Title Page

  • Conducted on

  • Prepared by

  • Location
  • Department/Areas Reviewed:

  • Completed by:

  • Date of GEMBA Walk:

  • If any answers are NO, provide the tier board number and owner to correct the issue in the action section

PPE

  • Is required PPE available in work area (i.e. check Fastenal machines)?

  • Corrective actions:

  • Do team members know what PPE they should wear the area and with specific machines?

  • Corrective actions:

  • Is the PPE dude in your areas up-to-date and posted?

  • Corrective actions:

  • Are Team Members wearing correct PPE for the area & tasks? Are PPE signs posted in areas?

  • Corrective actions:

  • Are Team Members wearing steel-toed or composite safety shoes?

  • Corrective actions:

  • Do new machines in your area have PPE Dude posted?

  • Corrective actions:

Welding

  • Are Weld Torches/Guns "goose necks" in good condition(i.e. no visible signs of dents, crimps and/or creases)?

  • Corrective actions:

  • Are all gas cylinders visibly marked with gas?

  • Corrective actions:

  • Are oxygen and acetylene cylinders kept away from sources of heat?

  • Corrective actions:

  • Are cylinders, cylinder valves, couplings, regulators, hoses, and apparatus kept free from oily and greasy substances?

  • Corrective actions:

  • Are compressed-gas cylinders secured in an upright position so they cannot fall or be knocked over?

  • Corrective actions:

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.