Personnel Log
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Prepared by
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Role
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Today's Date
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Location
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Assisted By (Optional)
General Safety
Emergency Preparedness
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Do you know who the First Aider is?
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Input their name(s) below:
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Find out and input their name(s) below:
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This is a Map showing where each Fire Extinguisher should be located. The ones Indicated are the Extinguishers you need to inspect. Please document any issues below. Thank You.
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Inspect each fire extinguisher indicated. Are any blocked or showing visible damage?
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This is a Map showing where each Fire Pull Station is located. The ones indicated are the stations you need to inspect. If any are blocked or shows signs of visible damage, please document it below.
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Inspect each Fire Pull Station indicated. Are any blocked or showing visible damage?
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There are 6 readily available emergency exits. You need to inspect the 4 indicated on the Map. Walk all the way to the exit and use the door. If there are any issues, please document it below.
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Inspect each Emergency Exit indicated. Do they open and close smoothly? Are they free from damage? Is it easy to access?
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This is a Map showing where each Control Panel is located. The ones indicated are the panels you need to inspect. If any are blocked, left open, or showing visible damage, please document it below.
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Inspect each Control Panel indicated. Are any blocked, left open, or showing signs of visible damage?
Personal Protective Equipment
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Are all observed Production Workers adhering to GMP Practices and Hygiene requirements? (Are workers washing their hands, wearing hairnets, etc.)
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All workers in direct contact with the product, are they wear their protective sleeves?
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Are all observed Production Workers wearing their Steel Toed boots?
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Are all observed Production Workers wearing their Eye Protection?
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Are all observed Production Workers wearing the appropriately colored smocks? (ex: Red smock in the Peanut In-feed room)
Housekeeping & General Conditions
Housekeeping and General Conditions
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Are the Work Area Inspections Completed?
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Are the Mobile Equipment inspections completed? (Forklifts, Powered Lifts, Powered Pallet Jacks, etc.)
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Are the Pallets in good condition (no damage or pieces missing?)
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Is there any Stock or material stored on the floor?
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Excess plastic has been removed from empty pallets.
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Packed Pallets are straight (no uneven or leaning stacks, no overhang)
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Packed Pallets are staged in their designated areas. (ex: not in walkways and not blocking forklift paths)
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Are Walkways, Work Areas, and Aisles free of plastic, pallets, rubbish, and empty boxes?
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Are Waste bins over flowing?
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Are all the appropriate brooms and brushes available?
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Is there enough lighting to preform the task? Are all over head lights in good working order?
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Inspect Electrical Cords. Do you see any damage? (Frayed or exposed wires, burn marks, cuts, etc.)
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Report it to your supervisor right away.
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Do the Electrical Sockets look like they are in good working order?
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Are the Handwashing stations clean and the Sanitation supplies properly stocked? (ex: Gloves, Ear Protection, Sleeves, etc.)
Equipment Inspection (ex: Conveyor Belts, Hoppers, Shrink Wrap Machines, etc.)
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4.1 Have there been any unexpected repairs so far during the shift? Confirm with your supervisor.
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Please list the Equipment and a short description of the issue.
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4.2 Do you see damage on any of the Equipment?
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4.3 Are all electrical panels locked out?
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4.4 Is all Equipment secured in place? (Wheels are locked or it is effectively bolted down)
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4.5 Are Equipment guards in place and undamaged? (ex: guardrails, Cover plates, etc.)
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4.6 Are all Hazard Warning Visible?
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4.7 The Control Panels, are the buttons properly identified? (ex: the stickers are worn out)
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4.8 Is the Metal Detector functioning properly?
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Please explain:
Wrap Up
Other Concerns or Comments
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Document other Hazards here. Please include Pictures.
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Document other Hazards here. Please include Pictures.
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Document other Hazards here. Please include Pictures.
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Document other Hazards here. Please include Pictures.
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Document other Hazards here. Please include Pictures.
Report complete
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Inspector Signature
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Time of Inspection completion: