Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Office Area Inspected

  • Location

Emergency & Fire

Emergency & Fire

  • Are emergency phone numbers posted?

  • Is the Emergency Evacuation route posted?

  • Employees know where to gather in case of evacuation?

  • Are EXIT signs illuminated and visible?

  • All exits and paths are free of obstacles?

  • Employees know how and where to get care for injury/illness?

  • First Aid kits are stocked (bandages, antibiotic ointment, burn cream)?

  • Signs are present for fire extinguishers?

  • Fire extinguishers are mounted, readily accessible and not blocked?

  • Fire extinguishers inspected monthly?

  • Proper clearance of 18" is maintained below sprinkler heads?

General Work Environment

General Work Environment

  • Are all work areas clean and orderly?

  • Are work surfaces kept dry and appropriate means take to assure surfaces are slip resistant?

  • Are all work areas and walkways adequately illuminated?

  • Is the ventilation system adequate?

  • Is the ambien temperature adequate? Not too hot or cold.

  • Are restrooms kept clean and sanitary?

Walking Working Surfaces

Walking Working Surfaces

  • Is carpet or tile flooring secured, will not cause a trip hazard?

  • Are aisles and passageways kept clear and marked as appropriate?

  • Are wet surfaces covered with non-slip materials?

  • Are holes in the floor, sidewalk, or other walking surface repaired properly, covered or otherwise made safe?

  • Are floor openings guarded by a cover, a guardrail or equivalent on all sides (except stairways or ladder entrances)?

  • Are materials or equipment stored in such a way that sharp projections will not interfere with the walkway?

  • Are standard guardrails provided wherever aisle or walkway surfaces are elevated 4 feet or more above any adjacent floor or the ground?

Stairs/Stairways

  • Do all stairways with at least four risers have standard stair rails or handrails?

  • Are all stairways at least 22 inches wide?

  • Are step risers uniform from top to bottom?

  • Are steps slip resistant?

Electrical

Electrical

  • Are all plugs, cords free from splices and insulation, in good condition?

  • Do all extension cords have grounding conductors?

  • Are extension cords or power strips used only temporarily? No daisy chaining?

  • Are cords secured so they do not run across pathways, under doors or walls?

  • Is the breaker panel accessible with 3 feet of clearance in front?

  • Are breaker panels labeled, identifying the function of each switch?

  • Are all unused openings, including conduit knockouts in electrical enclosures and fittings closed with appropriate covers, plugs, or plates?

  • Are electrical enclosures, such as switches, receptacles, junction boxes, etc. provided with tight-fitting covers or plates?

  • Are GFCIs available for use in wet areas?

Copiers, Equipment

Shared Copiers, Printers, & Equipment

  • Are shared equipment such as copiers or printers in good condition?

  • Are tools, such as cutting board blades in good working order? Stored in the down/closed position when not in use?

Material Handling & Storage

Material Handling & Storage

  • Are materials stored to prevent falls and spills?

  • Are storage containers labeled with contents?

  • Are racking/shelving systems in good working order and not damaged in any way that could affect the structural integrity?

  • Are storage racks secure from movement/shifting?

Covid-19 Response

Covid-19 Response

  • Do shared spaces (conference rooms, meeting rooms, break rooms, etc.) have clean supplies available for use?

  • Are these areas cleaned after use by the employees who used the shared space?

  • Do shared spaces have chairs spaced 6ft. apart to maintain physical distancing or barriers in place to separate each person?

  • Does everyone wear proper face coverings when 6 feet of separation cannot be maintained?

  • Is hand sanitizer, disinfecting wipes, cleaning spray, etc. available in common spaces?

  • Do restrooms have physical distancing measures in place such as utilizing every other sink or urinal, etc.?

  • Are shared tools adequately cleaned between uses?

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.