• Department

  • Document No.

  • Machine / Location

  • Conducted on

  • Prepared By:

Daily Checklist

  • Was daily safety check completed?

5S Housekeeping

  • Aisles/Walkways kept clear?

  • Work area kept organized?

  • Housekeeping: spills, cords or other trips, trash/clutter, lighting, or Flammables

Personal Protective Equipment

  • All appropriate equipment or gear worn correctly?

  • PPE kept in good condition?

  • Machine Guarding

Working Position

  • Body position

  • Location in working environment

  • Work Position / Posture

Tools and Equipment

  • Appropriate tools or equipment being used?

  • Tools or equipment being used correctly?

  • Tools or equipment in good condition?

Safe behaviors observed-actions taken to encourage safe behavior

Unsafe behaviors observed-action taken to correct and prevent recurrence

Line of fire. Is the worker in the line of fire?

  • Grinding or drilling operations creating flying objects or particles - goggles/face-shield. Heavy equipment movement in the area - operator aware of pedestrian? Around rigging operations - hand in pinch point not under equipment? Working in front of live electrical panel - NFPA70E PPE

  • Grinding, drilling or other operation that would cause flying debris

Safety procedures

  • Lock-out/Tag-out, Arc Flash, Hot Work Permit, Confined Space

  • Notes / Comments / Photos

  • Auditor signature

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.