Title Page
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Conducted on
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Prepared by
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Location
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Department/Areas Reviewed:
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Completed by:
AREA
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* If issues cannot be immediately corrected, move item to tier board for escalation
Working at Heights
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Do all tasks requiring working at a height greater than 4', use a platform ladder or some other form of fall arrest?
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Are all Team Members who work at heights at greater than 4' (except ladders or platforms with handrails) trained in fall protection?
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Are harness & lanyards inspected prior to use? Has the annual inspection tag been signed in the last year?
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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
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Are Team Members footwear in good condition with good traction?
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Are aisle ways kept clear and free from water, oil, shot blast or other materials that may cause slips?
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Are ladders in good working condition? Are load ratings visible and legible on ladders?
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Are A frame ladders only used for non-standard tasks versus in normal production?
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Are aisle ways kept free and clear of material, pallets and carts?
Floors
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Floor Matting (trip prevention): Does floor matting have < 10mm ( 0.4") edge in order to reduce tripping hazard?
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Anti Slip Protection: Is anti-slip protection used where there is risk of slipping on wet or contaminated surfaces? ie stairs ect.
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Pallet Stops: Do items bolted to the floor create tripping hazard?
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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
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Gradient: Are all ramps < 10ยบ?
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Highlight: Are all ramps marked with hazard warning tape?
Level Changes
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Process Steps: Are steps 200mm (7.8") high or 250mm ((9.8") for machinery access)? Are all steps in a set the same height?
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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?)
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Demarcation: Are height changes marked with "Hazard warning tape" or painted to highlight change in level?
Trap Hazard
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Whole Body: Are there areas where a whole body could be trapped? Is the area > 500mm (19.68")? Is there guarding implemented?
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Leg: Are there areas where a leg could be trapped? Is the area > 180mm (7.09")? Is there guarding implemented?
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Foot: Are there areas where a leg could be trapped? Is the area > 120mm (4.72")? Is there guarding emplemented?
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Hand: Are there areas where a hand could be trapped? Is the area > 100mm (3.93")? Is there guarding implemented?
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Finger: Are there areas where a finger could be trapped? Is the area > 25mm (0.9")? Is there guarding implemented?
