Title Page

  • Conducted on

  • Prepared by

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

  • Min/Max Adherence: No overflow condition exists. Supplies, components, WIP, FG, and empty packaging are within defined limits. No parts are on the floor.

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

  • Personal Items: Area is free of personal items except in explicitly designated locations.

  • Paperwork Current: All paperwork (including that posted on the Team Board) and signage is current.

  • Slip/Trip Hazards: Area is free of trip/slip hazards

  • Safety Item Accessibility: Exits, fire extinguishers, eyewash stations, spill kits, e-stops, etc are accessible.

  • 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.

  • Scrap and Non-Conforming Material: Scrap and non-conforming material is stored in proper, identified locations.

  • 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.

  • Fans: All fans in the area are clean with no dust accumulation or debris on blades or grille.

  • Waste removal: Standard Garbage, 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: Nothing is stored on top of panels, they are secured and in good condition, and there is 3' clearance.

  • Please Stop and correct condition.

  • Light Fixtures: Tops of light fixtures are clean

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

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

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

  • Walls & Columns: Walls, including mesh and tarp walls, are clean.

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

  • Labels/Kanban tags & Sequence Labels: ALL labels, Kanbans and Sequence signs are clean and of good appearance. Contents match labelling.

  • End of Shift 5S Expectations are posted: 5S Expectations (Form 4766) is available for every employee.

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

  • Sign off for 5S Audit completed:

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.