Title Page

  • Area / Department

  • Conducted on (Date and Time)

  • Inspected by

  • Use these score criteria for your inspection:

    5 – Area fully compliant and team show full understanding
    4 - Progressive area with substantial amount of the area compliant
    3 - Many example of successful implementation
    2 - Some examples but not fully implemented
    1 - Very few instances
    0 - No evidence
    N/A - Not applicable

SORT

  • Is the floor area free of unwanted items?

  • Are work surfaces, local storage, etc. free of unwanted items?

  • Are items stored according to frequency of use?

  • Are walls free from old signs, notices, out dates drawings etc.?

  • Is there a general clutter free appearance?

  • Capture photo\(s) of red tagged items

STRAIGHTEN

  • Are direction indications available to all facilities from the entrance onwards? (Fire exit signage)

  • Do all items of equipment have identification labels? (Tags / serial numbers)

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

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

  • Are switches,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.

  • Capture photo\(s) of red tagged items

SHINE

  • 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 maintained at a high level of cleanliness and their maintenance schedules displayed?

  • Is there a general appearance of cleanliness all round?

  • Capture photo\(s) of red tagged items

STANDARDIZE

  • Is a daily checklist that reflects standards on sort straighten and shine used to standardize procedures?

  • Are standard check lists used to regularly inspect 5S?

  • Are labels, notices etc. standardized?

  • Are current standards being followed, reviewed and improved upon?

  • Are pipes, cables etc. colour coded?

  • Capture photo\(s) of red tagged items

SUSTAIN

  • Have sort-straighen-shine-standardise been fully implemented and funtioning well?

  • Are past audits posted and used for improvement?

  • Capture photo\(s) of red tagged items

SAFETY

  • Are safe work practices in place and being followed? Do any obvious hazards exist that are being overlooked? For hazards identified please Click + Add to add a Job Step of the task being assessed

  • Step
  • 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

  • Capture photo\(s) of red tagged items

Visual Controls

  • Are visual aids in use, up to date and effective in telling how the area is performing, what problems are occurring and what improvements are made?

Continious Flow

  • Has continuous flow been established where possible?

  • Does work / the line move at a steady pace?

Cross Training

  • Are employees skilled at different jobs?

  • Are these skills documented on a skills matrix?

  • Is there a regular job rotation schedule?

Quality

  • Are Quality Control concepts in place?

  • Is there evidence of defect tracking or process recording?

  • Are metrics posted?

  • Are defects address not passed on?

Material Flow

  • Are parts replenished when they are needed, where they are needed, and presented to the operator as needed without disruption?

Employee engagement

  • Are employees actively engaged participating in continuous improvement efforts such as 6S and visual controls?

COMPLETION

  • Recommendation

  • Overall Rating

  • Full Name 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.