Information

📝EVALUATION GUIDELINES: Please use these score criteria for consistent and accurate assessment, based on specific observations and evidence. 🥇 PERFECT: Consistently meets or exceeds standards with excellent organization; No improvements needed. 🥈 VERY GOOD: Systematic and consistent adherence with minor room for improvement. 🥉 GOOD: Generally meets standards but lacks consistency or systematic approach. Improvements are necessary. ⌛ FAIR: Inconsistent meeting of standards; needs significant improvement. 👎 POOR: Fails to meet standards; requires immediate and substantial improvement.

📅 Month, Week & Date :

  • Month :

  • Week Number:

  • Conducted Date

EVALUVATION TEAM:

  • Select Evaluation Team No:

  • Select Team Members:

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Select Your 5S Team Captains:

  • Select your 5S Team / Area to add the Captain's details:

  • Select Captains Details.

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  • Select Captains Details.

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questions

Select your 5S Inspection Area/Team:

  • 5S Team No / Name / Area.

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unnecessary items cleared from the areas, and are unused tools returned to their proper places?

  • 3️⃣ Are waste segregation bins effectively utilized & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Are Arc & Welding Arms Present wherever Columns are available for both Fit up & Welding sections?

  • 6️⃣ Proper cable management system in place to ensuring cables are neatly stored and do not obstruct workflow when in use?

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Are floor markings, color codes, and signboards standardized and consistently followed? Are they utilized to identify materials with project names and batch numbers?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Proper Work Posture/Ergonomic positions to minimize unnecessary movements like walking, bending, or reaching. (Proper placement of worktable, tools, and equipment)

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹. Housekeeping/Cleaning. (AS-5S-C01) 🚮. Waste segregation & Disposal in Facility area. (AS-5S-C02) 🛠. Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVA SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by Evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unnecessary items cleared from the areas, and are unused tools returned to their proper places?

  • 3️⃣ Are waste segregation bins effectively utilized & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Is the area free of outdated notices, torn or old posters, calendars, pictures, etc.?

  • 6️⃣ Proper cable management system in place to ensuring cables are neatly stored and do not obstruct workflow when in use?

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Are floor markings, color codes, and signboards standardized and consistently followed? Are they utilized to identify materials with project names and batch numbers?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Proper Work Posture/Ergonomic positions to minimize unnecessary movements like walking, bending, or reaching. (Proper placement of worktable, tools, and equipment)

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹Housekeeping/Cleaning. (AS-5S-C01) 🚮Weekly Waste segregation & Disposal(AS-5S-C02) 🛠Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVO SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unused TOOLS removed from the area? (Lashing tools, Metal Straps, Crane Belt, Chains, Wood, Brooms), Garbage Bins returned to proper location?

  • 3️⃣ Are waste segregation bins effectively utilized (Wood, Metal, Paper, Cartoon, General Waste) & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Are unused Lifting tools and Lashing equipment on the Tools Station?

  • 6️⃣ Proper wood stacking, Crane Belts in place?

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Are floor markings, color codes, and signboards standardized and consistently followed? Are they utilized to identify materials with project names and batch numbers?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Proper Work Posture/Ergonomic positions to minimize unnecessary movements like walking, bending, or reaching. (Proper placement of worktable, tools, and equipment)

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹. Housekeeping/Cleaning. (AS-5S-C01) 🚮. Waste segregation & Disposal in Facility area. (AS-5S-C02) 🛠. Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVA SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unnecessary items cleared from the areas, and are unused tools returned to their proper places?

  • 3️⃣ Are waste segregation bins effectively utilized & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Are all unnecessary items and clutter removed from the working areas, including tables, shelves, and cabinets?

  • 6️⃣ Proper cable management system in place to ensuring cables are neatly stored and do not obstruct workflow when in use?

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Is there a system in place for scheduling and prioritizing maintenance tasks to minimize downtime and disruptions?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Are emergency exits, fire extinguishers, and other safety equipment regularly inspected and maintained for readiness?

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹. Housekeeping/Cleaning. (AS-5S-C01) 🚮. Waste segregation & Disposal in Facility area. (AS-5S-C02) 🛠. Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVA SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unnecessary items cleared from the areas, and are unused tools returned to their proper places? (Painting Cans, Pallets, Trolley, Brooms, Tools & Garbage Bins)

  • 3️⃣ Are waste segregation bins effectively utilized & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Is (Mixing Chamber, Chargehand Desk, Waste Collecting Area, Cleaning Station) separated in different Locations?

  • 6️⃣ Proper Stands for Painting the Handrails, plates and Fixtures for Painting

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Are floor markings, color codes, and signboards standardized and consistently followed? Are they utilized to identify materials with project names and batch numbers?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Proper Work Posture/Ergonomic positions to minimize unnecessary movements like walking, bending, or reaching. (Proper placement of worktable, tools, and equipment)

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹. Housekeeping/Cleaning. (AS-5S-C01) 🚮. Waste segregation & Disposal in Facility area. (AS-5S-C02) 🛠. Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVA SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

SORT, SET IN ORDER, SHINE, STANDARDIZE, SUSTAIN

  • 1️⃣ Are daily housekeeping tasks consistently performed to ensure the workspace remains clean and tidy at all times?

  • 2️⃣ Are all unnecessary items cleared from the areas, and are unused tools returned to their proper places?

  • 3️⃣ Are waste segregation bins effectively utilized (Wood, Metal, Paper, Cartoon, General Waste) & routinely emptied to prevent overflow and ensure proper disposal?

  • 4️⃣ Are tools, equipment, and materials safely organized with clear identification and placement in designated areas? Are they also displayed on shadow boards for easy access and visibility?

  • 5️⃣ Are safety protocols, including personal protective equipment (PPE) requirements, consistently followed by all personnel?

  • 6️⃣ Are warning signs and labels used effectively to communicate potential hazards and safety precautions?

  • 7️⃣ Are fire extinguishers positioned correctly, easily accessible, and kept clean? (Fire Extinguisher Cabinet doors working properly?)

  • 8️⃣ Are floor markings, color codes, and signboards standardized and consistently followed? Are they utilized to identify materials with project names and batch numbers?

  • 9️⃣ Are cleaning tools accessible, organized, and consistently returned to their station after use, ensuring a clean and tidy workspace?

  • 🔟 Proper Work Posture/Ergonomic positions to minimize unnecessary movements like walking, bending, or reaching. (Proper placement of worktable, tools, and equipment)

  • 1️⃣1️⃣ Proper use of storages like shelves, racks? Are the items clearly labelled for identification?

  • 1️⃣2️⃣ Are materials stored and stacked safely, and have items been properly secured to prevent tipping or falling?

  • 1️⃣3️⃣ White board: 📝. Display daily achievements summary. 📝. Display productivity status, hours spent, progress achieved. 📝.Display KPIs - key performance indicators. 📝. Display ongoing issues, resolutions, lessons learned. 📝.Display current inventory data (material stock status/project issuance details)

  • 1️⃣4️⃣ Daily & weekly CHECKLISTS Displayed & Up to Date? 🧹. Housekeeping/Cleaning. (AS-5S-C01) 🚮. Waste segregation & Disposal in Facility area. (AS-5S-C02) 🛠. Tools & Equipment's Inventory & Calibration checklist. (AS-5S-C03)

  • 1️⃣5️⃣ Has the team implemented any recent improvements or innovations?

  • 🗣 Ask if they have any improvement ideas or innovations. 💪🏻 Determine if they require assistance in developing new initiatives. 🤝🏻 Offer support and advice as needed to help them progress. 🙌🏻 Foster an environment where team members feel comfortable sharing their thoughts and concerns. 🏆Provide constructive feedback to enhance collaboration and generate positive changes.

  • 1️⃣6️⃣ Is the team's performance comparable or better than last week's?5

  • Please mention the major changes or performance made by team to determine scores.

📝 General Notes/Observations

  • 🎯Are there any obstacles/challenges that prevent effective implementation of 5S. (Team Captain responses)

  • 🪄Important Area of Improvements and Suggestions.

📲 INNOVA SAFE APP - HSE ENGAGEMENTS REPORT FOR BONUS POINTS

  • Enter the number of HSE engagement reports submitted by Evaluators.

  • Enter the number of HSE engagement reports submitted by 5S Captains / Team.

Evaluator Signatures

  • Signature of Evaluator 1️⃣

  • Signature of Evaluator 2️⃣

  • Signature of Evaluator 3️⃣

5S Team Captain Signatures

  • Signature of Team Captain 1️⃣

  • Signature of Team Captain 2️⃣

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.