Templates
Workplace HS Inspection Template

Workplace HS Inspection Template

Use this workplace health and safety (HS) inspection template to conduct general inspections of your workplace, to conduct systematic samplings of different dangerous activities.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
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or Download template as PDF
Workplace HS Inspection Template

Use this workplace health and safety (HS) inspection template to conduct general inspections of your workplace, to conduct systematic samplings of different dangerous activities.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

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.

Related categories

Preview of the 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:
Action: Assign to: Closeout date:
Action: Assign to: Closeout date:
Action: Assign to: Closeout date:
Inspector Name:
Select date
EPCM Rep Name:
Select date
Contractor Rep Name:
Select date
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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.