LOCATION : Crew Name:-
NAME OF TEAM MEMBER Date:-
1= No evidence exists that the requirements of Inspection/Audit Check item are in place.
2= Less than 50% of requirements are met.
Scoring Legend: 3= Requirements are implemented in most areas. More than 50% of requirements are met.
4= Documentation exists to demonstrate that process implemented. About 80% of the requirements met.
5= Requirements are fully implemented, working effectively & regularly reviewed to ensure continuous improvement.
Auditors are required to assess the organization against each sub-category on a scale of 0 - 5 as described below and then record the average score of each category
Note: based on the arithmetic average of the non-zero scores of the component sub-categories. A score of zero implies that the criteria in that sub-category are not
applicable to the organization. This score would not affect the category average score.
S. Needs
Items OK Attention
N/A Score Gaps Corrective Action Responsibility
No.
1 HSE MANAGEMENT SYSTEM
1.1 HSE Policy / Procedures
1.2 Staff Organogram
1.3 Staff CV's
1.4 Staff Certifications
1.5 Man Hours Record
2 PROJECT MANAGEMENT SYSTEM
2.1 Project Management (Procedure / Roles & Responsibility)
2.2 Work force competent and experiences suitable for job / certified
2.3 Organogram
3 QUALITY MANAGEMENT SYSTEM
3.1 QC Management (Procedure / Roles & Responsibility)
3.2 QC personnel competency
3.3 QA/QC (Documentation)
4 SAFETY PROCEDURES / PROCESSES
Task Risk Assessments: Site specific / DCMS reference given, Critical activities identified.
4.1 Hazards noted / Documented TRA available; Are identified controls in place?
4.2 Work Permits: Properly completed /cross references mentioned, conditions being followed.
4.3 Lifting Plans (Adequate to category of lift)
4.4 Emergency Response Plan: Available and understood by workforce
1 (Rev-00) March-2018
, S. Needs
Items OK Attention
N/A Score Gaps Corrective Action Responsibility
No.
4.5 Staff Emergency Contact list including ( Family Number for contact during any emeregcny )
4.6 Fire alarm / Hooter functional drills conducted
5 FIRE & SAFETY EQUIPMENT
Portable Extinguishers: Visible (placard/marking), mounted; unobstructed access; monthly
5.1
inspection completed.
2 (Rev-00) March-2018