks and hose couplings fitted on HP hoses

Confined Space

CS Permit in place and followed

Sentry trained and in place at entry point

Excavations and Penetrations

Excavation benched / battered

Barricading and signage to standard

Access / egress to standard

PPE to standard for task

Digging methodology meets Permit conditions

Caps on star pickets and rebar

Excavation and Penetration Permit in placed and followed

PPE

Appropriate PPE available at the worksite

Appropriate PPE in use

Occupational Health

Exposure to noise controlled

Fibrous material controls meets standard

Vibration controls in place for task

Vehicles and Mobile Equipment

Vehicles reverse parked or drive through

Road rules are being followed

Vehicle approved and meets FRCS standard

Vehicle daily pre start checks completed

Flashing lights and headlights on

Spotter used

Radio procedures being followed

Scaffolding

Erected by competent person

Scafftag fitted and current

Access ways clear with gates or drop bars fitted

Platforms not overloaded

Hot Work

Hot Work Permit in place and followed

Hazardous areas identified and controlled

Cutting / welding equipment to standard

Flashback arresters secured at both ends of hose, inspected prior to use and annually

Loading and Unloading

Loading / Unloading assessment checklist used

No over centre binders

Delivery driver inducted to site

Training and Competency

Personnel inducted to site (including visitors)

Night Work

Personnel trained in fatigue management

Works outside 0600 to 1800 hrs approved

Lighting meets lux requirement

Crib Room Health and Safety

CRAW posted in crib room and reflects current scope of works, CRM embeded

Storage of food hygienic with refrigeration, heating equipment function and clean

Potable hot / cold water available

HSE Noticeboards erected and to standard

Buildings are suitably rated and secured for wind region rating

Electrical appliances inspected and tagged

Emergency Rspoense

Fire fighting equipment in place and fit for purpose

Access to fire fighting equipment

First aid facilities in place and fit for purpose

Emergency assembly area(s) clear

Fire breaks in place and adequate

Minimum one person in crew Senior FA trained

Personnel know the ER procedure

Comments

Enter comments

Non Compliance and Recommendations

Action: Assign to: Closeout date:

Inspector Name:

(check name not set)

Select date

EPCM Rep Name:

(check name not set)

Select date

Contractor Rep Name:

(check name not set)

Select date

Previous template

Next template

Please note that this checklist template is a hypothetical appuses-hero 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.