Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Front Entry & Main Walkway

  • Level surface?

  • Are all floor surfaces clean and up to standard?

  • Is floor surface free from cracking, lifting or damage?

  • Surface not slippery?

  • Clean & free of producing objects

  • Walls from cracks

  • Doors operational, safe & secure?

  • Press no and explain if there are other items that require attention. Press yes if compliant

  • All areas free of cobwebs and dust?

Courts 1&2

  • Level Surface?

  • Surface not slippery?

  • Floor surface free from cracking, lifting or other damage?

  • Futsal goals safe & secure?

  • Stadium seating safe & secure?

  • Divider curtain safe & secure?

  • Score bench equipment safe & operational?

  • Adequate ventilation?

  • Press no and explain if there are other items that require attention. Press yes if compliant

  • Other equipment in working order & clean?

Courts 3 & 4

  • Level Surface?

  • Floor surface free from cracking, lifting or other damage?

  • Are all cobwebs and dust removed?

  • Surface not slippery?

  • Stadium seating safe & secure?

  • Adequate ventilation?

  • Basketball rings safe and secure?

  • Walls free from defect or protruding objects?

  • Doors operational, safe & secure?

  • Press no and explain if there are other items that require attention. Press yes if compliant

Office / Canteen

  • Level surface?

  • Floor surface free from cracking, lifting or frayed edges?

  • Walls & windows clean & free from defect or protruding objects?

  • Windows clean from posters?

  • Windows free of cracks?

  • Window frames & seals in good condition?

  • Doors operational, safe & secure?

  • Light fittings in place & secure?

  • Adequate lighting?

  • Press no and explain if there are other items that require attention. Press yes if compliant

  • Emergency lighting in working order & available?

Change rooms & toilets

  • Level surface?

  • Floor surface and free from cracking, lifting or frayed edges?

  • Walls free from defect or protruding objects?

  • Walls and windows free from poster

  • Window frames & seals in good condition?

  • Hand dryers safe and in working condition?

  • Press no and explain if there are other items that require attention. Press yes if compliant

Emergency Operations

  • Fire extinguishers in place, pressure checked & serviced?

  • Smoke detectors in place & operational?

  • Evacuation instructions clearly displayed?

  • Emergency evacuation training carried out in the last 12 months?

Evacuation kits checklist

  • Safery manual (red folder)

  • Emergency phone numbers (in red folder)

  • Emergency Evacuation Plan (in red folder)

  • Evacuation Checklist (in red folder)

  • Chief Warden caps

  • Area Warden caps

  • Torch with batteries

  • Permanent Marker

  • Adult Resuscitation mask x 1

  • Gloves x 2 pairs

  • Band aids x 10

  • Dressing Strip 7.5 x 1m

  • Triangular bandage x 1

  • Eye wash solution x 5

  • Eye pad x 1

  • Crepe bandage 7.5cm x 1.5m x1

  • Heavy crepe bandage 7.5cm x 2.3m x 1

  • Leucoplast tape 2.5cm x 1

  • Dressing sterile 7.5cm x 10cm x 1

  • Dressing sterile 7.5 x 5cm x 1

  • Gauze swabs x 15

  • Gauze bandage 5cm x 1

  • Gauze bandage 7.5cm 1.8m x 1

  • Steri stips x 1 sheet

  • Transparent island dressing 7.2cm x 5cm

  • Combine pad x 1

  • Cotton tips x 3

  • Blood spill kit x 1

  • Burns Module x 1

  • Wound Dressing No. 13 x 1

  • Wound dressing No 14 x 1

  • Would dressing no. 15 x 1

  • Liquid Antiseptic spray x 1

  • Safety pins x 3

  • Surgical scissors x 1

  • Tweezers x 1

  • Splinter probes x 1

  • Pen x 1

  • Notepad x 1

  • Permanent Marker

  • Audit completed by:

  • 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.