Free practical template

Critical control
verification.

Use this template at the point of work to check whether a critical control is present, effective and likely to remain effective.

Verification details

Record where and when the check took place.

Project / workplaceTask / activityLocationDate and timePerson completing verification

What matters

Keep the event, control and required standard specific.

Material unwanted eventWhat serious event could occur? Who or what could be affected?Critical controlWhich control must work to prevent the event or reduce its consequence?Performance requirementWhat must be true for this control to be considered effective?

Check the control

Verify through observation, conversation and evidence—not assumption.

The control is present and available at the point of work.The control meets the defined performance requirement.People understand the control and their role in maintaining it.The control is being used as intended.Nothing has changed that could reduce its effectiveness.

Evidence observedRecord what you saw, tested, discussed or reviewed.

Outcome and action

Choose one outcome. Act immediately if the control is not effective.

EffectiveThe control meets the requirement.At riskA gap could reduce effectiveness.Not effectiveStop or make safe before work continues.

Immediate action takenWhat was done to make the situation safe?Further action requiredWhat needs to happen to restore or strengthen the control?

Action ownerDue dateClose-out verified byClose-out date

Important: This template supports field verification. It does not replace competent advice, consultation, legal duties, risk assessment or workplace requirements.

Critical controlverification.

Verification details

What matters

Check the control

Outcome and action

Critical control
verification.