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Kmart & Target Ladders Assembly Safety Audit Report
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KEY DETAILS:
Date
*
DD dash MM dash YYYY
Your State
*
VIC
TAS
NSW
ACT
QLD
NT
WA
SA
Brand
*
Target
Kmart
Location
*
For example: Byron Bay
Your Full Name
*
Did you introduce yourself to the Store Manager? Y/N
*
Yes
No
Manager Name:
If no, who at the store did you report to?
Were you able to locate all of the assembled Ladders? Y/N
*
Yes
No
If no, please explain:
How many 5 step ladders did you complete a safety check on?
*
Refer to Project Brief for MANDATORY safety checks
How many 6 step ladders did you completed a safety check on?
*
Refer to Project Brief for MANDATORY safety checks
Please confirm ALL ladder safety checks have been completed?
*
All Nuts/Bolts/Screws Tightened
Wheel Installation checked and wheels move freely
Sturdiness - All ladders are sturdy when used
Installed safety bars are REMOVED
Safety Stickers applied as per brief
All of these need to be completed and verified by the Store Manager prior to leaving the store
Did you have any issues completing a safety check on any of the ladders?
*
Yes
No
If yes, please advise issues encountered
How many obsolete 7 and 8 step ladders needed to be dismantled?
*
All 7 step and 8 step ladders need to be dismantled. The store is to keep 2 x 7 step ladders only. These should have been dismantled and discarded on the assembly day
Was there a 6m2 Cleanaway Skip Bin on site for any remaining reserve (7/8 step) ladders?
*
Yes
No
Not Required - no ladders to dismantle
Line all safety checked ladders up and take a photo - LANDSCAPE ONLY
*
Accepted file types: jpg, jpeg, png, gif.
Did any ladders fail the safety check?
*
Yes
No
If Yes, how many failed and why?
Follow directions for ladders that fail the safety check as outlined in the Project Brief
Did you get store sign off?
*
Yes
No
Did the Store Manager verify that all ladders have been assembled & safety checked or disposed of accordingly?
*
Yes
No
Name of Store Manager who verified that the ladders were safety compliant?
*
Either the Store Manager or the highest ranking manager on duty - full name only
Does this store need to be revisited?
*
Yes
No
If, yes please advise why
Final comments?
*
SAFETY:
Were there any injuries, incidents or hazards during the shift?
*
Yes
No
If you have selected NO please simply hit SUBMIT below
What best describes the incident?
Injury
Hazard
Near Miss
Please describe the injury, incident or hazards during the shift
Whats was the action taken?
Has the injury, incident or hazrd been addressed accordingly?
Final comments of the injury, incident or hazard
Both Crew MEMBER and Crew LEADER must fill out an incident report on their assigned links on the last page of this report. This is extremely important!
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