Title Page
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Area / Department
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Conducted on (Date and Time)
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Inspected by
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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
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Is the floor area free of unwanted items?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are work surfaces, local storage, etc. free of unwanted items?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are items stored according to frequency of use?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are walls free from old signs, notices, out dates drawings etc.?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is there a general clutter free appearance?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Capture photo\(s) of red tagged items
STRAIGHTEN
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Are direction indications available to all facilities from the entrance onwards? (Fire exit signage)
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Do all items of equipment have identification labels? (Tags / serial numbers)
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are all rooms, cubicles and similar areas clearly numbered or named?
- 5
- 4
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- 2
- 1
- 0
- N/A
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Are specific areas demarcated for garbage/rejects/waste, etc.?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are switches,regulators, controls, etc. labeled?
- 5
- 4
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- 2
- 1
- 0
- N/A
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Are all cables, wires, pipes etc. neat and straight?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is colour coding used effectively for easy identification?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is there a general appearance of orderliness?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is it easy to find any item/document without delay?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Identify and allocate a place for all the materials needed for your work.
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Capture photo\(s) of red tagged items
SHINE
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Are cleaning schedules available and displayed?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are floors, walls, windows doors etc. maintained at a high level of cleanliness?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is use of adequate cleaning tools evident?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are machines, equipment, tools maintained at a high level of cleanliness and their maintenance schedules displayed?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is there a general appearance of cleanliness all round?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Capture photo\(s) of red tagged items
STANDARDIZE
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Is a daily checklist that reflects standards on sort straighten and shine used to standardize procedures?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are standard check lists used to regularly inspect 5S?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are labels, notices etc. standardized?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are current standards being followed, reviewed and improved upon?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are pipes, cables etc. colour coded?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Capture photo\(s) of red tagged items
SUSTAIN
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Have sort-straighen-shine-standardise been fully implemented and funtioning well?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are past audits posted and used for improvement?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Capture photo\(s) of red tagged items
SAFETY
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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
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Enter job step description
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Potential risk or hazard identified while task is being performed (select all that apply)
- Chemical (Toxic, Flammable, Corrosive)
- Explosion (Chemical Reaction, Over Pressurization)
- Electrical (Shock, Short Circuit, Fire, Static, Loss of Power)
- Ergonomics (Strain, Sprains, Human Error)
- Excavation (Collapse)
- Fall (Slip, Trip)
- Fire
- Mechanical (Mechanical Failure, Stuck between objects)
- Noise
- Radiation (Alpha, Beta, Gamma, X-rays)
- Struck by Objects
- Extreme Temperature
- Visibility (lack of lighting, Obstructed vision)
- Weather
- Other
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Enter other potential risk/s identified
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Rate risk/ hazard before control measures
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Take a photo of step/ activity (Optional)
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Hazard Control Measures
- Engineering Controls
- Administrative Controls
- Personal Protective Equipment
- Other
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Engineering Controls
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Administrative Controls
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Personal Protective Equipment
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Other preventive measures
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Capture photo\(s) of red tagged items
Visual Controls
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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?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
Continious Flow
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Has continuous flow been established where possible?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Does work / the line move at a steady pace?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
Cross Training
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Are employees skilled at different jobs?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are these skills documented on a skills matrix?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is there a regular job rotation schedule?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
Quality
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Are Quality Control concepts in place?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Is there evidence of defect tracking or process recording?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are metrics posted?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
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Are defects address not passed on?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
Material Flow
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Are parts replenished when they are needed, where they are needed, and presented to the operator as needed without disruption?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
Employee engagement
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Are employees actively engaged participating in continuous improvement efforts such as 6S and visual controls?
- 5
- 4
- 3
- 2
- 1
- 0
- N/A
COMPLETION
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Recommendation
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Overall Rating
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Full Name Signature of the Inspector