Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Previous Inspection

  • Has the last inspection been reviewed?

  • Are there no outstanding actions?

Fire Inspection

  • Evacuation Plan displayed and understood by all employees?

  • Evacuation procedures discussed regularly? (3 to 4 times a year)

  • Extinguishers in place, clearly marked for type of fire?

  • Extinguishers recently serviced? (Check 6 monthly punch mark on tabs.)

  • Extinguishers clear of obstructions?

  • Adequate direction notices for fire exits?

  • Exit doors easily opened from inside?

  • Exits clear of obstructions?

General Lighting

  • Good natural lighting?

  • Reflected light from walls & ceilings not causing glare to employees?

  • Light fittings clean and in good condition?

  • Emergency exit lighting operable?

Building Safety

  • Floor surfaces even and uncluttered?

  • Entry and Walkways kept clear?

  • Intersections kept clear of boxes etc?

  • Furniture in sound condition?

  • Are doors and cabinets locked? (Kitchen knives, cleaning storage, staff room)

Restrooms

  • Restroom safety is supported by building design, organizational policies and operational procedures.

  • There is an established "adults only" restroom or policies and procedures to ensure adults and children are not using restrooms at the same time.

  • Organization implements a restroom inspection and monitoring schedule?

Electrical Safety

  • No broken plugs, sockets or switches?

  • No power leads across walkways?

  • No frayed or damaged leads

  • Are electrical outlets covered?

First Aid

  • Are contents regularly checked?

  • Are all first aid contents available?

  • Is there easy access to first aid supplies?

  • Employees aware of location of first aid supplies?

  • Is there access to an A.E.D?

  • Employees aware of location of the A.E.D?

  • Are emergency numbers displayed?

Office Hazards

  • Condition of filing cabinets?

  • Condition of chairs?

  • Desks in good condition? (No damage.)

  • Phone system working?

  • TV's properly anchored?

  • All cabinets above 3ft anchored properly?

Emergency Documents

  • Are all employees aware of the Employee/ Volunteer accident procedures?

  • Do all employees know where to find Employee/ Volunteer incident reports?

Dress Code

  • Are ALL Staff dressed appropriately as defined by the organization's dress code? (badge, Club shirt, etc?)

General Security

  • Control and Tracking is utilized over Club entries and exits during hours of operation by adult Club professionals

  • Club professionals, volunteers, and visitors are clearly identifiable throughout the Club?

  • Potential hiding places in and around the facility have been eliminated and or are well monitored (i.e stairwells, closets, utility rooms, sides and backs of building)

  • Unsupervised program areas, storage closets, utility closets, etc. are securable and locked during operational hours.

  • Is there a documented emergency preparedness plan in place, including schedule for emergency drills?

  • There is a visible code of conduct for Club members, including anti-bullying policy?

  • There is an enforced staff-to-youth ration for each program area, activity and for field trips.

  • Adult Club professionals are actively engaged with members in program areas and positioned to adequately supervise the entire area?

Sign Off

  • On site representative

  • Auditor's Signature (Safety Committee Chair, Board Chair, CEO, etc)

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.