Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Housekeeping/5S

  • Work and storage areas are clean and tidy.

  • Work stations are well organized and no trip hazards are present. <br>

  • Aisles and walkways are clearly marked and unobstructed.

  • Emergency equipment (eyewash, fire extinguishers) is constantly accessible.

  • Emergency routes and emergency doors are kept clear of any item and fully accessible . Emergency exit doors are not locked.

  • Wastes/scrap bins are emptied and not overflowing.

Personal Protective Equipment (PPE)

  • Signs indicating required PPE are in place.

  • PPE is appropriately stored when not in use and kept in good condition.

  • Safe work shoes are being worn by employees, visitors and contractors.

  • Safety glasses are being worn by employees, visitors and contractors.

  • Appropriate gloves are being worn by employees, visitors and contractors.

  • Hearing protection is being worn by employees, visitors and contractors.

Maintenance

  • Equipment (lighting fixtures, machine guarding, barriers, etc.) are maintained in good working condition and in place.

Ergonomics

  • No awkward position, no excessive or overhead reach; limited bending and twisting.

Tools, Equipment, Machines

  • Tools, equipment and machines are operating properly. safety guards are in place Electrical wiring is in good condition.

  • Safety knives are being used instead of utility knives or other types of blades.

  • There are no homemade tools or equipment, such as step stools, ladders and untested under-hook devices.

  • Hand tools are in condition and employees are using the right tool for the job.

Powered Industrial Vehicles (PIV)

  • PIVs are being operated safely, operators yield to pedestrians, loads are being transported safely

Other

  • Other

  • Other

Accomplishments

  • Select one or two items for which the employees or the site should be commended:

Additional Comments and Corrective Actions

  • Add signature

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.