Title Page

  • Conducted on

  • Prepared by

  • Location
  • Exit Route: Map is posted and route is unobstructed

  • Unused tools, parts, or equipment: Area is free of unused tools, equipment or parts - and free of those used by other departments.

  • Slip/Trip Hazards: No trip/slip hazards

  • Shadowboards: Board is fully stocked and items are returned to board when not in use.

  • Coat racks and personal belonging cabinets: Fixtures and area are clean and well organized.

  • Racks/Bins/Cabinets/ Furniture: All are clean, in good appearance and being used for intended purpose.

  • Computers/Printers/ Scanners & Related Wiring: Equipment is clean and appears to be operating properly. Cables/wires are well organized and secure.

  • Waste removal: Standard Landfill, Paper, Plastic/Bottle, and Compost bins are in proximity. Bins are clean and not overflowing.

  • Lighting: Lighting appears sufficient for area. All bulbs are working and clean.

  • Electrical Panels: Verify that nothing is stored on top of panels, that they are secured and in good condition, and that there is 3' clearance.

  • Please correct condition immediately.

  • Light Fixtures: Tops of light fixtures are clean

  • Floor: Floor appears clean and recently swept/mopped.

  • Under conveyors: Areas under conveyors appear clean.

  • Mutilation protection: Area mutilation protection is in place where appropriate and is in good condition.

  • Painted Surfaces: Painted surfaces are in good conditions - in particular, yellow painted surfaces that are prone to damage.

  • Common Areas: Adjacent common areas falling within zone are free of 5S concerns - clean floor and railings, paint in good condition, and lighting functioning.

  • Labels/Kanban tags: ALL Labels/Kanbans are clean and of good appearance. Contents match labelling.

  • Work cells and individual stations are identified.: Cell/Line and individual stations are identified with standard MAFACT signage.

  • Movable items: Movable items have homes defined by shadowboxing/signage and items are located to standard.

  • Min/Max Inventory levels adherence/defined: Min and Max inventory levels for stocked supplies, components, WIP, and empty packaging are clearly communicated with signage, shadowboxing, or other visual signals.

  • Please enter Auditor's Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.