Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

HR Related Items

  • 1. Are adequate chairs and tables provided in break room?

  • 2. Is break room neat and clean?

  • 3. Have areas been provided to store lunches?

  • 4. Is there a working wash basin (With hot and cold water) in break room?

  • 5. Is there a soap dispenser in the break room?

  • 6. Are required employment and safety postings in the break room?

  • 7. Are temperature controls working throughout the building?

  • 8. Are coke machines, microwaves, etc. provided and working properly?

  • 9. Is the Blood Borne Pathogen kit available and located in the proper area?

  • 10. Is the First Aid kit available and located in the proper area?

  • 11. Is an evacuation plan posted complete with primary and secondary exits and meeting points?

  • 12. Are take cover shelters labeled? Training Provided?

  • 13. Are badge readers working?

  • 14. Are handicap parking spaces provided and # adequate?

  • 15. Does parking lot drain appropriately during rain?

  • 16. Is parking lot striped?

  • 17. Adequate Personal Protective Equipment onsite and provided to everyone?

  • 18. Have adequate smoking areas been provided with ash trays and water or fire extinguisher near by?

  • 19. Are emergency contacts posted?

  • 20. Are parking lot and sidewalks painted to denote elevation and surface changes?

Fire

  • 21. Does the fire sprinkler system meet MSIG requirements?

  • 22. Has the fire sprinkler system been certified by an outside contractor and building inspector?

  • 23. Has the fire pump been certified by and outside contractor and building inspector?

  • 24. Are fire extinguishers installed in all locations and denoted by a sign or red paint at the top of pole?

  • 25. Have fire extinguisher's been serviced within 1 year and visually checked within one month?

  • 26. Are smoke detector units included in the ductwork?

  • 27. Have emergency lights been tested and are they working properly?

  • 28. Are emergency lights included in the restrooms?

  • 29. Are single motion push bars installed on all exit doors?

OSHA

  • 31. Is the OSHA 300 log onsite with 3 years past + current injury data?

  • 32. Are Federal and State OSHA postings in place?

  • 33. Do you have a written Emergency Evacuation Plan in addition to the emergency evacuation map?

  • 34. Are SDS (Safety Data Sheets) available for chemicals?

  • 35. Do you have training records for portable fire extinguishers?

General

  • 36. Has the local building inspector issued an occupancy certificate?

  • 37. Are there adequate #s of emergency eyewash stations for battery charge?

  • 38. Have the eyewash stations received a monthly check?

  • 39. Is PPE readily available near the battery charge area? Gloves, apron, face shield?

  • 40. Is a spill cleanup kit available near the battery charge area?

  • 41. Have back flow preventers been checked and certified?

  • 42. If propane trucks are used, is proper ventilation provided?

  • 43. Are propane truck tanks located outside with proper, "No Smoking" signage?

  • 44. Are we using an energy efficient lighting system? (Not metal halide)

  • 45. Are dock locks installed and working properly?

  • 46. Are dock levelers installed and working properly?

  • 47. Are dock lights installed and working properly?

  • 48. Are sprinkler system valves locked and is a key control system in place?

  • 49. Fire Pump Test completed and capacity approved?

  • 50. Is there an emergency shut off procedure for the sprinkler system? Is it posted and have individuals been trained?

  • 51. Is the sprinkler system monitored electronically?

  • 52. Are there 2 means available for signaling evacuation?

  • 53. Has evacuation signaling means been checked for proper operation?

  • 54. Have inside poles been painted yellow to 15' (Fire ext. poles w/red band)

  • 55. Has weight limit been posted on the mezzanine?

  • 56. Are storage racks bolted to the floor?

  • 57. Are storage rack beam locks in place?

  • 58. Are power poles utilized in office areas to minimize trip hazards? Adequate #?

  • 59. Are electrical panel circuits labeled in electrical boxes?

  • 60. Is 3' maintained beettween electrical panels, transformers, etc. and combustible material.

  • 61. Are security cameras in place and functioning?

  • 62. Are restrooms functioning with hot and cold water? Adequate # and size?

  • 63. Are Exit signs posted above doors?

  • 64.Is safety signage provided throughout the building as needed?

  • 65. Is motion detecting lighting used when possible? (Break rooms, conference rooms, etc.

  • 66. Is outside lighting adequate?

  • 67. Are protective barriers (bollards) provided near office areas to ensure forklifts don't damage walls?

  • 68. Are protective barriers (bollards) provided near electrical installations to ensure forklifts don't damage?

  • 69. Is dock door marking provided to ensure forklifts do not hit door?

  • 70. Are adequate #'s of chocks and glad hand devices available?

  • 71. Is there a dock safety policy and have associates been trained on dock safety procedures?

  • 72. In general are electrical installation, electrical outlets, cords, etc. complete and working correctly?

  • 73. Is security alarm operational?

  • 74. Are floor surfaces reviewed for slip during wet seasons? Proper no slip c/ms such as mats in place?

  • 75. Smoking areas identified, posted and fire proof receptacles provided?

Environmental

  • 76. Are all dumpsters closed top?

  • 77. No machines, equipment or pallets stored outside?

  • 78. Adequate bins for trash and recyclables?

Forklift/Pedestrian Separation

  • 79. Does facility meet SWS forklift safety requirements?

  • 80. Does facility meet SWS forklift/pedestrian separation requirements?

  • 81. Does facility meet SWS standard for prevention of accidents while walking?

  • 82. Have measure been taken on mezzanine to ensure no open sided floor?

OTHER

  • 83. Are "STOP" signs posted when leaving parking lot?

  • 84. Are weight limits posted on racks?

  • 85. Has sufficient space been allocated for staging and storage of material/equipment within the area?

  • 86. Has the space in and around the equipment been properly marked and labeled?

  • 87. Are environmental conditions within safe limits (respiratory, noise, heat)?

  • 88. Are all mechanical devices properly guarded?

  • 89. Is proper forklift key control being practiced?

  • 90. Proper signage prohibiting guns, alcohol, drugs, etc.

  • 91. Pallet jacks equipped with weight limit, corner guards, handle padding, etc.

  • 92. Does facility meet CTPAT requirements?

  • 93. Adequate # of toilets, urinals and wash basins?

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.