HSSEQ Form Revision

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Facility HSE Audit & Inspection Checklist

FACILITY NAME/ LOCATION RECORD NO:

OBSERVER NAME: HSSEQ MANAGER: OBSERVATION DATE: OBSERVATION TIME:

DESCRIPTION OF FACILITY

DESCRIPTION OF PRIMARY HAZARD(S) AT SITE

POSITIVE OBSERVATIONS (SUMMARY)

OPPORTUNITIES FOR IMPROVEMENT (SUMMARY)

SUMMARY

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A GENERAL YES NO N/A COMMENTS

The HSE Plan and procedures are

A01
available

Location specific risk assessment

A02
displayed

Training Requirements Identified/

A03
Applied

A04 “No Smoking” policy being maintained

Names of Safety Contacts, Fire

A05 Warden, and First Aider are clearly
posted

Is there an HSE notice board or similar

A06
facility available and highly visible?

Is HSSEQ Policy and others as

A07
appropriate posted and visible?

Yellow/black’, floor markings denotes

A08 the safe walkways/ areas for personnel
not required to wear full PPE

First Aid station is clearly marked and

A09
kit is complete with items in date

If stairs are present, no items are

A10 stored under/adjacent to stairs or on
stairwell landings

Emergency exit lights, if present, are

A11
fully illuminated and working. /

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A CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

A CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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B HYGIENE & WELFARE YES NO N/A COMMENTS

Toilet facilities are clean and in good

B01
condition

Washing facilities are clean and in good

B02
condition with soap and towels

B03 Non Potable water is clearly marked

B04 Waste bins are not overflowing

Eating area and facilities are clean and

B05
suitable for the facility

B06 Adequate drinking water is available

Temperature is suitable for the work to

B07 be completed (AC working in summer/
heating in winter and good ventilation)

B CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

B CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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C OFFICE/ ADMIN SPACE YES NO N/A COMMENTS

Good housekeeping is being

maintained, and all areas, are free
C01 from debris, such that no situation
exists that could create a fire, accident
or egress hazard

All aisles and exits are free from debris

C02 (there are no tripping hazards such as
worn carpet, chipped flooring etc.)

Electrical switches, outlets and plugs

C03 are intact, in good condition and
outlets are not overloaded

The use of extension cords is limited

such that they are not used in place of
C04
fixed wiring, and are not ‘Daisy
chained’,

Electrical cords are in good condition,

C05 not frayed or damaged, and do not
present a trip or electrical hazard.

No unauthorised personal electrical

appliances are being used in the work
C06
area (e.g.: coffee maker, popcorn
popper, etc.).

Cabinets, file cabinets, bookshelves,

and other heavy objects are secure
C07 with no tipping hazard, filing cabinet
drawers are closed immediately after
use.

Large, heavy objects are stored below

C08
shoulder level (not on cabinet tops)

Waste is being stored in proper

C09
containers, which are not overloaded.

Appropriate DSE arrangements are

C10
applied for each work position

C CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

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PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

C CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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D WAREHOUSE/ STORAGE YES NO N/A COMMENTS

Good housekeeping is being

maintained, and all areas, are free from
D01 debris, such that no situation exists that
could create a fire, accident or egress
hazard

All heavy equipment, tools, fixtures and

D02 materials are in their designated
location for storage when not in use.

Are Storage racks marked with the

D03
maximum loading weight per shelf unit

D04 Are all pallets in good condition

Items are safely stored and unlikely to

D05
fall

Large, heavy objects (that can be

D06 manually handled) are stored below
shoulder level

Shelving/ racking is secure and has

D07
guards to prevent items falling

All aisles and exits are free from debris

D08 (there are no tripping hazards such as
worn carpet, chipped flooring etc.)

A “DO NOT USE” warning sign is in

place on all non-operational equipment
D09
and machinery. In addition, lockout/tag
out is employed as applicable.

Is equipment clearly marked with its

D10 weight to assist in manual handling
assessment

Quarantine area is clearly marked and

D11
quarantined items identified

Equipment is marked with noise

D12
information

D13 Safe manual handling is in evidence

Are hearing protection signs posted

D14
where appropriate.

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D15 No PPE zones are clearly marked.

Appropriate signs are posted in all areas

D16
where PPE is required to be worn

Steps non-skid and free of slipping

D17
hazards?

All confined spaces are clearly marked

D18
and secured

Forklifts are fitted with visual and/or

D19
audible alarms

D20 Forklifts are in good condition

The rated lifting capacity of the forklift is

D21
clearly marked

Lifting gear is in date and clearly

D22
marked.

Fixed and portable Ladders are in good

D23
condition

Suitable facilities for lifting and retrieving

D24
items stored at height

Handrails are fitted where fall from a

D25
height of 1.5m or greater exists

Handrails if fitted are secure and free of

D26
defects

Toe guards are fitted at all open edges

D27
to prevent accidental falling.

Weekly, monthly inspections are

D28
completed

Waste is stored in suitable and

D29
compatible UN approved containers

D30 Waste containers are in good condition

Waste labels and markings are clearly

D31
visible

Waste are segregated according to

D32
regulatory requirements

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Spill collection systems are available for

D33
liquid waste

Necessary space for inspection and

D34
movement of loads is available

D CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

D CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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E WORKSHOP YES NO N/A COMMENTS

Are individuals undertaking work

E01
suitably trained and qualified

A “DO NOT USE” warning sign is in

place on all non-operational equipment
E02 and machinery. In addition,
lockout/tag out is employed as
applicable.

Protective goggles or face shields are

provided and worn where there is any
E03
danger of flying particles, splash, or
corrosive materials.

All equipment, tools, fixtures and

E04 materials in their designated location
for storage when not in use.

Sharps used (such as knives, razor

blades, box cutters, etc.) are
E05 appropriate for the task, not left laying
around and disposed into sharps
keepers when discarded.

All tools and equipment that are used

E06
by employees are in good condition

Rotating or moving parts of equipment

E07 are guarded to prevent physical
contact

Appropriate signs are posted at

E08
grinding wheels etc.

All machinery and equipment are kept

E10
clean and properly maintained.

All cord-connected, electrically-

operated tools and equipment are
E11
effectively grounded or of the approved
double insulated type

Start and stop controls are easily

E12
accessible

E13 Sufficient clearance is provided around

and between machines to allow for
safe operation, set-up and servicing,

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material handling, and waste removal.

Have noise level assessments been

E14 completed and are the results
available to all employees

Hot work area is suitably segregated

E15
from other working areas

Are hoists, cranes etc. clearly marked

E16
with their safe working loads

Is all lifting equipment in good

E17
condition with valid certification

E18 Are all ladders in good condition

Are hearing protection signs posted

E19
where appropriate.

Is equipment in original state with no

signs of modifications to the equipment
E20
that could affect its mechanical
integrity or its lifting capabilities?

Fire extinguishers (of the correct class)

are readily accessible in areas where
E21
torch soldering and brazing are
conducted

Hoses and gauges are in good

E22
condition and free of oil and grease.

All welding operations are provided

E23 with shielding curtains to protect those
within the immediate area.

E CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

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E CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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F COSHH YES NO N/A COMMENTS

F01 Is a COSHH inventory available

COSHH Assessments have been

F02
completed and results posted

Controls in COSHH Assessment are

F03
implemented

SDS are available for every hazardous

F04
substance at the site

F05 All substances are properly labelled

Name of COSHH assessor is clearly

F06
posted

Flammables are stored in an approved

F07
and labelled flammable storage cabinet

Secondary containment is provided for

all hazardous materials (i.e.: motor oil,
F08
hydraulic fluid, etc.) and the area is kept
clean and free of spilled materials

Is workplace atmospheric monitoring in

F09
place

Hoses, pipes and connections used in

torch soldering and brazing operations
F10
are in good condition and are not
burned, dented, or cracked.

Combustible materials are stored a

F11 minimum of 10 meters from torch
soldering and brazing operations.

The valve protection caps are in place

F12 on all gas cylinders that are not either
connected or currently in use.

Gas cylinders are properly secured in an

F13
upright position except in welding carts.

Gas cylinders are properly stored and

secured. Oxygen is stored at least 6m
F14
away from flammable gases or
materials.

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There is no evidence of
F15 Oil/diesel/chemical leaks? If so describe
where.

Eyewash station(s) are clearly marked

F16 and all items in date and in good
condition

Eye wash stations, within the work area

F17 are flushed regularly and record tag is
up to date.

Quick drench shower units are flushed

F18
regularly and record tag is up to date

Have employees been trained on

F19
chemical hazards?

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F CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

F CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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G WASTE AND ENVIRONMENT YES NO N/A COMMENTS

Waste is being stored in proper

G01
containers, which are not overloaded.

G02 Correct waste labels visible on bins

G03 Is waste properly segregated

Are external waste bins fitted with lids to

G04
protect from wind, rain and vermin

Is waste disposed of in accordance with

G05
local regulations

Is waste minimization and recycling

G06
being undertaken

Have noise level assessments been

G07
completed

Are all rain water run offs free from

G08
debris and clean

Are all rain run offs free from evidences

G09
of pollution

G CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

G CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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H ACTIVITIES ON SITE YES NO N/A COMMENTS

JHA/ Toolbox Talk completed,

H01 documented, signed by all workers and
posted in a visible position?

Are all required permits in place for the

H02
work being undertaken

H03 Are valid permits clearly posted

H04 Are all permit conditions being met

Has a task specific risk assessment

H05 been completed and reviewed by all
workers

Is an emergency response plan

H06
available

Are the necessary warning signs

H07 posted and is the work area properly
protected

H08 Is ventilation adequate

Is ingress and egress to the workspace

H09
suitable

Have Lockout-Tagout/ Isolations been

H10
checked and verified

Are there adequate numbers of trained

H11 personnel involved in the lifting
operation

Is all lifting equipment in good

H12
condition with valid certification

Are the monitors in use the correct

H13
type for the task being undertaken

H14 Is the PPE supplied adequate

Is the supplied PPE used by the

H15
workers

Is a dedicated decontamination area

H16
for personnel present on site

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H CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

H CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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I FIRE SAFETY YES NO N/A COMMENTS

Good housekeeping is being

maintained, and all areas, are free from
I01 debris, such that no situation exists that
could create a fire, accident or egress
hazard

Fire extinguishers are clearly marked

I02
and free from obstructions.

Fire extinguishers are in good condition

I03
and within inspection date.

Fire extinguishers are mounted between

I04 60 cm and 150 cm from the floor (except
wheeled).

All equipment and materials have at 50

I05
cm clearance from fire extinguishers.

Fire extinguishers (of the correct class)

I06 are readily accessible in areas where
hot works are conducted

I07 Is emergency lighting clearly marked?

Is the emergency lighting tested on a

I08
regular basis

Emergency exit lights, if present, are

I09
fully illuminated and working.

Is the fire alarm tested on a regular

I10
basis

Fire suppression systems if fitted are in

I11
good condition and inspected regularly

Fire hose reels (if applicable) are

I12
checked and record tag completed.

All Fire and Smoke doors close

I13
effectively

Procedures to raise fire alarm and

I14
evacuate are clearly displayed

Are fire wardens suitably trained and

I15
identified

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I CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

I CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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J ELECTRICAL SAFETY YES NO N/A COMMENTS

J01 High voltage signs in place

J02 Warning signs are posted

Electrical boxes are secure and clearly

J03 marked. If appropriate enclosures are
secured

J04 RCD are fitted where necessary

Is there clear access to electrical

J05
cabinets

All light fittings are intact (incl. bulb

covers and lens) and are appropriate for
J06
the location, there are no missing,
broken or burned out bulbs/tubes

Electrical switches, outlets and plugs are

J07 intact, in good condition and outlets are
not overloaded

Have all electrical items and plugs been

J08
tested and passed as safe

The use of extension cords is limited

J09 such that they are not used in place of
fixed wiring, and are not ‘Daisy chained’,

Electrical cords are in good condition,

J10 not frayed or damaged, and do not
present a trip or electrical hazard.

No personal electrical appliances are

J11 being used in the work area (e.g.: coffee
maker, popcorn popper, etc.).

Has electrical equipment with plugs

J12
been PAT tested?

Battery charging area is clearly marked

J13
and segregated.

PPE and eyewash is readily available in

J14
battery charging area

Transformers/ Generators are protected

J15
from vehicle impact.

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Generators noise levels are less than

J16
90dBA in working areas?

All employees who work on or around

electrically energized equipment or lines
J17
are instructed in CPR methods and
dealing with an electric shock

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J CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

J CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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K SPILL PREVENTION & RESPONSE YES NO N/A COMMENTS

Are liquid substances stored in drip

K01
trays or sealed bunds

Is there site free of the signs of leaks or

K02 pools of a substance that has not be
cleared up promptly

Is there a spill response plan available

K03
on site

K04 Spill kits are available and marked

Unbounded liquids not stored by drains

K05
or open ground.

K CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

K CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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L SPECIALIST EQUIPMENT YES NO N/A COMMENTS

Gas monitors are calibrated and fully

L01
charged.

Is calibration gas available for bump

L02
testing

L03 Chemical detector tubes are in date?

Is fall protection available for working at

L04
heights and in good condition?

L05 Are HAZMAT suits in good condition

Are HAZMAT suits tested and a log

L06
book kept of usage and decontamination

Are SCBA sets properly stored and with

L07
valid test/ inspection records

L08 Are fit test records available

L09 Are SCBA sets in good condition

If air is used to fill SCBA, is according to

L10
the required standard.

If an SCBA compressor is fitted is the

L11 intake clear of exhausts and air quality
test records available

L12 Is APR in good condition?

L13 APR cartridges or filters are in date?

Are APR cartridges or filters suitable for

L14 all types of contaminants present on
site?

Safety helmets in good condition and

L15 changed in accordance with
recommendations.

Is a list kept with all expired /

L16
recalibrated items?

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L CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

L CORRECTIVE/ PREVENTIVE ACTIONS– Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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M OUSTSIDE AREA YES NO N/A COMMENTS

Is the perimeter/ security protection

M01
intact (if fitted)?

M02 Is security acceptable?

Is the muster point clearly marked and

M03
in a safe position?

M04 Is night lighting adequate?

M05 Are suitable warning signs posted?

Is equipment properly stored and

M06
secured?

Where smoking is permitted is a

M07 suitable shaded area with seating
available?

Where smoking is permitted are there

M08 enough non-combustible receptacles
for cigarette ends?

All vehicles on site in good condition

M09
with working lights etc.?

Is vehicle parking clearly marked and

M10
segregated?

M11 Vehicles are reverse parked?

All confined spaces are clearly marked

M12
and secured?

Are areas in and around the buildings

M13 kept free from accumulated packaging
materials and pallets?

Vulnerable items are protected from

M14
vehicle impact

M15 Structures are in a sound condition

M CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

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PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

M CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

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N HSSEQ MANAGER/ SAFETY REPS YES NO N/A COMMENTS

Safety Office/ Representative

N01
appointed? Aware of duties?

Do employees know who their Safety

N02
Manager/ Officer or Representative is?

N CORRECTIVE/ PREVENTIVE ACTIONS TAKEN – Closed Out On Site

PERSON
ITEM# ITEM COMMENTS
RESPONSIBLE

N CORRECTIVE/ PREVENTIVE ACTIONS – Not Closed Out On Site

PERSON TARGET
ITEM# ITEM COMMENTS
RESPONSIBLE DATE

CLOSING MEETING (with Site Manager/ Supervisor etc.) –Compulsory Before leaving site

Date: Time: Comments:

Manager/ Supervisor: Contact Details: Signature:

ObserverManager/ Supervisor: Contact Details: Signature:

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