Information
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Audit Title (Enter Facility Name and Month of SOT)
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Zone Number
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Conducted on
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SOT Performed By
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Person Interviewed
Questions
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What concerns you the most about your safety while at work?
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Do you believe that you are adequately prepared for an emergency? (If not, where is improvement needed?)
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How would you change the safety program to make it better?
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What part(s) of the safety program are working well?
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Do you know how and where to report an injury, including first aid injuries? Do you know where the nearest first aid kit is located?
Zone Inspection
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Is/Are the fire extinguisher(s) easily accessible? Have they been inspected in the last 31 days?
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Is fire extinguisher signage visible?
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Is/Are fire extinguisher(s) properly mounted?
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Is the Exit door accessible and unblocked?
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Are the aisles and walkways clear of obstructions?
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Are there any visible trip hazards?
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Are all electrical panels unblocked and accessible?
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Are there objects stored on top of cabinets or shelves that could fall?
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Are there power strips that could potentially be overloaded? Are they free from space heaters?
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Is the housekeeping in the area acceptable?
Hazard Observations
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Any additional hazards observed?
