Information
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Site
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Centers are required to conduct and document daily/weekly/monthly inspections. Results of the inspection are recorded below. In the event a deficiency is identified but cannot be corrected, the Safety Officer, Dorm Coordinator, Department Manager or Building Manager will submit a maintenance work order. Completed checklist must be returned to the Center Safety Officer, [CSO]. Not all areas are inspected; however, this report shows the findings of those areas inspected.
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Areas of the inspection are conducted at random. Not all items will be inspected. As such, not all deficiencies or good practices will be observed or noted. Please ensure you are always inspecting your areas. Please use this report as a guidance on how to conduct your own inspections within your area. Please also share this report with your staff within your areas to improve on Safety within your area.
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Please share with your staff to make improvements to safety related issues.
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Conducted on?
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Prepared by
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Document Number
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If deficiencies were found, they must be corrected by the date provided. Afterwards, you will need to notify the Safety Officer by no later than the date provided by email & accompanying photographs. If there were no deficiencies, then please just share the findings with your staff.
Comments notated on the Departmental Safety Inspections
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Reason for inspection
- Complaint Investigation
- Fire Safety
- General Safety
- General Walkthrough
- Great Job
- Hazard/Near Miss Issue
- Observations
- Pre-Inspection Walkthrough
- Request for Inspection
- Safety Violation
- Other Safety Issues
- Daily Inspection
- Weekly Inspection
- Monthly Inspection
- CTST Project Inspection
- Issues found previously have been corrected
- Other, please see notes.
- Safety Hazard
- Tripping Hazard
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Is the Hazard/Near Miss eligible for the contest?
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Student or Staff's Name:
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Student or Staff's ID #:
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Notes or comments from the area Manager or staff
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Notes from the Safety Officer
Monthly Fire/Sprinkler Inspection (PM)
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Finding Summary
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The Inspection revealed the following
- Looks good.
- No deficiencies found
- Delta Fire has been made aware and the system is operational.
- Please ensure to enter a Work Order to correct the noted deficiency.
- Safety Officer corrected this issue
- It would benefit your area and staff to have additional training on this issue.
- Refrain from further use, until the Safety Officer has a chance to review the OSHA Standards further.
- Other
- Follow-Up Needed
- Issue has been notated multiple times.
- Corrections were made, thank you
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You will need to correct the deficiency and notify the Safety Officer no later than
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Department Manager
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If there were any deficiencies found, you will need to notify the Center Safety Officer once they are corrected, so a follow-up inspection can be completed.
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Items inspected are at random. As such, the findings will be listed below.
Below are the results of our findings.
- Good Practices / Deficiency Finding
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Where is this finding located?
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- AED Machine / Oxygen / First Aid Supplies
- Cleaning
- COVID Signage
- Electrical
- Emergency Lighting / Exit Sign Issues
- Extension Cord
- Eyewash Station
- Fire Extinguisher Inspection
- Fire Hazard
- Fire System
- GFCI Outlets
- GHS Labels
- Hazard/Near Miss
- Housekeeping
- Issues found previously have been corrected
- Laundry
- Light Covers
- Locks
- Logs
- Maintenance Issue
- Maps
- Missing cover
- Monthly Departmental Safety Inspection
- Other
- Other Notes / Thoughts
- Restrooms
- Safety Hazard
- SDS Book
- Signage
- Showers
- Sinks
- Space Heater
- Stairs
- Storage Issue
- Supplies
- Surge Protector
- Toilets
- Training Issue
- Trash
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The Inspection revealed the following;
- Compliant
- Non-Compliant
- No Deficiencies
- Non-Compliant > No Work Order has been submitted.
- Non-Compliant > Work order was submitted - Will not count against Dorm Score
- N/A
- Not Inspected on this day
- Follow-Up Needed.
- Follow-Up completed. Deficiency(s) have been Corrected.
- Corrected
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You will need to correct the deficiency and notify the Safety Officer no later than
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Notes or other Comments
Digital Sound Level Meter
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