Use these score criteria for your inspection:

3 - There is an ability to maintain it.
2 - This is being complied with more systematically.
1 - It is done but not systematically.
0 - Not at all.
N/A - Not Applicable


Is the floor area free of unwanted items?

Are tops and insides of all cupboards, shelves, tables, etc. free of unwanted items?

Are items stored according to frequency of use?

Are walls free of old posters, calendars, pictures , notices etc.?

Is there a general clutter free appearance?

Capture photo\(s) of red tagged items

Are direction indications available to all facilities from the entrance onwards?

Do all items of equipment have identification labels?

Are all rooms, cubicles and similar areas clearly numbered or named?

Are specific areas demarcated for garbage/rejects/waste, etc.?

Are switches, fan regulators, controls, etc. labeled?

Are all cables, wires, pipes etc. neat and straight?

Is colour coding used effectively for easy identification?

Is there a general appearance of orderliness?

Is it easy to find any item/document without delay?

Identify and allocate a place for all the materials needed for your work.


Are cleaning schedules available and displayed?

Are floors, walls, windows doors etc. maintained at a high level of cleanliness?

Is use of adequate cleaning tools evident?

Are machines, equipment, tools, furniture maintained at a high level of cleanliness and their maintenance schedules displayed?

Is there a general appearance of cleanliness all round?


Is a daily checklist used to standardize 5s procedures?

Are standard check lists used to regularly inspect 5S?

Are labels, notices etc. standardized?

Do isles/gangways have a standard size and colour?

Are pipes, cables etc. colour coded?


Is there a system for how and when the 5S activities will be implemented?

Does management provide support to 5S programme by recognition, resources and leadership?

Have first 3S become a part of the daily work?

Do employees show positive interest in 5S activities?

Are 5S posters and 5S points of work reminders displayed?

Are trainings and other programs implemented to sustain workplace organization?


Click + Add to add a Job Step of the task being assessed


Enter job step description

Potential risk or hazard identified while task is being performed (select all that apply)

Enter other potential risk/s identified

Rate risk/ hazard before control measures

Take a photo of step/ activity (Optional)
Hazard Control Measures

Engineering Controls

Administrative Controls

Personal Protective Equipment

Other preventive measures



Overall Rating

Full Name and Signature of the Inspector
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.