SITE SAFETY SCORECARD

Project Title: Date/ Time:

Location:

Audit Team:
Performance Rating: 0%
Rating

-all
A)

l
No. ITEM DESCRIPTION Remarks

Score

Actua
Over
(NA,
1 Personal Protective Equipment (PPE's)
1.1 Head Protection 2 2
1.2 Feet Protection 2 2
1.3 Hand Protection 1 1
1.4 Eye Protection 1 1
1.5 Ear Protection 1 1
1.6 Full Body Harness ( Tied-off and in good condition) 3 3
1.7 Respiratory Protection 1 1
1.8 Skin Protection 1 1
1.9 Reflectorized Vest 1 1

2 Scaffold Working Platform/Mobile Scaffold (in conformance w/approved design)

2.1 Compliance with Scaffold Safety Checklist Requirements 3 3

2.2 Maintenance/ Storage 1 1
3 Fall Protection

3.1 Project Manager's approval on Fall Protection Plan 4 4

3.2 Active floor edges has proper railings/barriers (life line) 3 3
Below active floors' edges have railings/barriers (top/ mid
3.3 3 3
rails/ toe boards) with warning signs
Safety Catch / Safety Net and/ or Overhead Protections are
3.4 2 2
provided and properly maintained
Slab openings (pipe chases) with more than a foot size is
3.5 2 2
covered or enclosed.
Lifelines attached to fixed/ rigid points are present at required
3.6 3 3
areas (e.g. active floors)
Butterfly platform access has proper access, proper railing
3.7 2 2
height, and side end railing
Hanging working platforms has proper access, and railings
3.8 2 2
including both ends.
Openings at elevator lobby should have proper railings/
3.9 2 2
barriers
Staircase canopy/ enclosure, installed 2 floors below active
3.10 3 3
floor
4 Electrical Facilities
4.1 Electrical works performed by Certified Electrician 2 2
All extension wires and cables are elevated overhead and
4.2 5 5
located in a safe location.
All extension wires and cables are equiped with rated circuit
4.3 1 1
breaker, fuse links and or GFCI.
All tapping points are enclosed with barriers / railings and
4.4 2 2
with warning sign boards.
4.5 All extension cords for power tools are rated and royal cord. 1 1
All electrical connections should conform to standard
4.6 1 1
electrical procedure
Circuit Breakers are in good condition /weatherproof on
4.7 1 1
exposed area
4.8 Extension cord must be double insulated (royal cord). 1 1

Form No.: F-IMS004 Rev 0 Dec 01 2015 Page 1 of 4

 Rating

-all
A)

l
No. ITEM DESCRIPTION Remarks

Score

Actua
Over
(NA,
All convenience outlets are enclosed in a wooden
4.9 1 1
box/approved enclosure
All activities near high tension wires/cables must be
4.10 protected in accordance with the recommendation of the 1 1
utility provider.

5 Fire Protection and Control

5.1 Proper Type/Location of Fire Extinguishers 1 1

5.2 Adequate quantity of Fire Extinguishers 2 2
5.3 Inspection Tags 1 1
6 Motorized Gondola
Compliance with Gondola/ Hoist Safety Checklist
6.1 5 5
Requirements
6.2 Third Party Inspection 2 2
7 Material and Passenger Personnel Hoist
7a Entry points are properly barricaded, especially when in use 3 3
7b Entry points are fully controlled by the Hoist Operator 2 2
Gaps between the hoist and edge should be between 25mm
7c 3 3
to 100mm (TRA 1100/ EN 12159)
8 Construction Heavy Equipment
8.1 Proper isolation with required signages 1 1
Inspection log report ( Maintenance,Repair,Test and
8.2 1 1
Inspection )
8.3 Load radius Indicator 1 1
8.5 Authorized/ Certified Heavy Equipment Operator 2 2
8.6 Authorized/ Certified Rigger 2 2
8.7 Third Party Inspection 3 3
9 Power Tools
9.1 Inspection Checklist report/Color code 2 2
9.2 Correct Disc/Voltage 1 1
9.3 Properly Guarded 2 2
10 Compressed Gas Cylinders ( Oxy-Ace )
10.1 Proper storage 1 1
10.2 Caps In place 1 1
10.2 Gauges/Hose 1 1
10.3 Flash Back Arrestor 2 2
10.4 Proper Handling 2 2
11 General Site Housekeeping and Arrangement
Site Access /Passageway cleared from any debris and
11.1 2 2
materials.
11.2 Garbage Disposal Area/ Trash Containers/Lids 2 2
Material Stacking/ Precasts are secured and properly
11.3 1 1
stockpiled
11.4 Material Recovery Facility (MRF) 1 1
Storage of Flammable and Combustible goods are within
11.5 1 1
safe distance from production areas
MSDS (hazardous solvents, materials) are properly posted
11.6 2 2
and informed all concerned.
11.7 Maintain housekeeping during stripping activity 1 1
11.8 Removal of debris during architectural and structural activities 2 2
11.9 No water ponding at MEPF works 1 1
11.1 Good housekeeping at warehouse 2 2
No presence of debris and materials above the Street
11.12 1 1
Protections and Canopies
11.13 Maintain housekeeping at production areas of subcon 2 2
Maintain housekeeping at loading/ unloading area as well as
11.14 1 1
at the location of pumpcrete/ concrete mixer truck along road
12 Workplace Illumination, Ventilation, Noise and Vibration
12.1 Fully illuminated offices 1 1
Work areas, especially for grinding, cutting, etc., are properly
12.2 2 2
illuminated

Form No.: F-IMS004 Rev 0 Dec 01 2015 Page 2 of 4

 Rating

-all
A)

l
No. ITEM DESCRIPTION Remarks

Score

Actua
Over
(NA,
Proper ventilation for activities exposed to fumes and dusts
12.3 3 3
such as grinding, sanding, welding, etc.
Proper ventilation system is installed in activities inside
12.4 2 2
confined spaces
Noise levels at workplace are within the prescribed Threshold
12.5 1 1
Limit Value (TLV)
Vibration related activities are implemented with a proper job
12.6 1 1
rotation scheme as part of their administrative control
Vibration related activities are provided with proper PPE (Anti
12.7 vibration gloves), and ergonimically appropriate work area 1 1
(platforms, stable ground, etc.)
13 Safety Administration (as per OSHS Requirement)
13.1 Construction Health and Safety Program (DOLE Approved) 5
13.2 Organized Health and Safety Committee 1
13.3 Safety Advisor / Safety Officer/ Safety Inspector 3
Worker's Pre-Employment records (medical requirements,
13.4 2 2
NBI Clearance, etc.)
Regular update of HIRAC (Hazard Identification, Risk
13.5 2 2
Assessment and Control) based on the project phase
Regular submission of:
WEEKLY:
- SIR (Safety Inspection Report),
- Site Safety Scorecard
MONTHLY:
13.6 - Project HSE Report to DOLE, 3 3
- OTPs (Objective, Target and Programs),
- Checklist of Flammable and Combustible Materials,
- Monitoring of Heavy Equipment Third Party Inspection and
Operators/ Riggers Certification,
- HSE Calendar of Activities,

14 Incident investigation, reporting and documentation are conducted ( HSE Reporting )

Input in the IRM (within 24 hours)and Hard copy of incident
14.1 2 2
for site document & Head Office.
Close-out report and Report follow up after all corrective
14.2 2 2
actions are done.
15 Emergency Preparedness and Response Plan/ Crisis Management
15.1 Copy of Crisis Management Approved Plan 2 2
Approved and signed duties and responsibilties of the ERT
15.2 1 1
(Including Fire Brigade) members/ T.O.
15.3 ERT members have undergone proper training 1 1

15.4 ERT T.O. is visibly posted in the bulletin board 2 2

Emergency Contact numbers of ERT Team posted at HSE
15.5 1 1
Bulletin Board
Readily available and properly communicated Emergency
15.6 1 1
Procedures
Drills (Fire/ Earthquake /Evacuation) conducted with post
15.7 3 3
assessment of procedures
Strategically located Emergency Floor Plan and signages
15.8 1 1
including Designated Emergency Evacuation area

15.9 Emergengy Alarm Horn or Buzzer is always available 1 1

16 Work Permits
Approved Permits are secured and strictly observed. With
16.1 3 3
attached JHA and Proper Permit Close - out
16.2 Cold Work Permit 1 1
16.3 Hot Work Permit 1 1
16.4 Confined Space 2 2
16.5 Excavation Permit 1 1
16.6 LOTO (Lock out - Tag-out) 1 1
16.7 Critical Lifting Permit 1 1
17 HSE Education
Bulletin Board - located in a conspicuous location with
17.1 1 1
updated HSE information

Form No.: F-IMS004 Rev 0 Dec 01 2015 Page 3 of 4

 Rating

-all
A)

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No. ITEM DESCRIPTION Remarks

Score

Actua
Over
(NA,
Standard Corporate signages/posters (installed and
17.2 1 1
maintained)
Safety Toolbox Meeting conducted daily for the following
17.3
trades:
17.4 - Structural 1 1
17.5 - Architectural 1 1
17.6 - MEPF 1 1
Conduct Regular HSE Committee Meeting (at least once a
17.7 2 2
month)
17.8 Minutes of Committee Meeting ( DOLE Received ) 2 2
17.9 Annual Medical report ( DOLE Received ) 1 1
18 Health and Welfare
18.1 Registered Nurse/ Certified First Aider / First Aid Kit 2 2
18.2 Part time Occupational Health Doctor 2 2
18.3 Clinic/Treatment Room 2 2
18.4 Drinking Water Station (with potability test result) 1 1
On-site updated Memorandum of Agreement (MOA) for
18.5 1 1
nearest hospital
18.6 Emergency vehicle at site 1 1
18.7 Designated Smoking Area(not permitted inside the building) 1 1
18.8 Washing Facilities/ Toilet/ Sanitation 1 1
18.9 Canteen/ Nutrition Hall 1 1
18.10 Rest Area/ Camps/Accomodations 2 2
Actual Rate: 0.0
Overall Rate: 189

Remarks:

Audited By: Noted by:

Project Manager

Area Manager

VP - Operations

Chief Technical Officer

Conforme:

Form No.: F-IMS004 Rev 0 Dec 01 2015 Page 4 of 4