Title Page

  • Area Inspected

  • Conducted on (Date and Time)

  • Inspected by

CAPTURE CURRENT STATE

  • Take a photo, or photos, of the workspace, in current state, at the start of the audit.

  • Use these score criteria for your inspection:

    3 - There is an ability to maintain it.
    2 - This is being complied with more systematically.
    1 - It is done but not systematically.
    0 - Not at all.
    N/A - Not Applicable

SORT OUT - "IF YOU DONT NEED IT, GET RID OF IT!"

  • Are the aisleways, walkways, and floor space free of unwanted items?

  • Are surfaces, shelves, tables, etc. free of unwanted items?

  • Are items stored according to frequency of use?

  • Is there a general clutter free appearance?

  • Capture photo(s) of any red tagged items resulting from this sort, if applicable.

SET IN ORDER - "A PLACE FOR EVERYTHING, AND EVERYTHING IN IT'S PLACE!"

  • Do all items and equipment have identification labels?

  • Are specific areas demarcated for garbage/rejects/waste, etc.?

  • Are controls (light switches, equipment controls, etc...) labeled?

  • Are all cables, wires, pipes, etc. labeled, organized, neat and straight?

  • Is color coding and/or signage used effectively for easy identification?

  • Is there a general appearance of orderliness?

  • Is it easy to find any items or documents without delay?

  • Identify and allocate a place for all the materials needed for your work.

SHINE - "A CLEAN WORKPLACE IS A SAFE WORKPLACE!"

  • Are personal belongings stored in a non-disruptive manner?

  • Are floors, walls, surfaces, etc. free of trash, debris, dust, and dirt?

  • Are machines, equipment, tools, furniture maintained at a high level of cleanliness and their maintenance schedules displayed?

  • Is use of adequate cleaning tools evident?

  • Is there a general appearance of cleanliness all round?

STANDARDIZE - "CLEAR EXPECTATIONS THAT EVERYONE CAN HELP MEET IT!"

  • Are "expectation images" posted, visible, accessible, and clear?

  • Are labels, notices, and other signage standardized and adequate?

  • Do isles/pathways meet required standards for size, color, etc.?

  • Are pipe markings, cable markings, floor markings, etc. standardized and adequate?

  • Are 5S general information posters visible and accessible in the area?

SUSTAIN - "A SYSTEM THAT WORKS BOTH TODAY AND TOMORROW!"

  • Is the area's 5S owner visibly identified and up to date?

  • Are area 5S scores posted and up to date?

  • Are 5S scores reported and up to date on Performance Management board?

  • Have first 3S become a part of the daily work?

  • Do employees show positive interest in 5S activities?

  • Are trainings and other programs implemented to sustain workplace organization?

COMPLETION

  • Observations & Recommendations

  • Overall Rating

  • Full Name and Signature of the Inspector

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.