Title Page

  • Conducted on

  • Prepared by

  • Location
  • Department/Areas Reviewed:

  • Completed by:

AREA

  • * If issues cannot be immediately corrected, move item to tier board for escalation

Hearing Protection

  • Are Team Members wearing hearing protection in required areas?

  • Are team members wearing hearing protection correctly and can they demonstrate the proper way to insert ear plugs?

  • Do areas requiring double ear protection have signs posted in the area and does the PPE Dude have this included?

Confined Space

  • Are all confined spaces marked in your work area?

  • Are Team Members aware of the requirements for entering a confined space?

  • Do you know where to obtain the monitoring equipment for entering a confined space?

  • Have your team members been trained in confined space within the last year?

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.