Case Paper - Facility Inspection Form

• Case Paper, Philadelphia PA

  Select

• Prepared by

• Location
  Address

• 02/22/2023

  Date

• Workplace Inspection Checklist

  Yes

  No

  N/A

• Entrances and Exits

  Yes

  No

  N/A

• Are entrances and exits to and from work areas free from obstructions?

  Yes

  No

  N/A

• Are exit doors clearly marked?

  Yes

  No

  N/A

• Walkways, Floors and Stairs

  Yes

  No

  N/A

• Are stairs and walkways kept clear of boxes, equipment, cables and other obstacles?

  Yes

  No

  N/A

• Is the tread on stairs in good condition and adequate to minimize slipping?

  Yes

  No

  N/A

• Is the foot space on each stair adequate?

  Yes

  No

  N/A

• Are handrails adequate and in a good state of repair?

  Yes

  No

  N/A

• Are stairs in a good state of repair?

  Yes

  No

  N/A

• Do stairs have anti-slip materials where warranted?

  Yes

  No

  N/A

• Are floors clear of slip and trip hazards, e.g., extension cords, torn carpet, uneven surfaces, cracks, holes, etc.?

  Yes

  No

  N/A

• Are walkways clear of trip hazards such as open drawers, boxes, etc.?

  Yes

  No

  N/A

• Are walkways and stairs wide enough?

  Yes

  No

  N/A

• Are walkways free of oil and grease?

  Yes

  No

  N/A

• Are walkways adequately lit and clearly marked?

  Yes

  No

  N/A

• Do walkways have unobstructed vision at intersections?

  Yes

  No

  N/A

• Storage Facilities

  Yes

  No

  N/A

• Are materials stored in bins whenever possible?

  Yes

  No

  N/A

• Is sufficient storage provided?

  Yes

  No

  N/A

• Are heavy items stored between mid-thigh and shoulder height?

  Yes

  No

  N/A

• Is there a safe means of accessing high shelves?

  Yes

  No

  N/A

• Is storage equipment in good condition and not overloaded?

  Yes

  No

  N/A

• Is stored material secured to prevent shifting/falling?

  Yes

  No

  N/A

• Are storage areas free from rubbish?

  Yes

  No

  N/A

• Are shelf units properly attached to walls and are cabinets/cupboards stable?

  Yes

  No

  N/A

• Are racks and pallets in good condition?

  Yes

  No

  N/A

• Lighting, Ventilation and Temperature

  Yes

  No

  N/A

• Does the lighting in the work area allow staff to see their work easily?

  Yes

  No

  N/A

• Are all light fittings in good working order? No flickering lights, etc.?

  Yes

  No

  N/A

• Are glare and excessive brightness minimized in the work area?

• Is temperature maintained at a comfortable level?

  Yes

  No

  N/A

• Is there adequate ventilation throughout the work area?

• Are all light bulbs, tubes and lighting covers adequately cleaned?

  Yes

  No

  N/A

• Are ventilation ducts kept clean and unobstructed?

  Yes

  No

  N/A

• Is general indoor air quality acceptable for the majority of occupants, i.e., temperature, humidity, air flow, etc.?

  Yes

  No

  N/A

Equipment

• Is equipment clean and working properly?

  Yes

  No

  N/A

• Are photocopiers located away from workstations to reduce noise and exposure to fumes?

  Yes

  No

  N/A

• Is all lifting or moving equipment in good condition?

  Yes

  No

  N/A

• Are fax machines, printers, binders, laminators and other office equipment in good condition?

  Yes

  No

  N/A

• Are procedures for safely operating equipment accessible to staff?

  Yes

  No

  N/A

• Are lockout/tagout procedures used?

  Yes

  No

  N/A

• Are there clear indications when equipment is switched on?

  Yes

  No

  N/A

• Are there procedures to report faulty equipment?

  Yes

  No

  N/A

• Are equipment guards in place?

  Yes

  No

  N/A

• Are noise levels controlled and is hearing protection being used?

  Yes

  No

  N/A

Hazardous Substances

• Are hazardous substances properly labeled?

  Yes

  No

  N/A

• Are hazardous substances properly stored?

  Yes

  No

  N/A

• Do procedures exist for the safe use and disposal of hazardous substances?

  Yes

  No

  N/A

• Are material safety data sheets available for all chemicals?

  Yes

  No

  N/A

• Is there a register of hazardous substances?

  Yes

  No

  N/A

• Are all containers labeled?

  Yes

  No

  N/A

• Are eye wash stations readily available and easily accessible to employees?

  Yes

  No

  N/A

• Electrical

  Yes

  No

  N/A

• Are all cords, plugs and sockets in good condition, i.e., not frayed, exposed, cracked, etc.?

  Yes

  No

  N/A

• Has electrical equipment been inspected, tested and tagged in accordance with company policies and regulations?

  Yes

  No

  N/A

• Are portable power tools in good condition?

  Yes

  No

  N/A

• Are all electrical items in good condition?

  Yes

  No

  N/A

• Have switches and circuits/circuit breakers been identified and are they in working condition?

  Yes

  No

  N/A

• Are battery chargers marked and well ventilated?

  Yes

  No

  N/A

Staff Amenities

• Are staff toilets and bathroom facilities in good condition?

  Yes

  No

  N/A

• Are toilets and bathroom facilities cleaned regularly?

  Yes

  No

  N/A

• Is kitchen equipment in good working order?

  Yes

  No

  N/A

• Are hot water taps appropriately marked?

  Yes

  No

  N/A

• Is kitchen and bathroom rubbish removed regularly?

  Yes

  No

  N/A

• Are surfaces in bathrooms and kitchen areas slip free?

  Yes

  No

  N/A

• Do kitchens contain fire extinguishers that are serviceable and accessible?

  Yes

  No

  N/A

• Are microwaves, refrigerators, etc., cleaned regularly to reduce risks of infection and fire?

  Yes

  No

  N/A

Emergency Procedures

• Can emergency signals and alarms be clearly heard?

  Yes

  No

  N/A

• Are emergency exits clearly marked, easy to open and functional?

  Yes

  No

  N/A

• Are alarms and signals tested on a regular basis?

  Yes

  No

  N/A

• Are emergency exit lights operational?

  Yes

  No

  N/A

• Has there been an evacuation drill in the last 12 months?

  Yes

  No

  N/A

• Are evacuation drills reviewed and documented?

  Yes

  No

  N/A

• Have floor wardens been appointed?

  Yes

  No

  N/A

• Are the names and details of office/floor wardens and emergency procedures displayed?

  Yes

  No

  N/A

• Is an evacuation plan displayed?

  Yes

  No

  N/A

• Are fire extinguishers easily identified and located?

  Yes

  No

  N/A

• Have fire extinguishers been inspected and tagged within the last six months?

  Yes

  No

  N/A

• Emergency Procedures (Continued)

  Yes

  No

  N/A

• Are fire hoses conveniently located in major corridors?

  Yes

  No

  N/A

• Are sprinkler systems and smoke detectors operational?

  Yes

  No

  N/A

• Have re-entry procedures following an evacuation been developed and displayed?

  Yes

  No

  N/A

• Has emergency evacuation training been provided to all employees?

  Yes

  No

  N/A

First Aid

• Have first aid responders’ names been communicated to all employees?

  Yes

  No

  N/A

• Are the names and contact details of first aid responders and locations of first aid kits displayed?

  Yes

  No

  N/A

• Are there adequate numbers of currently-trained first responders in or near work areas?

  Yes

  No

  N/A

• Are first aid kits clearly labeled?

  Yes

  No

  N/A

• Are first aid kits easily accessible?

  Yes

  No

  N/A

• Are first aid kits regularly maintained and stocked?

  Yes

  No

  N/A

• Are emergency telephone numbers clearly displayed?

  Yes

  No

  N/A

• Are storage areas for AED devices communicated to personnel?

  Yes

  No

  N/A

Security

• Are premises secure while employees are at work, e.g., during minimum staff shifts?

  Yes

  No

  N/A

• Are security doors operational?

  Yes

  No

  N/A

• Are there procedures for managing suspicious mail and threats?

  Yes

  No

  N/A

• Have employees been trained in workplace violence procedures?

  Yes

  No

  N/A

Desks/Workstations

• If desks are adjustable, can the adjustments be easily made?

  Yes

  No

  N/A

• Is there enough space on each desk for the work required?

  Yes

  No

  N/A

• Is the height of desks appropriate for the main tasks performed, e.g,. keyboarding?

  Yes

  No

  N/A

• Are items in constant use within easy reach?

  Yes

  No

  N/A

• Are workstations/desks stable and undamaged?

  Yes

  No

  N/A

• Do workstations have adequate storage?

  Yes

  No

  N/A

• Are waste bins emptied regularly?

  Yes

  No

  N/A

• Is there sufficient space around workstations to provide safe access?

  Yes

  No

  N/A

• Desks/Workstations (Continued)

  Yes

  No

  N/A

• Have staff been provided with information on how to optimize their workstation, where applicable? Provide comment:

• Have aids been provided for computer workstations (for example, foot rests and document holders)?

  Yes

  No

  N/A

Personal Computers

• Are monitor screens located approximately an arm’s length away?

  Yes

  No

  N/A

• Are the tops of screens located just below eye level?

  Yes

  No

  N/A

• Can the height and angle of the monitor be adjusted?

  Yes

  No

  N/A

• Are characters displayed on screens legible and stable?

  Yes

  No

  N/A

• Is screen glare minimized?

  Yes

  No

  N/A

• Is the mouse situated in a convenient position so that the user does not have to reach or stretch?

  Yes

  No

  N/A

• Is the mouse easy to move?

  Yes

  No

  N/A

Chairs (Used for working at personal computers)

• Can the height of chairs be adjusted according to the tasks being undertaken?

  Yes

  No

  N/A

• Can the height of back rests be adjusted to provide appropriate lumbar support?

  Yes

  No

  N/A

• Can the angle of the back rests be adjusted so that users are sitting upright when using a personal computer?

  Yes

  No

  N/A

• Can the chairs be moved close to the workstation without being obstructed by arm rests?

  Yes

  No

  N/A

• Are chairs stable and undamaged?

  Yes

  No

  N/A

Training

• Are new employees provided safety training during employee orientation?

  Yes

  No

  N/A

• Is job-specific training held for employees on a regular basis?

  Yes

  No

  N/A

• Is training provided on the safe use of common equipment?

  Yes

  No

  N/A

• Are personnel familiar with applicable material safety data sheets?

  Yes

  No

  N/A

• Are all personnel familiar with the emergency evacuation plan?

  Yes

  No

  N/A

• Is all training documentation current and accessible?

  Yes

  No

  N/A

• Have all personnel been trained in work-alone procedures?

  Yes

  No

  N/A

• Have personnel been trained in the use of personal protective equipment (gloves, respirators, hearing protection, safety glasses, lab coats, hard hats) and is PPE provided where necessary?

  Yes

  No

  N/A

• Safe Lifting

  Yes

  No

  N/A

• Have workers been trained on, and are they using, safe lifting techniques?

  Yes

  No

  N/A

• Are employees avoiding heavy loads (splitting into smaller loads or asking for help)?

  Yes

  No

  N/A

• When lifting, do employees bend their knees to take pressure off their backs?

• Workplace Inspection Committee Action Sheet

  Yes

  No

  N/A

• Response to Identified Inspection Issue

  Yes

  No

  N/A

• Action Required

  Yes

  No

  N/A

• Person Responsible/ Target Completion Date

  Date

• Verified Completion Date/Signature

  Sign