ADI UK Rochdale HSE Gemba - Repairs / Mezzanine / Offices / Reception

• Conducted on

  Date

• Prepared by

• Location
  Address

Repairs

• Lighting adequate?

  Safe

  At Risk

  N/A

• Aisle & floors clean, pallets in line?

  Safe

  At Risk

  N/A

• Stairwell clean & free from obstruction?

  Safe

  At Risk

  N/A

• Emergency exits clear of obstruction?

  Safe

  At Risk

  N/A

• Mezzanine Safety Gate is good condition?

  Safe

  At Risk

  N/A

• Kick stools / safety steps in good condition?

  Safe

  At Risk

  N/A

• Employees using handrail on stairs?

  Safe

  At Risk

  N/A

• Aerosols cabinet tidy and closed?

  Yes

  No

  N/A

• Any trip hazards from office equipment?

  Safe

  At Risk

  N/A

• Substances not in use returned to storage cupboard?

  Safe

  At Risk

  N/A

• Are tools and work equipment not in use stored correctly?

  Safe

  At Risk

  N/A

• Are hand tools and power tools in good condition?

  Safe

  At Risk

  N/A

• Broken pallets in use?

  Safe

  At Risk

  N/A

• Tier 1 board up to date - review Cell Level Risk Assessment?

  Safe

  At Risk

  N/A

Mezzanine

• Lighting adequate?

  Safe

  At Risk

  N/A

• Aisle & floors clean, pallets in line?

  Safe

  At Risk

  N/A

• Pallets & loads thoroughly secured?

  Safe

  At Risk

  N/A

• Broken pallets in use?

  Safe

  At Risk

  N/A

• Emergency exits clear of obstruction?

  Safe

  At Risk

  N/A

Office

• Any trip hazards from office equipment?

  Safe

  At Risk

  N/A

• Emergency exits clear of obstruction?

  Safe

  At Risk

  N/A

• Tier 1 board up to date - review Cell Level Risk Assessment?

  Safe

  At Risk

  N/A

• Fridges and drink machines clean?

  Safe

  At Risk

  N/A

Reception

• Any trip hazards from office equipment?

  Safe

  At Risk

  N/A

• Floors clean, dry and free of obstructions & trip / slip hazards?

  Safe

  At Risk

  N/A

• Employees using hand rail on stairs?

  Safe

  At Risk

  N/A

• Emergency exits clear of obstruction?

  Safe

  At Risk

  N/A

• Sign in - out book up to date?

  Safe

  At Risk

  N/A

• Drink machines clean?

  Safe

  At Risk

  N/A

Employee Behaviour Observation Checks

• 

• Evidence of heft test / is the employee aware of load contents?

  Safe

  At Risk

  N/A

• Is the employee adhering to a Good Posture / loads suitable for manual handling?

  Safe

  At Risk

  N/A

• Is the employee over-stretching / twisting?

  Safe

  At Risk

  N/A

• Is the employee holding the load close to trunk?

  Safe

  At Risk

  N/A

• Discuss unsafe observation programme with employee.

  Safe

  At Risk

  N/A

• Discuss unsafe observation programme with employee.

• Discuss evacuation procedure with employee.

• Discuss accident reporting with employee.

• Any recognition: