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

Working at Heights

  • Do all tasks requiring working at a height greater than 4', use a platform ladder or some other form of fall arrest?

  • Are all Team Members who work at heights at greater than 4' (except ladders or platforms with handrails) trained in fall protection?

  • Are harness & lanyards inspected prior to use? Has the annual inspection tag been signed in the last year?

  • Is there a fall protection work plan for all instances where TMs are required to wear fall arrest or use fall prevention equipment?

Fall Protection

  • Are Team Members footwear in good condition with good traction?

  • Are aisle ways kept clear and free from water, oil, shot blast or other materials that may cause slips?

  • Are ladders in good working condition? Are load ratings visible and legible on ladders?

  • Are A frame ladders only used for non-standard tasks versus in normal production?

  • Are aisle ways kept free and clear of material, pallets and carts?

Floors

  • Floor Matting (trip prevention): Does floor matting have < 10mm ( 0.4") edge in order to reduce tripping hazard?

  • Anti Slip Protection: Is anti-slip protection used where there is risk of slipping on wet or contaminated surfaces? ie stairs ect.

  • Pallet Stops: Do items bolted to the floor create tripping hazard?

  • Surface: Are floors maintained in a dry, clean, non-slip condition free of dust, water, and oil? If risk exists then a rough non slip surface should be applied

Ramps

  • Gradient: Are all ramps < 10ยบ?

  • Highlight: Are all ramps marked with hazard warning tape?

Level Changes

  • Process Steps: Are steps 200mm (7.8") high or 250mm ((9.8") for machinery access)? Are all steps in a set the same height?

  • Lighting: Is lighting adequate as stated; Production Areas >50 fc, Sub- assemby Areas/Inspection 100 fc, Offices 50 fc, Storage yards 20 fc (What is considered sub-assembly?)

  • Demarcation: Are height changes marked with "Hazard warning tape" or painted to highlight change in level?

Trap Hazard

  • Whole Body: Are there areas where a whole body could be trapped? Is the area > 500mm (19.68")? Is there guarding implemented?

  • Leg: Are there areas where a leg could be trapped? Is the area > 180mm (7.09")? Is there guarding implemented?

  • Foot: Are there areas where a leg could be trapped? Is the area > 120mm (4.72")? Is there guarding emplemented?

  • Hand: Are there areas where a hand could be trapped? Is the area > 100mm (3.93")? Is there guarding implemented?

  • Finger: Are there areas where a finger could be trapped? Is the area > 25mm (0.9")? Is there guarding implemented?

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.