HEALTH AND SAFETY SELF AUDIT CHECKLIST

General
No Question Yes No Reference/Note
1. Has your business registered with BDBC on form OR1! "ara 1
#. $re you dis%&aying a Hea&th and afety "oster with the a%%ro%riate
information !
"ara #
'. Do you ha(e )* mi&&ion of em%&oyers &iabi&ity insurance! "ara '
Safety Policy
+. Do you em%&oy * or more %eo%&e! ,f no go to Q 1-
.. Ha(e you %re%ared a written statement of your hea&th and safety
%o&icy!
"ara *
Does your %o&icy /
0a1 state your genera& %o&icy on hea&th and safety!
0b1 describe the organisation for carrying out your %o&icy!
0c1 describe the arrangements for carrying out your %o&icy!
2. Do your staff 3now about the %o&icy and understand it!
4. ,s the %o&icy re(iewed regu&ar&y and if circumstances changed
Accidents
1-. Do you ha(e an accident boo3! "ara .
11. $re a&& incidents recorded!
1#. $re you aware of your duties under the Re%orting of ,n5uries6
Diseases and Dangerous Occurrences Regu&ations 144*! 0R,DDOR1
1'. Do you ma3e a&& staff aware of the need to re%ort wor37re&ated
in5uries6 dangerous occurrences or cases of disease!
1+. Do you 3now who to re%ort in5uries6 dangerous occurrences and
cases of disease to!
1*. Do you ha(e a su%%&y of forms 08#*-21 for re%orting accidents!
1.. $re you aware of the ty%es of accidents/in5uries6 dangerous
occurrences and cases of diseases which are re%ortab&e!
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3.
1
First Aid
No Question Yes No Reference/Note
19. Ha(e you %ro(ided ade:uate and a%%ro%riate first aid e:ui%ment and
faci&ities!
"ara 2
12. Do you ha(e an ade:uate and a%%ro%riate number of first aid
%ersonne&!
a1 :ua&ified first aiders
b1 a%%ointed %erson
14. Ha(e a&& em%&oyees been informed of first aid arrangements!
#-. Ha(e you assessed the first aid needs of your wor3%&ace!
#1. $re first aiders; :ua&ifications (a&id and in date!
Ris Assess!ent
##. Ha(e you identified a&& re&e(ant ha<ards %resented by your wor3
acti(ities!
"ara 4
#'. Ha(e you assessed the ris3s arising from the identified ha<ards!
#+. Ha(e you recorded the significant findings of your assessment!
#*. $re your ris3 assessments re(ised and amended when %rocedures
change!
#.. Ha(e you contro& measures in %&ace to dea& with the ris3s!
Dis"lay Screen E#$i"!ent
#9. Ha(e you identified =users; of D> in your business and the
wor3stations they use!
"ara 11
#2. Ha(e you trained both users and assessors!
#4. Ha(e you assessed wor3stations and reduced any identified ris3s!
'-. Do you %&an for brea3s/change of acti(ity for users!
'1. Do you %ro(ide eye and eyesight testing and necessary correcti(e
a%%&iances for users!
%an$al Handlin&
'#. $re manua& hand&ing o%erations carried out by your business! "ara 1#
''. ,s there a ris3 of in5ury from manua& hand&ing o%erations!
''. Can these o%erations be a(oided!
'+. Can these o%erations be automated or mechanised!
'*. Ha(e you carried out a manua& hand&ing assessment if some ris3 of
in5ury remains!
'.. Ha(e you determined what measures are needed to reduce the ris3 of
in5ury to the &owest &e(e& reasonab&y %racticab&e!
'9. Ha(e these measures been im%&emented!
'2. Ha(e you trained a&& em%&oyees affected in manua& hand&ing
techni:ues!
'4. $re the manua& hand&ing assessments re(iewed!
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
#
Personal Protecti'e E#$i"!ent (PPE)
No Question Yes No Reference/Note
+-. ,s %ersona& %rotecti(e e:ui%ment re:uired for wor3 at your %remises! "ara 1'
+1. Can %rocesses or acti(ities be changed to e&iminate the need for "">!
+#. Ha(e you assessed what ""> is re:uired to ensure it is SUITA*LE!
+'. Does the ""> com%&y with an >N standard ie C> mar3!
++. Do you ha(e a system of maintenance and re%&acement for "">!
+*. ,s suitab&e accommodation %ro(ided for "">!
+.. Do you %ro(ide information6 instruction and training on ""> for
em%&oyees!
+9. Do you ta3e ste%s to ensure ""> is used!
+2. Do you ha(e arrangements for re%orting &oss or defect!
+or E#$i"!ent
+4. ,s the wor3 e:ui%ment/7
1. uitab&e ? for %articu&ar tas3s 0the ris3 assessment carried out
under reg '011 of the @anagement Regu&ations wi&& he&% to se&ect
wor3 e:ui%ment and assess its suitabi&ity for %articu&ar tas3s.
#. @aintained ? in efficient state6 in efficient wor3ing order and in
good re%air. ,s the maintenance &og 3e%t u% to date!
'. ,ns%ected ? where the ris3 assessment has identified a significant
ris3 to the o%erator from the insta&&ation of use of the wor3
e:ui%ment ? (isua& chec3s6 functiona& chec3s and testing.
"ara 1+
*-. Do you carry out ins%ections!
*1. Do you arrange for a suitab&e ins%ection to be carried out before the
wor3 e:ui%ment is/7
a1 %ut into ser(ice!

b1 after maintenance and re%air!
*#. ,s ade:uate hea&th and safety information and written instructions
gi(en to those who use the wor3 e:ui%ment!
*'. Ha(e a&& %ersons who use wor3 e:ui%ment recei(ed ade:uate training
when using wor3 e:ui%ment and ris3s entai&ed and %recautions to be
ta3en!
*+. Does the wor3 e:ui%ment ha(e/7
a1 sto% contro&s!
b1 emergency sto% contro&s!
c1 contro&s which are c&ear&y mar3ed!
d1 $ means to iso&ate it from a&& sources of energy!
**. ,s the wor3 e:ui%ment stab&e!
*.. ,s the &ighting suitab&e and sufficient!
*9. $re maintenance o%erations carried out when the e:ui%ment is shut
down!
*2. $re any warning signs unambiguous and easi&y understood!
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
'
Liftin& ,"eration - Liftin& E#$i"!ent
No Question Yes No Reference/Note
*4. Do you ha(e any &ifting e:ui%ment!
.-. ,s it thorough&y eAamined by a com%etent %erson at &east . month&y
for %eo%&e &ifting e:ui%ment and annua&&y for other e:ui%ment!
"ara 1*
+or"lace Healt./ Safety and +elfare
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HEALTH
0entilation ? shou&d be ade:uate6 in many cases windows and door
wi&& be sufficient. ,f mechanica& (enti&ation is used it shou&d be
%ro%er&y maintained.
Te!"erat$re ? shou&d be reasonab&e 0norma&&y 1.C1. Bhere this is
not reasonab&e &oca& heating or coo&ing may be used.
Li&.tin& ? shou&d be suitab&e and sufficient for %eo%&e to wor3 and
mo(e about safe&y.
Cleanliness and 1aste !aterials ? 3e%t sufficient&y c&ean. uitab&e
waste storage and remo(a&.
Roo! di!ensions and s"ace ? each %erson shou&d be %ro(ided with
at &east 11m
'
.
+orstations and seatin& ? be ergonomica&&y suitab&e and &i3ed to
the tas3/wor3er. eats shou&d gi(e ade:uate su%%ort for the &ower
bac3 and footrests %ro(ided where necessary.
SAFETY
%aintenance ? of the wor3%&ace6 e:ui%ment6 de(ices and systems in
efficient wor3ing order.
Floors and traffic ro$tes ? these inc&ude routes for %edestrians and
(ehic&es. urfaces shou&d not ha(e ho&es6 be une(en or s&i%%ery and
3e%t free of obstructions.
Gla2in& ? trans%arent/trans&ucent surfaces in doors6 gates and wa&&s to
be either safety materia& or %rotected against brea3age where
necessary for reasons of hea&th and safety.
+indo1s and 1indo1 cleanin& ? shou&d be ca%ab&e of being o%ened
safe&y. hou&d be %ro(ision for safe c&eaning if this cannot be carried
out at ground &e(e&.
Doors and &ates ? shou&d be suitab&y constructed and fitted with
safety de(ices if necessary!
Escalators ? function safe&y. Ha(e any unnecessary safety de(ices
and readi&y accessib&e emergency sto% contro&s.
"ara 1.
"ara 1.
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
+
No
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9+.
9*.
9..
99.
Question
+ELFARE
Sanitary con'eniences and 1as.in& facilities ? at readi&y accessib&e
%&aces6 to be 3e%t c&ean6 ade:uate&y (enti&ated and &it. Bashing
faci&ities must ha(e hot and co&d water6 soa% and a means of hand
drying. Che number of faci&ities to be %ro(ided is &aid out in the Code
of "ractice.
Drinin& +ater ? ade:uate6 who&esome6 readi&y accessib&e6
cons%icuous&y mar3ed where necessary. $&so sufficient drin3ing
(esse&s.
Acco!!odation for clot.in& ? ade:uate6 suitab&e and secure.
C.an&in& facilities 3 for s%ecia& wor3 c&othing and readi&y accessib&e
from wor3rooms.
Facilities for rest and eatin& !eals ? suitab&e6 sufficient and readi&y
accessib&e. uitab&e faci&ities to eat mea&s where mea&s are regu&ar&y
eaten in the wor3%&ace. Rest area shou&d %rotect non7smo3ers from
discomfort caused by tobacco smo3e.
Yes No Reference/Note
"ara 1.
Electricity at +or
92. Has the e&ectrica& insta&&ation of the bui&ding been chec3ed in the &ast
* years!
"ara 19
94. Do you ha(e a certificate issued by a com%etent %erson to show the
insta&&ation is safe!
2-. Do you ha(e a register of %ortab&e e&ectrica& e:ui%ment!
21. Do you carry out maintenance of %ortab&e e&ectrica& e:ui%ment!
a1 (isua& chec3s!
b1 combined ins%ection and test!
Control of S$4stances Ha2ardo$s to Healt.
2#. Do you ha(e a &ist of substances used in the wor3%&ace! "ara 12
2'. Ha(e you identified any substances ha<ardous to hea&th!
2+. Ha(e you e(a&uated the ris3s to hea&th re/7
- &e(e& of eA%osure!
- Duration of eA%osure!
- 8re:uency of eA%osure!
2*. Ha(e you decided on/7
- %re(ention or contro& of eA%osure!
- maintaining contro& measures!
- using contro& measures!
- any monitoring/sur(ei&&ance!
- information/instruction/training!
2.. ,s the assessment recorded!
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
*
29. ,s the assessment re(ised and amended as necessary!
Le&ionnellosis5Coolin& To1ers
No Question Yes No Reference/Note
22. Ha(e you a wet coo&ing tower or e(a%orati(e condenser! "ara 14
24. ,f yes6 ha(e you registered with BCBC!
4-. Ha(e any other sources of Degione&&a been identified and assessed by
a com%etent %erson!
41. Has a scheme for the %re(ention or contro& of Degione&&a been
%re%ared and im%&emented!
4#. Do you ha(e a system in %&ace for the disinfection and maintenance of
the system!
4'. $re records or water treatment %rogrammes 3e%t!
4+. Do you ha(e a com%etent %erson a%%ointed to manage the system and
ensure it o%erates safe&y!
Noise
4*. Do you thin3 you may ha(e a noise %rob&em! 0,f you ha(e to raise
your (oice when standing neAt to someone this &e(e& is about
2*dB0$1 therefore %ossib&e %rob&em.
"ara #-
4.. Ha(e you had the noise eA%osure assessed by a com%etent %erson!
49. Has the noise &e(e& been reduced as far as reasonab&y %racticab&e!
42. If yo$r noise e6"os$re is a4o'e t.e action le'el78
a1 Ha(e a&& em%&oyees been informed of the ris3s!
b1 Ha(e you %ro(ided6 maintained and ensured use of ear
%rotectors!
c1 @ar3ed ear %rotection <ones 0as necessary1!
d1 >nsured ear %rotection is free&y a(ai&ab&e!
Press$re Syste!s
44. Does the %&ant contain a re&e(ant f&uid at a %ressure greater than
-.*bar abo(e atmos%here!
"ara #1
1--. ,s there a %ressure (esse& in the system!
1-1. ,s the %&ant used by em%&oyees!
1-#. ,s the system %ro%er&y maintained!
1-'. $re records 3e%t of eAamination and manufacturers test!
1-+. Has a com%etent %erson drawn u% a scheme of eAamination!
1-*. Has a com%etent %erson in accordance with the written scheme
carried out eAaminations!
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
.
For Lift Tr$cs
No Question Yes No Reference/Note
1-.. $re for3 &ift truc3s eAamined/7
Dai&y
Bee3&y
@onth&y
"ara #*
1-9. $re the eAaminations/7
Eisua&
@echanica&
1-2. $re eAaminations recorded!
1-4. $re the truc3s eAamined by a com%etent %erson!
11-. Ha(e they issued a certificate!
111. Ha(e a&& dri(ers recei(ed/7
Basic training
On the 5ob training
Refresher training 0as necessary1
11#. $re a&& dri(ers authorised!
11'. $re they authorised by a com%etent %erson or com%etent com%any!
11+. $re the dri(ers authorised for each truc3 ty%e used!
11*. Do dri(ers recei(e a fitness test!
11.. Do you segregate %edestrians and for3 &ift truc3s!
119. Do you ha(e a se%arate charging area 0if a%%&icab&e1
112. $re the truc3 &anes and %edestrian routes c&ear&y mar3ed!
114. Do you ha(e an effecti(e (ehic&e management system!
1#-. Do you ha(e corner guards for any rac3ing!
Fire Safety
1#1. Ha(e you identified the fire ha<ards in your business/7
a1 ,gnition sources eg smo3ing6 e&ectrica& e:ui%ment!
b1 8ue& ha<ards eg high&y f&ammab&e &i:uids/chemica&s!
"ara #'
1##. Ha(e you identified those %eo%&e who may be in(o&(ed ie office staff6
members of the %ub&ic6 contractors!
1#'. Ha(e you considered those %eo%&e with %articu&ar needs/7
a1 Disab&ed staff
b1 Eisitors
c1 &one wor3ers
d1 ineA%erienced staff
1#+. ,s the fire ris3 ade:uate&y contro&&ed/7
a1 information and instruction!
b1 $de:uate emergency %rocedures!
1#*. $re the fo&&owing chec3ed/7
a1 @eans of esca%e
b1 fire detection and raising the a&arm
c1 first aid fire fighting e:ui%ment
d1 fire dri&&s %ractised
e1 fire training for a&& staff
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
9
1#.. ,s there any further action necessary to contro& the ris3 of fire!
Gas Safety
No Question Yes No Reference/Note
1#9. Do you ha(e your gas a%%&iances regu&ar&y chec3ed! "ara #+
1#2. Do you ha(e maintenance records and an annua& safety certificate!
1#4. Do you use on&y CORF, registered %ersonne&!
Infor!ation/ Instr$ction and Trainin&
1'-. Ha(e you decided who shou&d be trained!
a1 those in senior %ositions
b1 su%er(isors/managers
c1 em%&oyees
d1 young %eo%&e
e1 trainees
"ara #.
1'1. Ha(e you decided on the &e(e& of training re:uired!
1'#. Ha(e you com%etent %ersonne& to carry out s%ecific tas3s!
1''. Do you ha(e a designated indi(idua& res%onsib&e for ensuring that
training needs in hea&th and safety are assessed and that suitab&e
training ta3es %&ace!
1'+. Do you %ro(ide induction training for new staff!
1'*. Do you ho&d training records for each member of staff!
1'.. $re they regu&ar&y re(iewed and u%dated!
,f you ha(e any further :uestions6 %&ease contact a member of the 8ood and afety Ceam
On -1#*. 2+*+9+.
8i&e reference/ cuss(/foodsafety/3ee%/a%cGhea&th and safety se&f audit chec3&ist.doc
References are to %aragra%h number in the Basingsto3e and Deane Borough Counci& Hea&th
and afety ,nformation "ac3
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