Title Page

  • Work Area(s) Inspected

  • Conducted on

  • Prepared by

  • Location

1. Sort

  • Area is free of unneeded tools & equipment

  • There are no items present in aisles, stairways, corners, exits, & doorways

  • Area is free of unneeded inventory, materials, parts, and works in progress

  • Safety hazards do not exist (clear walking/working surfaces, excess debris, broken or unguarded tools)

2. Set in Order

  • All items, equipment, tools, and materials are in their assigned places

  • Aisles, workplaces, and assigned equipment locations are clearly indicated.

  • Unused items, materials, tools & equipment are put away in their appropriate locations immediately

3. Shine

  • Floors, walls, stairs, and surfaces are free of dirt, debris, oils, and grease

  • Equipment is kept clean and free of dirt, oil, and grease

  • Adequate cleaning materials and supplies are stocked and easily accessible

  • Lines, labels, signs, etc. are clean/clear and unbroken

  • Waste containers are adequate in size, location, cleanliness, quantity, and are emptied at an acceptable frequency

4. Standardize

  • Necessary information is visible

  • All standards are known and visible

  • All signs, labels, lineouts, and color coding conform to the facility standard

  • Checklists exist for all cleaning and maintenance procedures

  • All quantities and limits are easily recognizable

5. Sustain

  • There is a defined frequency and procedure for cleaning and inspecting

  • Daily / Weekly 5S duties were performed last week

  • Employees are following rules, standards, and work procedures in practicing 5S (I.E. 5S practices are visually evident)

  • Job Aids and One-Point Lessons are available and up to date

  • Audit results are posted along with a well defined Action Plan to combat areas that do not meet the 5S standards

  • Auditor

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.