Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Inspected by

  • Location
  • Criteria:
    EXCELLENT: Comply with the criteria without exception.
    AVERAGE: Comply with the criteria with minimal exception.
    POOR: Does not comply with the criteria.


  • Materials, parts or components • Are materials moved in a timely manner?

  • Machines and other equipment • Are there any unused machines or other equipment around?

  • Visual control • Are all waste materials in the correct skips?

  • Containers • Are customer packaging stored safety & incorrect locations?

  • Is unused equipment and machinery eliminated from the area?

  • Is the floor clear of all tools, spare parts, and materials?

  • Are the floors in 'common areas' free of trash and debris?

  • Are obsolete inventory and raw material eliminated from the area Ike below the table?

  • Is the work in process organized so as to reduce travel time and other forms of waste?

  • Is the work in process inventory reduced to the least possible amount?

  • Are aisles, doorways, electrical panels, and fire extinguishers free from material and blockages?

  • Are tripping hazards and obstructions eliminated from the area?


  • Location indicators • Are Sub-Con locations clearly marked?

  • Item Indicators • Are shelves clearly marked with location?

  • Quantity Indicators • Are Finished Goods stacked to correct No. of boxes?

  • Parking/loading docks • Are all unused trucks and forklifts parked in the designated area?

  • Material storage • Is stock rotation (FIFO) being adhered to?

  • Are work areas, storage areas, and equipment surroundings clearly labeled, marked, and/or footprinted if necessary?

  • Are storage places for tools and equipment designated and marked?

  • Are storage places for work in the process designated and marked?

  • Is machinery, storage equipment and columns identified and numbered?

  • Are all pipes, controls and gauges identified and labeled to show function or purpose?

  • Are team bulletin boards current and in good order?


  • Floors & gangways • Are floors, exits & entrances kept clear, clean and free of waste?

  • Work Surfaces • Are work surfaces clean & tidy?

  • Cleaning Responsibilities • Is the person responsible for allocating cleaning duties? (Stores Supervisor)

  • Habitual cleanliness • Is the set standard being maintained?

  • Are recycling bins located as necessary with trash and recycling being controlled in the area?

  • 5S holding and disposal areas are well maintained?

  • Are slot locations free of empty pallets and trash?

  • Are machines clean, well kept and in good repair?

  • Are slot locations in pick ready condition?

  • Are slot locations free of hanging shrink wrap or banding?

  • Are floors and equipment in the area free of dirt/grease or fluids?


  • Concerns sheets • Are concerns regularly being generated?

  • Concerns • Are concerns regularly being acted upon?

  • Operation standards • Are Operation Standards written, clear and actively used?

  • Check Sheets • Have checks been carried out & documentation completed?

  • Are shine maps available and employees aware of responsibilities

  • Is there a standard work in place including quality checks, and usege of work stations?

  • Are bins and parts property identified and labeled?

  • Are supplies labeled and in their place?

  • Are footprinted and labeled areas adhered to?

  • Are visual safety signs and floor markings used to identify hazards in the area?


  • Training • Is everyone adequately trained in 5S procedures?

  • Parts • Are parts being stored correctly?

  • Timed Deliveries • Are times being adhered to?

  • Cleaning routine • Is cleaning routine present & are ail toots & materials available?

  • Hourly monitor • Are supplier delivery times adhered to?

  • Are all start-up safety checks carried out and documented?

  • Is everyone within the area wearing proper personal protective equipment?

  • Are unused tools, equipment, raw materials and work property stored?

  • Are emergency plans, labels, and equipment visible and property stored in the area?

  • Are corrective actions from 5S audit identified and adhered to?

  • Are employees receiving weekly feedback on their 5S efforts?

  • Is there evidence of the 5S daily checklist being used and updated 5S audit scores on the teamboard?


  • 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.