AUDIT FORM FOR GENERAL PPE & KNIFE

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Who are you auditing today?

• Take a picture of who you are auditing today.

  Media

• Any Non-compliance to be recorded in the notes section of the corresponding question along with corrective measures

Hand PPE

• Has the employee been provided with and have access to the appropriate PPE for all required task?

  Yes

  No

  N/A

• Is the employee wearing the proper company provided gloves for the task being performed while in the production area of the facility (cut resistant, heat, cold, latex, etc.)?

  Yes

  No

  N/A

• Is the employee wearing the PPE properly?

  Yes

  No

  N/A

• Are these gloves in acceptable / usable condition (free from holes, tears or cuts)?

  Yes

  No

  N/A

• Should these be replaced?

  Yes

  No

  N/A

• Take picture of employee wearing hand PPE.

  Media

Eyewear PPE

• Has the employee been provided with and have access to the appropriate PPE for all required task?

  Yes

  No

  N/A

• Is the employee wearing the proper company provided safety eyewear for the task being performed while in the production area of the facility (general safety glasses, prescription safety glasses, face shield, welding helmet, goggles, etc.)?

  Yes

  No

  N/A

• Is the eyewear in acceptable / usable condition (free from scratches, pitting, proper fit, etc)?

  Yes

  No

  N/A

• If employee is wearing prescription glasses are the glasses in compliance company safety rules (Protective eyewear that has a prescription or safety glasses that fit over normal prescription glasses)?

  Yes

  No

  N/A

• Should safety eyewear be replaced?

  Yes

  No

  N/A

• Take picture of employee eyewear PPE.

  Media

Hearing PPE

• Has the employee been provided with and have access to the appropriate PPE for all required task?

  Yes

  No

  N/A

• Is the employee wearing the proper company provided hearing protection for the task being performed while in the production area of the facility (earplugs, earmuffs, etc.)?

  Yes

  No

  N/A

• Is the employee wearing the PPE properly?

  Yes

  No

  N/A

• Is the hearing protection in acceptable / usable condition (free dirt, cracks, loose, don’t seal well)?

  Yes

  No

  N/A

• Should Hearing PPE be replaced?

  Yes

  No

  N/A

• Take picture of employee wearing hearing PPE.

  Media

Footwear PPE

• Is the employee wearing the proper PPE while in the production area of the facility (steel toe, toe caps for visitors)?

  Yes

  No

  N/A

• Is the footwear in acceptable / usable condition (free rips, holes, soles of shoes, etc)?

  Yes

  No

  N/A

• Is the employee wearing the PPE properly?

  Yes

  No

  N/A

• Should safety footwear be replaced?

  Yes

  No

  N/A

• Take picture of employee wearing footwear PPE.

  Media

Knife

• Has the employee been provided with and have access to the appropriate knife for all required task?

  Yes

  No

  N/A

• Is the employee using the company provided knife?

  Yes

  No

  N/A

• Is the employee using the knife properly?

  Yes

  No

  N/A

• Is the knife in acceptable / usable condition?

  Yes

  No

  N/A

• Should the knife be replaced?

  Yes

  No

  N/A

• Take picture of employees knife.

  Media

Employees understanding and attitude

• Does the employee understand the rules and regulations regarding PPE and knives in the workplace?

  Yes

  No

• Inquire why he does not understand and write answer below.

• Other comments to be noted:

Please sign to complete audit

• Add signature

  Sign