Compliance Field Assessment Form
Use this form to assess compliance standards at field sites. Please complete all sections based on your observations.
Field Site Name
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessor Name
*
Site Cleanliness
*
1
2
3
4
5
Safety Compliance
*
Not compliant
1
2
3
4
Fully compliant
5
1 is Not compliant, 5 is Fully compliant
Required Documentation Present?
*
All present
Some missing
None present
Equipment Condition
*
1
2
3
4
5
Staff Adherence to Procedures
*
Never
1
2
3
4
Always
5
1 is Never, 5 is Always
Compliance Assessment Table
*
Rows
Not compliant
Partially compliant
Fully compliant
Signage visible
1
2
3
Hazard controls in place
4
5
6
Access restricted as required
7
8
9
Additional Comments or Observations
Submit Assessment
Should be Empty: