Job Safety Analysis (JSA)

This detailed Job Safety Analysis (JSA) checklist template can be used in Construction and other environments as part of Health and Safety procedures, to identify risk factors and mitigation procedures before starting a job.​

Job Safety Analysis (JSA)



General Information

1. Foreman


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2. Weather/Conditions


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3. Job Steps to be performed


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Human Performance

1. First Time Evolution


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2. Lack of Experience/Apprentice


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3. Near by Work Activities


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4. Mix Up Potential


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PPE

1. Hard Hat


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2. Safety Glasses


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3. Safety Boots / Steel Toed Boots


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5. FR Clothing


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6. Face Shield


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7. Welding PPE


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8. Face shield


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9. Arc Rated PPE


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Permits

1. Confined Space


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2. Hot Work


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3. Excavation


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4. Line Breaking


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5. Critical Lift


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6. Permit Notes


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Emergency Equipment

1. Fire Extinguisher


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2. Eye Wash


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3. Safety Shower


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4. Evacuation Route/Reporting Area


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5. Emergency Phone


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Hazard Recognition

1. Fall Protection


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2. Fall Prevention


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3. Hole Covers


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4. Life Lines


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5. Anchorage Point


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6. Struck By/Pinch Points


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7. Visibility


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8. Slips/Trips


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9. Work Area Notes


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10. GFCI Required


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11. Quarterly Inspection of Electrical Tools


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12. Guards and Handles In place


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13. Tools Required for the job


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14. Adequate Lighting


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15. Flammables/Combustibles


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16. Fire Blanket


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17. Flash Shielding


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18. Lead Paint/Coatings


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19. Potential Asbestos Identified


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20. Hexavalent Chromium


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21. Other Heavy Metals


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22. Heat/Cold Stress


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23. Barricading Necessary


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24. Proper Signage


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25. Environmental Conditions to Note


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Competent Person Identified

1. Rigging/Signaling


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2. Scaffolding


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3. Confined Space


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4. Fall Protection


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5. Excavations


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6. Electrical


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Equipment Necessary

2. Aerial Lift/Scissor Lift


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3. Fork Lift


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4. Training Verified


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5. Overhead Hazards


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6. Make sure to complete pre operational checks and document


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7. Other Hazard Notation/Mitigation


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Job Task Assessment-1

1. Ladders


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2. Barricades


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4. Housekeeping


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5. Electrical Cords/Tools


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6. Fall Protection


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7. Hand Tools


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8. Fire Extinguisher


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9. Do check if item not applicable


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Job Task Assessment-2

1. Protection from falls


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2. Protection from electrocution/shock


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3. Proper PPE for task


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4. Walkways clear


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5. Work area picked up and orderly


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6. Ladders used correctly


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7. Protection from Pinch/Crush Points


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8. Using tools correctly


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9. Cords in good condition


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10. Protection from hot work


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11. Task Assessment Notes


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Post Shift Review

1. Was anyone injured In the cource of working today or did any unplanned event occur which could result in injury or loss? If so, explain below and ensure it has been reported to your Project Manager and Safety Manager.


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2. Explanation


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3. Suggestions for Improvement


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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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