Title Page

  • Location

  • Specific area (QFM geography) being assessed

  • Prepared by

Internal Building

  • Are ceiling tiles free of any damage/loose/water stains?

  • Are ceiling fans operational i.e. no missing control knobs/bent blades?

  • Are internal lights working?

  • Are walls free of significant marks/damage/cracking?

  • Are blinds in place and in good condition?

  • Are light switches operational i.e. not pushed in/damaged?

  • Are data points free of damage i.e. not pushed in?

  • Does the fire equipment (hydrant/extinguisher/blanket) have a current test/tag in date?

  • Is the operable wall operational and free of significant marks/damage?

  • Are door grills/vents sound and free of damage?

  • Is furniture free of damage/stains/missing parts, edge strips on desks or bookshelves in place?

  • Is the fridge operational and in the correct location?

  • Are door stops in place and free of damage/missing parts?

  • Is the toilet/toilet seat (if fitted)/caps/flush buttons operational and free of damage?

  • Are sinks and taps free of water leaks and damage?

  • Is the vinyl skirting sound and free of damage i.e not coming away from the wall?

  • Is the vinyl flooring free of significant marks/stains?

  • It's the carpet flooring free of significant marks/stains?

  • Does the inside of the building meet the cleaning standard i.e. no cobwebs etc?

  • Are there any other items that need addressing?

External Building

  • Are roof gutters free of weeds/leaks/damage?

  • Are gutters/downpipes free of showing signs of rusting/damage?

  • Are steel walkway structures sound and free of rust/damage?

  • Are external lights working?

  • Is external building/walkway signage in good condition i.e. fixing brackets and graphic?

  • Is external blockwork free of cracks/missing pointing or mastic? Repair or monitor?

  • Is the eye wash station and shower operational with no missing parts i.e yellow caps?

  • Are concrete paths free of significant cracks? Repair or monitor?

  • Does the outrside of the building meet the cleaning standard i.e. no cobwebs etc?

  • Are drinking fountains operational and free of leaks/poor flow?

Grounds & Gardens

  • Is the immediate area in the sector appealing to the eye?

  • Are grassed areas free of significant wear? i.e. take into account weather and season.

  • Are gardens and grassed areas free of pests/weeds/disease?

  • Are the plants in gardens beds healthy/well maintained/missing?

  • Are trees healthy/well maintained with sufficient clearance from buildings/gutters?

  • Is there a uniform coverage of mulch?

  • Are grassed areas free from trip hazards?

  • Are there any other landscaping concerns?

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.