The Site Specific

Safety Plan (SSSP)

is a communication
tool between
subcontractors and
main contractors
and should be
completed before
starting a
construction
project. When used
correctly, it ensures
that relevant site
information is
regularly updated
and safety is
monitored.

A SSSP helps record the basic health and safety actions companies need to do,
such as:

Hazard management and identification

Accidents and incident investigation

Train and/or supervise staff

Emergency ready eg. Prepared with first aid / rescue plan

Responsibilities:
- Provide opportunities for employees to be involved
- Employees have a responsibility for their own safety
For managing hazards:
Health & Safety
Policy
Subcontractor

Communication &
Consultation
Emergency

Safety Inspections
Hazard
Identification, Risk

Management Info

Procedures

Assessment & Control

Incident
Management

Safety Performance
Monitoring

Plant & Equipment

Registers

Safe Work
Procedures

Full range of Safety

and Hazard Registers

Notifiable Works
SDS sheets
Training Register

Evacuation Plan
Supervision

PPE register and

issuing form

Employee Health

Employee Induction
& Training

Just some of the additional information in this file to consider:

General Hot
Works
Induction/Visitor
Register
Task Analysis

Notifiable Works
Accident/Incident
Register
Full range of Safety and
Hazard Registers

Toolbox Safety
Tips and Meetings
Accident
Investigation
Inspection Form

A Safety Plan to Suit Your Job

Your Specific Safety Plan Checklist contains Yes or No check boxes.
Where there is a Yes/No option, a response must be given.
Tick the Actioned box when the subcontractor has completed the required
action.
All items must be responded to in order to sign off the Site Specific Safety Plan
(SSSP).
Once the SSSP is signed off, site access can be granted to the subcontractor.

The person who is designated to act on behalf of your business for safety on site
may be a dedicated safety representative, your supervisor, or one of your
employees.

Definition of a Principal
A person who engages any person (other than as an employee) to do any work for
gain or reward.
A principal can be a:
client who directly contracts a main contractor or subcontractors
a main contractor who engages subcontractors
subcontractors who engage other subcontractors
self-employed persons who engage subcontractors.
Definition of a Person Who Controls a Place of Work
A person who controls a place of work can be a person who:
owns, leases, subleases or is in the possession of/occupies a place of work
owns, leases or subleases plant or equipment used in the place of work.
Definition of a Person
A person can be a legal person such as an employer or a natural person such as
an employee.
A person can be:
the Crown
a group of people who act as an individual such as a company, a body
corporate or the Crown
an employee
a self-employed person.
Persons in control of the workplace. The subcontractor must identify the person
who has control of the workplace and confirm this on form 1 of this SSSP. This
will often be the projects principal, but if the work is being done directly for a
client on their premises, then the employer in control of the site may be the client
or building owner. The people in control of the workplace, and their site
representative, have the overall responsibility for health and safety management
for the site, which will include managing most of the items in the SSSP Checklist
and co-ordination of all trades health and safety.
All hazards to be brought onto the site or created during the course of the work
must be identified and controlled. The standard Task Analysis Worksheet may be
used to analyse the various tasks within your trade work, identify the significant
safety hazards and detail the method of control. These sheets must be attached
and forwarded with your SSSP.

A Hazardous Substance/Dangerous Goods Register must be maintained with the

appropriate Safety Data Sheet (SDS). If specific emergency processes need to be
set up, this will be addressed on the Task Analysis Worksheet to be incorporated
into the project emergency planning and evacuation processes.
Communication/Employee Participation

(Toolbox Safety Meeting Minutes)

On-site safety requirements must be communicated to all site personnel. This

will include the notification of hazards brought onto the site or created during the
course of the work. Do this by posting hazards on the main site hazard board, or
advising staff during regular safety meetings. The aim is to ensure that all
workers on site are aware of the hazards as they arise and are advised when they
no longer exist. If English is the second language of any of your employees, then
you must maintain a liaison person on site who can effectively communicate
between them and the site management team.
Toolbox meetings should be run on a regular basis and run for 10-15 minutes. The
frequency of meetings will depend on the size, nature and location of the site.
Some hazardous activities could require daily meetings, while often a
weekly/fortnightly meeting will suffice. Safety meetings for workers should be
short and to the point.
Why do we run Safety Meetings?

Inform workers of changes to company procedures

Identify new hazards and review existing hazards

Develop/review hazard controls

Discuss/review accident and incident data

Employee participation

Communication

Discuss programs

Develop/review work processes

Short training sessions

Record Meetings
Details of meetings should be recorded and kept on file. Record meeting dates,
attendees and discussion items. Show follow-up items from previous hazards,
accidents and incidents.
Emergencies(Emergency Plan; Emergency Evacuation Plan)
In the event of a site evacuation, the Emergency Evacuation Alarm will be
sounded and your employees must promptly evacuate the site. The site
management team will notify you of your assembly point at the time of your
induction onto the site.

Some emergencies that you may need to prepare for, and have a procedure to
deal with, include spillage of hazardous substances, serious harm accidents to
your staff, and rescue of a fall arrest victim. Each potential emergency you
identify under your hazard management process must have an emergency plan
and procedure prepared and included with the hazard management information
submitted so that any effect it may have on the Emergency Evacuation Plan can
be identified and rectified.
You must have a person on site trained in First Aid, with a current valid
certificate, in case of an injury or accident.

Accident/Incident Reporting
All accidents and incidents must be reported immediately to site management.
Accident and Incident Investigation Reports are to be given to site management
as soon as is practicable. You must also report serious harm accidents directly
to Provincial or State agencies. In the case of serious harm accidents, the scene

must not be disturbed until a full and complete accident investigation has been
undertaken.

Safety Inspections and Safety Reviews

You are required to carry out regular, documented safety inspections of your own
work areas while on site, at the intervals and as per the prime contractors safety
manual. Copies of the Accident and Incident Investigation Report must be given
to site management for discussion at safety meetings. Any
recommended/completed corrective action will be advised at these meetings.
Training/Induction
All persons starting work on this site must go through a formal induction process.
During this process, safety rules and various site specific issues will be
discussed.
Please supply a list of all your employees working on this site, along with their
access card numbers and expiry dates at the time of the induction. All employees
will be expected to show their Site Safe access cards at induction.

You will need to provide and maintain evidence of your employees skills training,
e.g. trade qualifications, certificate of competency, etc.
Sign-off/Approval
Before any work commences on site, the subcontractor will sign off their SSSP
and submit it with all attachments to the principal/site management for approval.

The principal/site management will review the plan using the Site Specific Safety
Plan Evaluation and return it to the subcontractor if not complete, or request a
meeting with the subcontractor to review and action any deficiencies.
Once all the evaluation checks have been satisfactorily agreed, the principal/site
management will sign and date the SSSP confirming approval and return a signed
copy to the subcontractor for their record.
Subcontractors
The subcontractor must have a process in place for approving their own
subcontractors safety systems. If the subcontractor contracts out some of their
work to another subcontractor, then the site management must be notified in a
schedule attached to the subcontractors SSSP of the names and contact details
for all their subcontractors.

Hazard Register
PROJECT/SITE
IDENTIFIED
HAZARD

POTENTIAL
HARM

SIGNIFICANT
HAZARD
Yes

No

HAZARD
CONTROLS

REGULAR CHECK OF HAZARD CONTROLS IN

PLACE
Training
Date
Date
Date
Date
Required Checked Checked Checked Checked

Hazardous Substance/Dangerous Goods Register (Safety Data Sheets SDS)

PROJECT/SITE

EMPLOYER

SDS records concise health, safety and technical information held for all products used and stored by the organisation

Date

Substance,
Chemical,
Material or
Solvent

Supplier
SDS
Report
Held Y/N

Hazard Potential

Safer Alternative

Protective
Clothing
Required

Action
Recommen
ded

Action
Review
Date

Completion guide and action sign-off

Completed Safety Data Sheets are held for all products and the information, health risks and the directive to use protective
equipment have been conveyed to employees and recorded in the Safety Training and Competency
Register.....signed (Site management) ...(Date)

Task Analysis Worksheet

JOB DESCRIPTION

PROJECT/SITE

EMPLOYER

PPE required:

DATE

Task Analysis completed by:

Plant required:
Signage required:

Date:

SEQUENCE OF BASIC STEPS

POTENTIAL SIGNIFICANT HAZARDS

HAZARD CONTROL METHOD

List the 4 to 8 steps required to

complete the job
(Follow the flow of the product or the
process)
Step
No.

List the potential SIGNIFICANT hazards beside

each step. Focus on what can cause harm and
what can go wrong
(Use the Seven Point Analysis as a guide)
Step
No.

List the control methods required to

ELIMINATE, ISOLATE or MINIMISE
each SIGNIFICANT hazard
E/I/M

Seven Point Analysis

To help identify hazards, for each step ask Can I?:

be struck by or against anything

strain or sprain my back or other muscle

be caught in, on or between anything

come in contact with a hazardous

slip, trip or fall from height, on the same or substance
lower level

come in contact with an energy

be injured by poor plant/job design
source

SEQUENCE OF BASIC STEPS

List the 4 to 8 steps required to
complete the job (Follow the flow of
the product or the process)
Step
No.

POTENTIAL SIGNIFICANT HAZARDS

List the potential SIGNIFICANT hazards beside
each step. Focus on what can cause harm and
what can go wrong
(Use the Seven Point Analysis as a guide)
Step
No.

HAZARD CONTROL METHOD

List the control methods required to
ELIMINATE, ISOLATE or MINIMISE
each SIGNIFICANT hazard
E/I/M

Task Analysis Sign-off

All persons involved in Task Analysis have been trained in the processes
NameSignature..
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Toolbox Safety Meeting Minutes

PROJECT/SITE

EMPLOYER

FOREMAN/SUPERVISOR

DATE

PRINCIPAL

Attendees:

Signatures of attendees:

Site activity/safe work practices/accident/incident investigations discussed:

Employee issues raised:

Safe observations reviewed/discussed:

Date to be
resolved by:

Task Analysis completed/reviewed:

Date:

Pre-start Site Assessment

PROJECT/SITE

ASSESSOR

SIGNED
DATE

Hazards
Height/Overhead Work:
Falling material
Ladders
Scaffolds
Roofs
Cranes
Elevated work platforms

Trenches/Confined Spaces:
Pits and trenches
Tanks
Shafts
Confined spaces

Plant:
WoF/current test tag
Machine guards
RCDs
Leads
Vibration

Controls

General Environment:
Public access/protection
Signage/barriers
Organisation/housekeeping
Wet/slippery environment
Hazardous materials
Chemicals
Services (gas/water/power)
Exposure to weather
Extreme temperatures
Traffic
Noise
Dust and debris
Explosion/fire
Machinery
Mobile plant

Personal Protective Equipment:

Safety boots
Hearing protection
Eye protection
Hi viz clothing
Safety helmet
Respiratory protection

General Comments and Observations:

Self Safety Inspection Checklist

PROJECT/SITE

EMPLOYER

Safety representative:

Inspection by:
Date:

Remedial complete (sign/date):

1
1.
1.
1.
1.
1.
2
2.
2.
2.
2.
3
3.
3.
3.
3.
4
4.
4.
4.
4.
5
5.
5.
5.
5.
5.
5.
5.
6
6.
6.
6.
6.
6.
6.
6.
7
7.
7.
7.
8

Site Control
/x
Hazard board and signage up-toEnvironmental plan issues
Toolbox Talk last date
/
Safety inductions for all on site
Safety notice board current
Site Facilities
Offices clean, adequate and
Smoko sheds clean, potable
Toilets clean, washing water
Tool/equipment sheds adequate
General Site Tidiness and
Clear, safe access to work areas
Stairways and accessways clear
Hoardings/fence and gates
Loose materials secure from
Personal Safety Equipment
Signage displayed and legible
Hardhats being worn
Correct footwear being worn
Glasses/ear muffs/vests/masks
First Aid/Fire Prevention
First Aid box
Availabl
Curre
Accident register
Fire
Available
Current (12 mth)
Sufficient
Evacuation
Procedure
All emergencies
Cranes/Hoist/Lifting Equipment
Proper lift assessment plan done
Crane certification current
Slings/chains certified
Operator procedures in place
Inspections being done
Man cage available
Emergency plan in place
Compressed Air Equipment
In good condition
Appropriate guards fitted
Trained user
Excavations correctly shored

9
9.1
9.2
9.3
10
10.
10.
10.
10.
10.
10.
10.
10.
11
11.
11.
11.
12
12.
12.
12.
13
13.
13.
13.
13.
13.
13.
13.
13.
13.
13.
13.
14
14.
14.
14.
14.
15
15.
15.

Welding/Gas Cutting
Hot work permits being issued
Fire extinguishers on hand
Operators using PPE
Electrical Equipment
Main board
Current tagged and damageCurrent tagged plant
Current tagged lifeguards
Leads safely placed
Equipment in good condition
Appropriate guards on
Adequate temporary lighting
Chemicals
Correctly stored
Safety Data Sheet (SDS)
Operators using PPE
Tools
PAT tool current and secure
Staff trained in tool use
PAT signage on site
Scaffolding
Notifiable weekly
Handrails/mid-rails
Toe boards
Platforms
Ladders/stairs
Base sound
Work platforms clear
Platforms trip free
Planks tied down
Headroom clear
Ties/bracing adequate
Ladders
Good condition
Secured top and bottom
Stays to step ladders
Working 2 steps down
Fall Hazards
Floor edges
Floor
Lift shafts
Stairs
Excavations

/x

Remedial Action Schedule

ITEM

COMMENTS/ACTION DESCRIPTION

PERSON TO
ACTION

COMPLETE

Emergency Plan and Procedures for Hazardous Work

PROJECT/SITE

EMPLOYER

Potential Emergency
Situations

List separately:

Procedure:

Responsibilities

Personnel:

Key responsibilities:

Evacuation Procedures

Visitors:
Assembly areas:
Alarms:

Medical Treatment

Training and

First Aiders:

Emergency services:

Location of nearest
medical centre:

Key subcontractors telephone numbers:

Procedure to advise site staff:

Communication

Emergency Evacuation Plan

Emergency Evacuation Plan
In the case of emergency requiring evacuation of the project, either:
FIRE, EARTHQUAKE, SERIOUS ACCIDENT, STRUCTURAL COLLAPSE, TSUNAMI,
EXPLOSION, AVIATION INCIDENT, HAZARDOUS SPILL OR PRACTICE
EVACUATION
The following warning will sound:
______________________________________________________________________________

If this warning sounds, SHUT DOWN all plant and equipment.

All personnel on the project are to proceed IMMEDIATELY by the
SAFEST IDENTIFIABLE ROUTE to the SAFE ASSEMBLY POINT

And REMAIN there, so ALL personnel can be ACCOUNTED FOR

DO NOT RETURN to the project until the project manager has given the
OFFICIAL CLEARANCE
MEDICAL FACILITIES LOCATED AT:

When calling 911, READ THE FOLLOWING TO THE DISPATCHER:

We have an emergency at
We need help from Ambulance/Fire
Directions to the emergency are
Our phone number is
The medical problem seems to be
Send someone outside to meet the emergency services

EMERGENCY TELEPHONE NUMBERS:

Dial 111 for:
FIRE, AMBULANCE, POLICE, GAS, CHEMICAL SPILLS
PHONE NUMBERS MAY DIFFER CHECK YOUR LOCAL DIRECTORY
HOSPITAL
(
)
WORKSAFE Safety
(
) ________________________

POISON CENTRE
(_______) _____-__________
POWER (Customer Service)
(
)
24hr Faults
(
)
Subcontractors on site:
(
)
SAFETY MANAGER IS:
TRAINED FIRST AIDER IS:
FIRST AID KIT AND FIRE EXTINGUISHER LOCATED AT SITE OFFICE
OR:

Accident/Incident Register
PROJECT/SITE
Date
Details:
and
Time
Name of person (injured or observer):
Description of accident/incident/near miss
Cause of harm (if any)
Type of injury/disease (if any)

EMPLOYER
Immediate action
taken:

First Aid
Corrective
action
Review Hazard
Register

Serious
Harm
Y/N

WORKS
AFE
Notified
Y/N
Date

Investigation
actioned and
documented
Y/N

Investigation
outcomes
discussed at
safety meeting
on:

Notice or Record of Accident/Serious Harm

1. Particulars of employer, self-employed
person or principal: (Business name,

postal address and telephone number)

2. The person reporting is:

 an employer
 a principal
self-employed person

a

3. Location of place of work:

(Shop, shed, unit nos., floor, building,

street nos. and names, locality/suburb, or
details of vehicle, ship or aircraft)
4. Personal data of injured person:




(Specify all)

Sex (M/F)

5. Occupation or job title of injured

person:

(Employees and self-employed persons

only)

6. The injured person is:

 an employee
 a contractor
(self-employed person)
 self
 other
7. Period of employment of injured
person:

(Employees only)
 1st week

12.
Body part:
 Head
 Neck
Trunk
 Upper limb
 Lower limb
Multiple locations
 Systemic internal organs
13.
Nature of injury or disease:
Fatal

Name
Residential
address

Date of
birth

11.
Agency of accident/serious harm:
 Machinery or (mainly) fixed plant
 Mobile plant or transport
 Powered equipment, tool or appliance
 Non-powered handtool, appliance or
equipment
 Chemical or chemical product
 Material or substance
 Environmental exposure (e.g. dust,
gas)
 Animal, human or biological agency
(other than bacteria or virus)
 Bacteria or virus

 1st month

 1-6

 Fracture of spine

Puncture wound
 Other fracture
 Poisoning or
toxic effects
 Dislocation
 Multiple
injuries
 Sprain or strain
 Damage to
artificial aid
 Head injury
 Disease,
nervous system
 Internal injury of trunk
 Disease,
musculoskeletal system
 Amputation, including eye  Disease,
skin
 Open wound
 Disease,
digestive system
 Superficial injury
 Disease,
infectious or parasitic
 Bruising or crushing  Disease,
respiratory system

months
 6 months-1 year
 Over 5 years
 Non-employee

 1-5 years

8. Treatment of injury:
 None
 First Aid only
 Doctor but no hospitalisation

Hospitalisation

am/pm

Date

Shift
Afternoon

 Day
 Night

14.
Where and how did the
accident/serious harm happen?

(If not enough room, attach separate

sheet or sheets)

9. Time and date of accident/serious

harm:
Time

 Foreign body
 Disease,
circulatory system
 Burns
 Tumour
(malignant or benign)
 Nerves or spinal chord
 Mental
disorder

Hours worked since arrival at

work

(Employees and self-employed

persons only)
10.
Mechanism of accident/serious
harm:
 Fall, trip or slip
 Hitting objects
with part of the body
 Sound or pressure
 Being hit by
moving objects
 Body stressing
 Heat, radiation
or energy
 Biological factors

Chemicals or other substances
 Mental stress

15.
If notification is from an employer:
(a)
has an investigation been carried
out?
 Yes
 No
(b)
was a significant hazard involved?
 Yes
 No

Signature and date:

________________________

___ / ___ / ___

Name and
position:

(Use capitals)
Check that the details on this copy are complete and forward it to your nearest
WorkSafe office

Accident and Incident Investigation Report

EMPLOYER

BRANCH/DEPARTMENT

NAME OF INVESTIGATOR
PARTICULARS OF INCIDENT
Day of Incident
(circle)

Time

Project/Site

Date Reported

M T W T F S
S
INJURED PERSON
Name:
Age:
Phone number:
Reported date of incident:

Address:

Length
of
Time on job:

TYPE
OF  Bruising
 Other
Dislocation
 Strain/sprain 

Internal
(specify)
Scratch/abrasion
 Fracture

Amputation

Foreign Injured part

 Burn scald
 Chemical of body:
Laceration/cut
DAMAGED PROPERTY
Property/material damaged:

employment:
Remarks:

Nature of damage:
Object/substance inflicting damage:

INCIDENT
Description
Describe what happened (space overleaf for diagram essential for all vehicle
incidents):

Analysis
What were the causes (root and contributing causes) of the incident?
Root causes safety system failures:

Contributing causes unsafe acts and conditions:

Prevention
What action has or will be taken to prevent a
recurrence?
Tick items already actioned (use space overleaf if
required)

Completed

X

By
whom

TREATMENT AND INVESTIGATION OF INCIDENT

Type of treatment given:
Name of person giving Doctor/Hospital:
First Aid:

Incident investigated by:

Date:

WORKSAFE
advised:
Yes
No

Signed by: Employer.......and

Employee...

Date:
/

When

NOTES:

Safety Training and Competency Register

This register is a record of training, qualifications, experience and competencies
for your employees. Complete the register for each employee, noting Site Safe
training that has been completed, along with other safety and trade training
undertaken. List certificates, licences and other formal qualifications in the
column to the right of the training section.
Other
Site
Safe
Training
(See
key
below)

Trade
and
Skills
Training
(Specify
all
types)

Formal
Qualifications,
Certificates,
Licences, and
Unit
Standards
(Specify all
types)

Competence

Level of
Competence in
Current Job
(use LULU)

Date

Current
Site
Safe
Card
Expiry
Date

Training, Qualifications,
Experience

No. Years
Experience in

Name

Site
Induction

Current
Site
Safe
Card
Type
and
Number
(See
key
below)

Key:

Site Specific Safety Plan Evaluation

This evaluation process assumes that the contractor has already submitted their
health and safety systems to the client and that the client has approved these
systems. The purpose of this evaluation is intended to provide the client with
confidence that the contractor is aware of their responsibilities and has
procedures in place that meet these responsibilities on this specific project.