03+000Lusail Real Estate Development Company 03+000HSE -Labour Camp Inspection Form

Lusail Real Estate Development Company

Health, Safety, Security, Environment, Logistics & Quality
Department

Lusail Construction Safety Procedural Form/Checklist – Labour Camp

Inspection Form

Document No.: LUS-HSE-FM4-446-091.01 Rev 1

Uncontrolled Copy Controlled Copy x Date 1-Apr-15

COMPANY PROPRIETARY INFORMATION

Prior to use, ensure this document is the most recent revision by checking the Master Document List. To request a change, submit a Document Change
Request to the Document Control Representative. Master copy of this document will be maintained by the LREDC QA/QC Manager. Not Controlled if
printed.

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Document No: LUS-HSE-FM4-446-091.01
 03+000Lusail Real Estate Development Company 03+000HSE -Labour Camp Inspection Form

Amendment Record
This document is reviewed to ensure its continuing relevance to the systems and process that it describes. A record of
contextual additions or omissions is given below:

Rev. No. Description / Comments Prepared By Checked By Approved By Issue Date

(Pg. 1) Company Propriety

1 Information - Not controlled if HSE Working Michael Ford Uwe Krueger 1-Apr-15
printed has been added Group

1 (Pg. 2) Revised Amendment Table HSE Working Michael Ford Uwe Krueger 1-Apr-15
Group

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 03+000Lusail Real Estate Development Company 03+000HSE -Labour Camp Inspection Form

Labor Camp Inspection Form

Date of
Inspection done by: Inspection:
Company
Company:
Representative:
Camp
Location:
Representative:

Kitchen Management Actual Target Comments

Kitchen walls, floor and construction is water

2
resistant, non-slip and durable?
Food good quality, nutritious and fresh? 2 2
System to ensure for food safety and hazard
2
identification in place?
Staff trained and certified? 2

Do all food handlers have a food hygiene certificate? 2

Is all extraction working? 2
Are all extraction fan filters clean and maintained? 2
Appropriate and sufficient ventilation? 2
Appropriate and sufficient lighting? 2

Adequate storage (wet and dry stores)? 2

Appropriate and sufficient fire safety precautions? 2

All equipment and utensils in good working conditions

2
and kept clean?
Temperature of fridge and freezers checked daily and
2
recorded? (Fridge 1-4 °C freezer > -10°C)
Problematic equipment, reported if any? 2

Chopping boards clean and not damaged? 2

Condiments stored in the fridge and containers clean? 2

Dish clothes and rags sanitized and stored dry? 2

Are electrical plugs/sockets/switches in good repair? 2

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 03+000Lusail Real Estate Development Company 03+000HSE -Labour Camp Inspection Form

Food Containers
Clean and not damaged? 2
Frozen food containers not damaged? 2
Transporting food in satisfactory containers? 2
Dry food stores
Clean, cool, well-lit and well ventilated? 2

Food not stored on the floor? 2

Stored of large volumes of rice/flour/maize/dry

2
products in sealed marked containers?
Detergents/chemicals/insecticide soaps stored in
2
separate location?
Stock rotation taking place, no expired goods? 2
Any evidence of infestation? 2
Storage facility adequate for amount of stock? 2
Perishable food

Drip trays in position for defrosting meats? 2

Thermometer positioning at hottest place and in
2
working condition?
Evidence of refrigerator cleaning program? 2

Raw food separated from cooked food? 2

Food is covered adequately to prevent

2
contamination?
Production date/consume by date displayed on items? 2

No evidence of defrosting or dripping? 2

Clean and packed well for cold air to circulate freely
2
between items?
Cooked food kept at tem > 63°C or <5°C? 2
Score per section 2 74 2.70

Dining Room Actual Target Comments

Is the general condition of the dining are clean &

2
hygienic?

Furniture is clean and made of durable material? 2

Is there an available electronic insect zapper in the

2
dining room?
Non-absorbent, non-corrodible containers with close-
2
fitting lids for food waste?
Hand washing facility available? 2
Documented inspection of the catering facility and
2
food preparation arrangements?
Are the drink dispensers clean & free of spills? 2
Is all lighting satisfactory? 2

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 03+000Lusail Real Estate Development Company 03+000HSE -Labour Camp Inspection Form

Is the area free of pests? 2

Score per section 0 18 0.00

Labor camps minimum requirements Actual Target

Comments
Is there a process in place for occupants to report
2
repair and maintenance issues?
Camp area well kept and maintained? 2

Constant supply of electricity, with back-up

2
generator?
Evidence of fire precautions and monthly inspection
2
of fire prevention equipment?
Mosque facilities available? 2
A sanitary crew available for cleaning arrangements
2
and deep cleaning program?
Camp is free from standing water? 2
Documented monthly electrical
2
safety inspections?
Cleaning Chemicals
and Cleaning
Equipment
Have all persons been trained in using the chemicals
2
correctly?
Cleaning chemicals stored correctly? 2

MSDS available with stored chemicals? 2

All chemicals correctly diluted and

2
bottles labeled?
All personal protective equipment
2
(PPE) available?
Is all cleaning equipment maintained and stored
2
correctly?
Score per section 0 28 0.00

Living Accommodation Actual Target

Employees have a minimum of 4 meters squared of Comments
living space with a maximum occupancy of 8 2
employees per room?
Accommodation is clean and tidy? 2
Separate bed for each camp occupant? 2

No triple bunk beds? 2

Mattresses and pillows are in good condition and

2
clean?
Each bed has clean sheets, blankets and pillow cases? 2

Rooms have adequate lighting? 2

Is the air conditioner filter clean and maintenance

2
program in place and approved?

Is there a working smoke detector in each room? 2

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Rooms have a minimum of two 13-amp electrical

2
outlets?
No food preparation or storage of food in the rooms? 2

Evacuation plan is displayed in every room? 2

Locker available for storing personal belonging? 2

No smoking in rooms? 2

No evidence of overcrowding? 2

Is there fire-fighting equipment in the

2
accommodation?
Is there a deep cleaning program for the
2
accommodation?
Are floors clean and bins available and clean? 2
Is there any signs of vermin / pest? 2
Score per section 0 38 0.00

Ablution Blocks Actual Target

Comments
Are all ablution facilities clean, sanitary and in good
2
operating condition?
Showers clean and private? 2

Shower facilities have hot and cold running water? 2

Adequate drainage for waste water? 2

Each toilet in a private, lockable cubicle? 2

Sanitary crew available to perform daily cleaning? 2

Hand wash basins: 1 per 10 employees
Shower stalls: 1 per 10 employees
Toilets: 1 per 15 employees 2

Urinals: 1 per 20 men

Are soap and a means of drying hands available? 2

Is toilet paper provided? 2
Score per section 0 18 0.00

Laundry Actual Target

Comments
Laundry facilities available for washing and drying
2
clothes?
Clothes which contain industrial contaminants is
2
being washed separately?

Are washing and drying machines operational? 2

Are electrical plugs/sockets/switches in good repair? 2

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Are lights operational? 2

Score per section 0 10 0.00
Recreational Room Actual Target Comments
Recreation facility available? 2

Outdoor shaded areas available? 2

Air conditioning available for all habitable room and
2
dining/recreation areas?
Available TV room? 2
Telephone booths and internet café available for
2
employees?
Designated smoking area provided outside? 2
Is the floor clean and free from slip, trips and falls
2
hazards?
Is there adequate lighting? 2
Is exercise equipment clean, safe and
2
stored neatly?
Are toilets clean and disinfected? 2
Score per section 0 20 0.00
Fire Safety Arrangements Actual Target Comments

Is there an upto date fire safety plan? 2

Is the emergency number contact details

2
displayed?
Are there trained and designated fire marshals? 2

Are fire drill performed on a regular basis? 2

Are there a sufficient number of fire extinguishers/fire

2
hose reel relative to the risk?

Are the fire extinguishers clearly identifiable? 2

Are fire extinguishers inspected and recorded

2
monthly?
Is emergency lighting installed along all emergency
2
exits and routes?
Assembly point provided and displayed in a
2
designated area?
Are no smoking signs posted at
2
designated areas?
Are emergency signs displayed at designated areas?
2
(directional arrows)
Are walkways, exit route free from obstructions? 2

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Smoke detectors (if appl.) operational? 2

Score per section 0 26 0.00
Healthcare Arrangements Actual Target Comments

Medical Aid Centre available? 2

Evidence of regular health education done for the

2
employees?
Drug and alcohol awareness program that includes
2
random and inspection for alcohol?
Weekly camp inspections done? 2

Water testing done monthly, results analyzed? 2

Evidence of pest control program? 2

Daily illness log and injury on duty log kept at medical
2
aid centre?
Appropriate disposal of waste water? 2
Is a designated nurse provided? 2

Are hazardous waste bins provided? 2

Are adequate consumables and emergency

2
equipment provided?
Is the nurse reporting all occupational, health, injury
2
or illness cases to HSE department?
Score per section 0 24 0.00
Final Score in Percentage (%) 0

Legend:
Full compliance = 2
Partial compliance = 1
No compliance = 0
Not applicable = NA
Each section is weighed equally

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Ÿ Please note that the camp will be revisited. It is the responsibilitu of the contractor to write the projected date of the close out in the above
mention prior to verification.

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GOOD PRACTICES
ACTUAL
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Additional Comments and Supporting Advice

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Additional Comments and Supporting Advice

Inspector Name: …………………………………. Signature: …………………………………. Date: ………………………

Revisit date due: …………………………………

Corrective action plan submitted to: …………………………………….. Organization: …………………………………….

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