Personnel Log

  • Prepared by

  • Role

  • Today's Date

  • Location

  • Assisted By (Optional)

General Safety

Emergency Preparedness

  • Do you know who the First Aider is?

  • Input their name(s) below:

  • Find out and input their name(s) below:

  • 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.

  • Inspect each fire extinguisher indicated. Are any blocked or showing visible damage?

  • 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.

  • Inspect each Fire Pull Station indicated. Are any blocked or showing visible damage?

  • 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.

  • Inspect each Emergency Exit indicated. Do they open and close smoothly? Are they free from damage? Is it easy to access?

  • 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.

  • Inspect each Control Panel indicated. Are any blocked, left open, or showing signs of visible damage?

Personal Protective Equipment

  • Are all observed Sanitation Workers adhering to GMP Practices and Hygiene requirements? (Workers are wearing hairnets, gloves, etc.)

  • Are all observed Sanitation Workers wearing their Steel Toed boots?

  • Are all observed Sanitation Workers wearing their specialized Eye Protection?

Housekeeping & General Conditions

Housekeeping and General Conditions

  • Are Walkways, Work Areas, and Aisles free of plastic, pallets, rubbish, and empty boxes?

  • Is there any Stock or material stored on the floor?

  • Are the Handwashing stations clean and the Sanitation supplies properly stocked? (ex: Gloves, Ear Protection, Sleeves, etc.)

  • Are all needed tools and supplies available?

  • Is the SDS Binder up to date and in good condition?

  • Are the Spill Containment Pallets clean and free of debris?

  • Are Spill Kits located at the Chemical Storage area(s)? Are they fully stocked?

  • Are the Large Bins in good working order? (wheels move easily, no structural damage or large cracks, etc.)

  • Is there enough lighting to preform the task? Are all over head lights in good working order?

  • Inspect Electrical Cords. Do you see any damage? (Frayed or exposed wires, burn marks, cuts, etc.)

  • Report it to your supervisor right away.

  • Do the Electrical Sockets look like they are in good working order?

Wrap Up

Other Concerns or Comments

  • Document other Hazards here. Please include Pictures.

  • Document other Hazards here. Please include Pictures.

  • Document other Hazards here. Please include Pictures.

  • Document other Hazards here. Please include Pictures.

  • Document other Hazards here. Please include Pictures.

Report complete

  • Inspector Signature

  • Time of Inspection completion:

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.