Title Page

  • Station Name

  • Audited on:

  • Auditor Name

  • Location
  • Staff Present - Names

Exterior/Paths/Grounds/Lighting/General

  • Is the Traffic Lights IPC Zone system implemented and evident from entry point?

  • Is the ground surface smooth with no slip trip hazards?

  • Salt available to treat frosty ground?

  • No bushes / hedges / weeds overhanging?

  • Is their sufficient External Lighting?

  • Is there safe separation of pedestrians and vehicles (walkways, bollards etc)?

  • Access Control Functional - All staff have cards?

  • Are all windows and doors secure?

  • CCTV Notice in place? All CCTV Functional?

  • Are Stairs and corridors clear, No inappropriate storage?

  • STF/STAIRS or any other safety signs all in place. Click No to list signs required.

  • A3 Poster - Employers/Employees Obligations present?

Kitchen Area

  • Floors, Walls, Ceilings, sound? Lighting safety caged?

  • Is there liquid mosituriser, and signage/instructions available for hand hygiene?

  • Is there disposable towels and a dispenser ?

  • Potable / Filtered water available?

  • Worktops, cooker, kettle, microwave, tables, chairs, foot operated bin etc in safe condition?

  • Is there a fridge clean notice for out of date foods?

  • Fridge/Freezer free of Ice build up?

  • Is all food, bread etc in suitable safe containers?

  • No evidence of infestation or animals?

  • No inappropriate items stored in kitchen?

Crew/Duty Room

  • Floors, Walls, Ceiling, Sound? Lighting Safety Caged?

  • Floor covering safe / clean / not worn?

  • Chairs / Furniture cleanable no penetration in fabric which alter flammability and in good order?

  • Tidy, uncluttered, no extension leads?

Female Facilities

  • Floors, Walls, Ceilings, sound? Lighting Safety Caged?Seating Present?

  • Sanitary Bins maintained and on contract?

  • No Clothing or other equipment stored in toilet area?

  • Toliets & sinks clean, all fittings and fixtures safe? No wooden parts?

  • Shower cubicles clean & safe, no shared towels or washgear?

  • Shower head & Sink legionella process in place?

  • Opaque Glass / blinds on windows, locks, lights etc functional?

  • Handwash signage, Mositurising soap, and disposable towels/dispensers in place?

  • If lockers present - clear uncluttered, sufficient in number, named & no items stored overhead?

Male Facilities

  • Floors, Walls, Ceilings, sound? Lighting safety caged?Seating present?

  • No Clothing or other equipment stored in toilet area

  • Toilets, Urinals & sinks clean, all fittings and fixtures safe? No wooden parts?

  • Shower cubicles clean & safe, no shared towels or wash gear?

  • Showerhead & Sink legionella process in place?

  • Opaque glass / blinds on windows, locks, lights etc functional?

  • Handwash signage, Mositurising Soap, and disposable towels/dispensers in place?

  • If lockers present - clear unclutered, sufficient in number, named & no items stored overhead etc?

Garage / Parking Area.

  • Roller doors, Gates etc all serviced and completely functional?

  • Floor / Ground clean and in good order, no obstructions?

  • Drop out chargers all in good order and service maked.

  • Is there safe separation of vehicles & pedestrians?

  • Lighting sufficient?

  • Ventilation, and prohibition of running engines signs present?

  • Clinical and general waste disposal - pedal operated bins?

  • Fuel / Oil spill materials and tools present?

  • Any equipment stored is clean, undamaged, and safely stored - free of dirt, dust, debris and off the ground?

  • No inappropriate storage?

  • Oxygen cage on site, correct signage, chains and restraints in use?

Stores Area

  • Area is clean, well laid out?

  • Safe and sufficient shelving / storage systems?

  • No Manual Handling hazards present(too high/too low)?

Wash/Sluice Area

  • Area Clean, Dry, Tidy and free from spillages?

  • Clinical & General waste bins provided are fit for purpose?

  • All equipment, Grimebeat, AdBlue stored safely?

  • All relevant PPE present - Goggles, Aprons, Gloves etc?

  • Chemicals safely stored, appropriate signage etc in use?

  • Disposable mops in use, segragated buckets etc?

  • Handwash facilities, signage, paper towels , dispensers and soap in place?

Waste (All Types)

  • Are General and recyclable waste separated?

  • Clinical bins being used for clinical waste only?

  • Waste posters and signage in place and being adhered to?

  • All sharps bins correctly marked and disposed of safely per policy?

  • Clinical waste bags sealed, tagged and in Big yellow bin at 3/4 full?

  • All clinical waste and full sharps bins in large bin?

  • Stericycle WTF's available, timely collections?

Vehicles

  • Vehicles (CAB & REAR) visibly clean inside and out? Picture & Reg Picture.

  • Evidence of VDI use? Daily Walk around Posters Displayed?

  • No damage external or internal? Click NO enter Reg Number and damage.

  • Footwells clear of debris / dirt? Picture of Reg and debris if not.

  • Evidence of Audit using Appendix 7 Cleaning standard

  • Medi9, Blue/White towel, spill kits on vehicle?

  • Is Sharps bin signed and dated as per policy?

  • Disposable Linen in use as per policy and CAO direction ?

  • No Excess medical gases on vehicle?

  • All manual handling items (belts, banana board etc) present?

  • Tax/CVRT/SCA disc in place? Picture if not.

  • No Loose equipment in rear saloon? Picture ?

Office / Administration/ Fire Safety

  • Physical Office environment - Walls, Storage, Lights, Ceiling's, Floor, Desk & Seating all in order?

  • Safety Statement SS & Corporate, RA's, SWPS, SDS, Chemical (including register)/ Biological, all present?

  • Safety Statement including RA's sign-off by all staff in past year?

  • NIMS/NIRF Forms available to all?

  • Staff & Supervsior can explain AINM/NIMS reporting process?

  • All NAS Policies present and up to date - pick 3 random ?

  • Lone Workers aware of and compliant with policies?

  • Fleetwave, RTW Interviews, Leave Cards, Rosters all available and in use?

  • DSE - HSEland E-Learning complete. Any relevant assessments done and actions implemented?

  • Mandatory Training Complete - MAPA, MH, Children first?

  • Station cleaning contract / schedule?

  • Fire Safety Register in use?

  • Fire Alarm and Emergency Lighting test in date? Check book for reports?

  • Fire Detectors, Emergency Lighting, Illuminated exit Signs in place?

  • All fire doors functional, including door closures and mag locks?

  • Assembly points & fire orders in place?

  • Fire Exits in order?

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.