HSE Daily Safety Statistics Report
Shift: Day Night Date
Location
1. Safety Inspection Summary
Category Total Items Compliant Non-Compliant Critical (IMP)
General Safety Checklist 13
Equipment & Hazard Checks 8
High-Risk Task Controls Varies
Permits & Special Work
3
Areas
Compliance Rate:
Total Observations:
Critical Safety Flags
2. Key Daily Safety Metrics
Metric Value Photo / Scanned checklists.
Total Workers on Site 13
High-Risk Activities in
8
Progress
Unsafe Acts/Conditions
Varies
Reported
Near Misses Reported 3
First Aid / Medical Cases 4
Toolbox Talk Conducted Yes No
Emergency Drills / Equipment
Checked
3. Observations / Non-Compliance Details
Description Immediate Responsible
Type Photo Attached
Action Taken Person
Water pooling at excavation Pumped,
Unsafe
edge barriers Supervisor A
Condition
placed
Worker without gloves in Gloves
Unsafe Act Safety Officer B
trench issued
Secured,
Scaffolding
Scaffold plank slipped Near Miss checked all
Team Lead
planks
4. Equipment Status with Photos / Scanned Checklist
Equipment OK Not OK % Functional Photo / Scanned
Rev:00
Checklist
Fire Extinguishers ☐ ☐
Ladders / Scaffoldings ☐ ☐
PPE Kits (Boots, Gloves ☐ ☐
Rescue Equipment ☐ ☐
Safety Signage & Barriers ☐ ☐
5. Safety Compliance Gauge
Good (90–100%)
Moderate (70–89%) Today’s Compliance Score: ________%
Poor (<70%)
Inspected By;
Name: .............................. Designation: ............................ Signature: .............................
Rev:00