Branch Weekly Assessment

• Audit Title

• Document No.

• Type your LID or Site Name in here:

• Conducted on

  Date

• Prepared by

• Location
  Address

Weekly Branch Gemba

• Are path to fire extinguisher clear of obstructions?

  Yes

  No

  N/A

• Are all exits marked properly and exit signs unobstructed?

  Yes

  No

  N/A

• Is the path to the exit free of obstruction (Minimum 36")?

  Yes

  No

  N/A

• If building is sprinklered, is storage at least 18 inches below sprinkler head height?

  Yes

  No

  N/A

• Are terminals on recycled batteries taped down?

  Yes

  No

  N/A

• Is the battery recycle storage area kept inside of the building at all times?

  Yes

  No

  N/A

• Are waste batteries on a pallet or in a container that will support the weight?

  Yes

  No

  N/A

• Is the container/skid labeled "Universal Waste Recycled Batteries"? And date marked when the first battery put in?

  Yes

  No

  N/A

• Refrigerator, microwave, toaster and other breakroom appliances appear to be cleaned on a regular basis?

  Yes

  No

  N/A

• Are personal heaters unplugged when not in use?

  Yes

  No

  N/A

• Is a log being used for the first aid kit to determine if event/injury is work related?

  Yes

  No

  N/A

• If the site is equipped with a rolling stair, is it in good condition?

  Yes

  No

  N/A

• Does the site conduct weekly safety inspections and are copies retained for 1 year?

  Yes

  No

  N/A

• Are the inspection results posted and corrective actions tracked to closure?

  Yes

  No

  N/A

• Is there at least 36 inches clearance in front of electrical panels?

  Yes

  No

  N/A

• Did you verify no electrical cords (i.e. extension cords) are not used as permanent wiring?

  Yes

  No

  N/A

• Are surge protectors used correctly?, No daisy chaining.

  Yes

  No

  N/A

• Is there any exposed wiring?

  Yes

  No

  N/A

• Is there a separation between storage of food and chemicals?

  Yes

  No

  N/A

• Are all cleaning chemicals labeled?

  Yes

  No

  N/A

• Is the "SDS Available upon Request" sign up and visible?

  Yes

  No

  N/A

• Are truck wheels chocked, stops, or other means to prevent movement and is the driver out of the cab during truck loading / unloading operations? (any truck applies)

  Yes

  No

  N/A

• Are door closers tension/speed safe?(risk of caught fingers?)

  Yes

  No

  N/A

• Are all box openers retractible blade or blade covered (Klever Kutter)

  Yes

  No

  N/A