HS810
HS Management Plan Checklist
Contractor details
Project details
Introduction - Contractor details and scope of work
Criteria
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Company name, project, address and ABN
Names trades/activity to be carried out
Names of the project and Principal contractor (if
applicable)
Includes details of any work to be subcontracted
Contract details and scope of works signed off by
Managing director/General manager.
Safety Policy
Criteria
Demonstrates a commitment to safety
Signed and dated by company principal
Roles and responsibilities
Criteria
Shows Management structure (eg flowchart)
Are HS responsibilities clear between UNSW and the
Contractor
Lists specific responsibilities for all employees
Signed off by persons with listed responsibilities
Risk management
Criteria
Includes a commitment to not commence work unless:
 The contractor has conducted risk assessments
and provided SWMS’s
 HS induction training is completed as required by
the project safety plan.
Includes the hazard identification and risk assessment
process to be followed.
Includes a commitment to consult with the workforce
Defines risks in terms of likelihood and consequences
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Has a site-specific risk assessment been conducted?
(Does the risk assessment include hazards identified
during the design stage (where applicable))?
Includes a register of risks for all processes
 Includes any risks from UNSW Risk Registers
where applicable?
Includes SWMS for all processes identified as being
medium or high risks.
Safe Work Method Statements
Criteria
Pass/Fail
Comments
All SWMS comply with and have been checked against
UNSW HS 811 SWMS Checklist?
Register of inductions/skills and competencies
Criteria
Pass/Fail
Comments
List of employee names
Work to be carried out by each worker
Each workers skills, experience and qualifications
Any additional training requirements for each worker
Induction records, including certificate numbers
Names of persons who presented the inductions
Worker’s compensation and rehabilitation details
Criteria
Pass/Fail
Comments
Workers compensation policy details provided (name of
insurer, policy number, amount covered)
Certificate of currency attached
Name of contractors rehabilitation coordinator
Name of contractors rehabilitation provider
Hazardous substances procedure and register
Criteria
Pass/Fail
Comments
Pass/Fail
Comments
Procedure for selection of substances based on hazards.
Register includes application and quantity.
Products risk assessed.
Includes controls based on assessed risks.
MSDS included for each substance.
Lifting gear
Criteria
Register included showing:
 Item description and plant number
 Date of inspection
 Condition
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 Name and qualification of inspector.
Current test certificate included for all gear.
Plant
Criteria
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Plant register included showing:
 Type of plant to be used
 Make
 Plant registration number (if applicable)
 Design registration number (if applicable)
 Inspection frequency
Inspection/maintenance reports included for all mobile
plant
Operator competencies confirmed for mobile plant
Electrical
Criteria
Testing and tagging procedure included
Register of all leads, tools and appliances to be used on
site includes plant numbers, inspection dates, tester’s
certificate number and sign off.
Personal protective clothing and equipment
Criteria
Register of PPE (in addition to standard items of hardhat,
safety boots, hearing, eye and dust protection) issued to
each employee showing date of issue
Signed off by each employee, including instruction in
correct use
Fire protection
Criteria
Register of all fire fighting equipment showing serial
numbers and inspection dates
Record of training in the use of extinguishers for persons
doing ‘hot work’ (refer to skills and competencies)
Does the contractors hot work permit system comply with
UNSW HS820 - Permit To Work Procedure
Training and consultation – toolbox talks
Criteria
Demonstrates a commitment to conducting weekly
toolbox talks.
Shows names of persons responsible for the delivery of
the toolbox talks.
Includes a blank form for recording topics, attendances
and feedback comments.
Has a schedule been developed of all meetings (including
toolboxes) along with details of participants of the
meetings — that is, will other contractors and
subcontractors attend tool box talks, meetings etc? If not,
why not?
First aid and hazard/incident management
Criteria
Shows first aid procedure to be followed (eg UNSW to
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provide, contractor to supplement)
 Includes names and qualifications of ticketed
employees.
Shows details of how hazards/incidents will be reported
 Blank hazard/accident/incident reporting form
included.
Acknowledgement that UNSW will be involved in
accident/incident investigation and resolution.
Are there details of how reports will be addressed,
timelines for rectification/implementation and when
investigations are to be carried out?
 Names the person responsible for conducting
accident investigations
 Blank accident investigation form included.
Is there a strategy for informing UNSW of investigation
outcomes? Details should include both proactive and
reactive strategies to ensure no repeat hazards or
incidents occur.
Emergency procedures
Criteria
Pass/Fail
Comments
Pass/Fail
Comments
Pass/Fail
Comments
Has an emergency management procedure applicable for
the site conditions and occupants been developed?
Is there a program to ensure testing and revising of the
emergency procedures?
Has site security and public protection been addressed
adequately, that is, hoarding, guarding etc?
Have emergency contact details been provided?
How will emergency situations be reported back to the
agency and do the notification timelines meet the
requirements of the agency?
Safety inspections
Criteria
Shows procedure for inspections eg frequency, area,
possible hazards
Names person(s) responsible for conducting inspections
Includes an example of the form to be used to record
inspection results
Sub-Contractor management
Criteria
Shows procedures for sub-contractor management
Are there provisions to ensure clear and decisive HS
responsibilities between the contractor and any
subcontractors exist?
Does the contractor have the safety requirements that
any subcontractor working on the project needs to meet?
Has the contractor clearly outlined the safety roles and
responsibilities that a subcontractor is expected to
perform? How will these requirements be communicated
to the subcontractor?
Has the contractor included subcontractor training and
competency requirements in the site training
requirements?
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Sign off
Safety plan received date:
Review date:
Assessment
 Accepted as satisfactory
 Accepted subject to comments – submit revised document
for acceptance
 Not accepted – refer comments and resubmit.
Other comments:
Reviewed by (Print name):
Position:
Signature:
HS Management Plan checklist
Current Version 1.1, 8/03/2013
Date:
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