Title Page

  • Conducted on

  • Prepared by

  • Location

Inspection:

  • Has the previous monthly workplace inspection been conducted, completed, signed off and any outstanding items transferred to this monthly inspection?

  • Is appropriate H&S information readily available for staff? (Evidence of shift briefs, notice boards, top area risks, posters etc)

  • Are computer workstations set up correctly and DSE assessments completed for individuals classified as ‘users’? (Individual or generic assessment recorded on eRA system)

  • Are first aiders clearly identified with contact numbers displayed? (First aid assessment completed, First aid personnel with current training)

  • Are first aid supplies available? (First aid kit content IAW minimum contents checklist (HS-A11-WI.1 Appendix 1. Time ex items within date)

  • Are welfare facilities clean, tidy, adequate and in good repair? (Kitchen, toilets, disabled facilities, rest changing rooms, lighting, temperature)

  • Are electrical installations & appliances free from damage? (Wall sockets, plugs, and cables free from damage. Where applicable – test/ guides & manuals > safety & security > H&S manual > section J4.2.5)

  • Are break glass alarm points and fire fighting equipment easily accessible, free from obstructions? (Fire extinguishers in date)

  • Are fire door vision panels clear and door closing mechanisms functioning correctly?

  • Are safety signs correctly displayed, legible and in good condition? (Emergency evacuation, fire points, warning signs etc)

  • Are floors, stairs, fire doors, walkways and evacuation routes free from obstructions and trip hazards?

  • Is there defective equipment identified and reported?

Additional Comments

Action Report

  • Item

  • Finding

  • Action taken (include defect number if applicable)

  • Complete (Name/date) If not complete - Item to be transferred to following inspection form.

  • Item

  • Finding

  • Action taken (include defect number if applicable)

  • Complete (Name/date) If not complete - Item to be transferred to following inspection form.

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  • Name of Manager/Nominee:

  • Signature:

  • Date:

  • Name of Safety Rep:

  • Signature:

  • Date:

  • Name of Operations/Team

  • Signature:

  • Date:

  • NOTE: Workplace inspections to be stored locally for a minimum of 3 years. Operations Manager, or equivalent, participation required quarterly

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