Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Inspected by

  • Location

S1 - Sort - SEIRI

  • No unnecessary items are left or stored in the workplace.

  • All machines and pieces of equipment are in regular use.

  • All tools, fixtures, and fittings are in regular use.

  • Storage area is defined to store broken, unusable or occasionally used items.

  • Standards for eliminating unnecessary items exist and are being followed.

S2 - Set in order - SEITON

  • Locations of tools and equipment are clear and well organized.

  • Locations of materials and products are clear and well organized.

  • Labels exist to indicate locations, containers, boxes, shelves and stored items.

  • Evidence of inventory control exists (i.e. Kanban cards, FIFO, minimum/maximum, etc.).

  • Dividing lines are clearly identified and clean as per standard.

  • Safety equipment and supplies are clear and in good condition.

S3 - Shining - SEISO

  • Floors, walls, ceilings, and pipework are in good condition and free from dirt and dust.

  • Racks, cabinets, and shelves are kept clean.

  • Machines, equipment, and tools are kept clean.

  • Stored items, materials, and products are kept clean.

  • Lighting is enough and all lighting is free from dust.

  • Good movement of air exists through the room (to limit the spread of viruses).

  • Pest control exists and effective.

  • Cleaning tools and materials are easily accessible.

  • Cleaning assignments are defined and are being followed.

S4 - Standardize - SEIKETSU

  • Information displays, signs, color coding and other markings are established.

  • Procedures for maintaining the first three S's are being displayed.

  • 5S checklists, schedules, and routines are defined and being used.

  • Everyone knows his responsibilities, when and how.

  • Regular audits are carried out using checklists and measures.

S5 – Sustain - SHITSUKE

  • 5S seems to be the way of life rather than just a routine.

  • Success stories are being displayed (i.e. before and after pictures).

  • Rewards and recognition is part of the 5S system.


  • Recommendations

  • Full Name and Signature of the Inspector

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.