What it's for
One site, one plan: who is in charge, where the nearest hospital is, which hazards you expect and how each is controlled, who else is working there and who has read the plan. This site specific safety plan template puts all of it on one Word form, and it works as a construction safety plan template for a small firm's own jobs.
The superintendent or safety lead fills it in before work starts, the approver signs, and the crew signs after going over it.
The form supplies no hazards, controls or procedures. What goes on each line is your call, from the job in front of you. It sits beside three other forms: a job hazard analysis breaks one task into steps, a construction safety checklist is for walking the site, and a toolbox talk sign-in sheet records a crew meeting.
What's inside
Four Letter-size pages, with our logo, a credit link and the page number in each footer. The pale yellow boxes are yours to fill in and nothing calculates. Page 1 opens on your letterhead, the title SITE SAFETY PLAN, and Plan no. and Date.
Page 1
- PROJECT: PROJECT, SITE ADDRESS, OWNER, GENERAL CONTRACTOR, START DATE and PLANNED COMPLETION.
- EMERGENCY INFORMATION: EMERGENCY NUMBER, NEAREST HOSPITAL, HOSPITAL ADDRESS, ROUTE TO THE HOSPITAL, ASSEMBLY POINT, FIRST AID KIT LOCATION and EXTINGUISHER LOCATIONS.
- SITE SAFETY CONTACTS: six rows under ROLE, NAME and PHONE, with three roles printed: Superintendent, Safety lead and Owner's representative.
Page 2
- SCOPE OF WORK: four numbered lines.
- SITE HAZARDS AND CONTROLS: eight rows under NO., HAZARD, CONTROLS and RESPONSIBLE, numbered 1. to 8.
- SUBCONTRACTORS ON SITE: six rows under COMPANY, TRADE, SITE CONTACT and PHONE.
- PERSONAL PROTECTIVE EQUIPMENT: WORN ON THIS SITE, with eight items to mark (Hard hat, Safety glasses, Gloves, High-visibility vest, Hearing protection, Fall protection, Respirator and Steel-toe boots), then OTHER PPE.
Page 3
- TRAINING AND MEETINGS: SITE ORIENTATION BY, TOOLBOX TALKS HELD and SAFETY MEETINGS HELD.
- INSPECTIONS: SITE INSPECTIONS BY, HOW OFTEN and RECORDS KEPT AT.
- INCIDENT REPORTING: REPORT INCIDENTS TO, PHONE and three numbered lines.
- The PLAN REVIEW block holds the sentence "Signed below, the preparer and the approver confirm this plan describes this site. A completed plan is a record, not a compliance determination." Then PREPARED BY and APPROVED BY, each signing with a printed name and title and a date.
Page 4
- REVIEWED WITH THE CREW: twelve rows under NAME, COMPANY OR TRADE, SIGNATURE and DATE.
How to fill it in
- Delete the words YOUR LOGO and insert your logo. Replace Your Company Name, fill in the address and contact line, then type over the underscores after Plan no. and Date.
- Fill in the PROJECT band.
- Under EMERGENCY INFORMATION, write ROUTE TO THE HOSPITAL as directions someone arriving cold could follow, and check the number and address against a map. Name a specific ASSEMBLY POINT, not "the front".
- Give each printed role in SITE SAFETY CONTACTS a NAME and PHONE. The three blank rows are for anyone else.
- Write the job under SCOPE OF WORK, one piece of work per numbered line.
- Under SITE HAZARDS AND CONTROLS, put one hazard on each row, its control beside it, and a name under RESPONSIBLE. Name the place: "open edge at the east stair opening" tells a crew more than "falls".
- List each firm under SUBCONTRACTORS ON SITE, with its contact.
- Under PERSONAL PROTECTIVE EQUIPMENT, mark what is worn on this site. The boxes are typed characters, not checkboxes you click: type an X over a ☐, or tick it on paper. Anything else goes on OTHER PPE.
- Fill in TRAINING AND MEETINGS, INSPECTIONS and INCIDENT REPORTING in your own words. If you walk the site with a safety checklist or hold toolbox talks, say so and say where those sheets are kept.
- The preparer and the approver each sign under PLAN REVIEW. Then go over the plan with the crew. Each person fills in their NAME and COMPANY OR TRADE, signs and dates it.
Keeping the plan usable
Keep a printed copy where the crew can see it. When the site changes (a new subcontractor, a new hazard, a new assembly point), change the plan, update the Date, reprint the pages that changed, and have new people sign the crew page.
Frequently asked questions
Does it come with hazards or controls filled in?
No. Every line starts blank except the three printed roles, the numbers 1. to 8. on the hazards table and the names of the PPE items.
Does it work in Google Docs or Pages?
Both open .docx files, and this one has no macros, form fields or content controls. Each app lays out Word files its own way, so check the page breaks.
Can I add rows?
Yes. The contacts, hazards, subcontractors and crew lists are ordinary Word tables: click in a row and insert rows above or below it. Their header rows repeat across a page break. The hazard numbers are typed, so number any row you add.
Is a signed plan a compliance record?
The file claims no compliance. The plan review sentence says a completed plan is a record, not a compliance determination, and the file does not decide what applies to your site or your company.