Information

  • Conducted on

  • Location
  • Building Owner

  • Contact person

  • Prepared by

1. Environment

  • 1.1 Is the temperature and airflow in the room adequate?

  • 1.2 Is the lighting adequate for the tasks being performed?

  • 1.3 Are there any sources of excessive noise?

2. Fire safety and emergency response.

  • 2.1 Are emergency procedures developed and displayed?

  • 2.2 Emergency Warden(s)/Evacuation procedures in place?

  • 2.3 Are all access and egress points readily accessible?

  • 2.4 Are exit signs in place and illuminated?

  • 2.5 Are fire extinguishers located in easy to see locations and accessible?

3. Equipment

  • 3.1 Are all electrical items and leads tested and tagged and in date?

  • 3.2 Are leads kept clear of walkways and safely arranged under desks?

  • 3.3 Does equipment appear to be in good condition?

4. Housekeeping

  • 4.1 Are areas generally kept tidy and well kept?

  • 4.2 Are areas free of clutter and walkways clear of obstructions and trip hazards?

  • 4.3 Are items safely stored so they are not at risk of falling or causing injury?

  • 4.4 Are filing cabinets/desk drawers closed when not in use?

  • 4.5 Are waste paper bins free of general rubbish and general rubbish bins not overfilled?

5. Manual Handling

  • 5.1 Are frequently used items within easy access/stored between knee and shoulder?

  • 5.2 Are heavy items stored at waist height?

  • 5.3 Are step ladders used to access items stored on higher shelves?

6. Toilet and kitchen facilities

  • 6.1 Toilet facilities clean and in good condition?

  • 6.2 Items available to maintain appropriate levels of hygiene?

  • 6.3 Kitchen facilities/food preparation areas clean and appropriate for use?

7. First Aid

  • 7.1 First Aid kit available with appropriate contents?

  • 7.2 Dates within use-by?

  • 7.3 Certified First Aider on site?

8. Other

  • 8.1 "If you are injured poster on display?"

  • 8.2 Health and safety board in use and relevant information displayed?

  • 8.3 Current (within 5 years) Material Safety Data Sheets available?

  • 8.4 Incident/injury report book template available for recording of incidents?

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.