Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

Begin Audit

Sign In and Facility Information

  • Facility Location

  • Facility Picture

  • Inspector

  • Supervisor, Leads, Operators, Safety Coordinator Names In Attendance On Audit

  • Date and Time

AIB / Food Safety

AIB / Food Safety

  • What were the results of your two previous AIB results

  • Are all AIB recommendations complete and documented

  • Has Grand Rapids Quality Assurance been updated

  • Do you use a PCO for weekly and monthly inspections

  • Does Maintenance Supervisor accompany AIB audits

  • Does Maintenance Lead accompany AIB audits

  • Is Building Maintenance responsible for AIB preparation and audits

Refrigeration

Refrigeration

  • When was your last Process Hazard Analysis (PHA)

  • Who conducted your last PHA audit

  • Are all PHA recommendations complete and documented

  • When was your last Mechanical Integrity (MI) audit conducted

  • Who conducted your last MI audit

  • Are all Mechanical Integrity recommendations complete and documented

  • When was your last GFS Internal Refrigeration inspection

  • Who conducted your last internal annual refrigeration inspection

  • Are all refrigeration audit recommendations complete and documented

  • What score was obtained on your last refrigeration inspection

  • How many CIRO refrigeration operators do you have on site

  • How many CARO refrigeration operators do you have on I site

  • Are all refrigeration operators CIRO and CARO licenses active with RETA

  • Have you had a Garden City Ammonia Program (GCAP) compliance audit

  • Are all GCAP recommendations complete and documented

  • Do you have a Process Safety Management (PSM) team in place on site

  • Who is your PSM coordinator on site

  • How many PSM meetings have been conducted in the past 12 months

  • Are notes taken and recommendations given during PSM meetings

  • Do you have city water / sewer

  • Do you have chemical water treatment

  • Who is your water treatment provider

  • Is your current water treatment effective

  • How often is your water treatment provider on site each month

Pay

Pay

  • Are all mechanics within the maintenance pay scale

  • Are all RETA certified operators within the refrigeration pay scale

  • Are you aware of how to budget ahead for operators who will be getting RETA certifications

DC Operations

DC Operations

  • What is the DC PPH

  • What is the DC repair expense account goal

  • Is the DC repair expense account result at or below goal

  • What is the DC miscellaneous expense account goal

  • Is the DC miscellaneous expense account result at or below goal

  • What is the DC refrigeration expense account goal

  • Is the DC refrigeration expense account result at or below goal

  • Do you utilize MPC on a monthly basis

  • Do you know the difference between an expense and a capital

  • Do you know how capital depreciation works

  • Do you know how the asset transfer / disposal process works

  • Do you have a capital plan list of projects

  • Do you have an expense plan list of projects or expenses

  • Do you he help with capital or expense planning

  • Do you currently use Performance IQ on a monthly basis

Utility

Utility

  • Do you currently track electric utility usage on a monthly basis

  • What is your electric utility charge per KWH

  • Does your electric utility have on peak / off peak rates

  • Is your refrigeration control system set to run on peak / off peak

  • What was your electric utility cost per case result for the previous fiscal year

  • What is your current electric utility cost per case goal for this fiscal year

  • Do you currently track gas utility usage on a monthly basis

  • Do you currently track water utility usage on a monthly basis

  • Do you currently track sewer utility usage on a monthly basis

  • Do you currently track garbage costs and weights on a monthly basis

  • Do you currently track recycle rebates on a monthly basis

  • Have you had an energy audit from an outside vendor

  • When do you plan to have your next energy audit

  • Have all energy conservation measures (ECM) been addressed and documented

  • Do you have an energy management team

Performance Management

Performance Management

  • Do you have the maintenance performance metrics in place and fully implemented

  • Are you posting the maintenance performance metrics results for mechanics

  • Are you posting the maintenance performance metrics results for custodians

  • Do you utilize a work schedule spread sheet to balance workloads

  • Do you utilize work schedules to balance workloads

  • Are notes created for all PM and CPM inspections and returned to the employee after the inspection is complete

  • What was your last months Assigned Maintenance (AM) ratio

  • What was your last fiscal years Assigned Maintenance (AM) ratio

  • How many PM failures have you had in the last fiscal month

  • How many CPM failures have you had in the last fiscal month

  • How many PM failures have you had in the last fiscal year

  • How many CPM failures have you had in the last fiscal year

  • Does each maintenance lead have inspection goals monthly

  • If inspection goals exist for maintenance leads what are they

  • Are goals daily, weekly, monthly

  • Does the maintenance supervisor have inspection goals every month

  • If inspection goals exist for maintenance supervisor what are they

  • If inspection goals exist for maintenance supervisor what are they

  • Are goals daily, weekly, monthly

  • Who is the main person responsible for Maximo in your facility

  • How often do you personally use Maximo

  • What percentage of PM and CPM were inspected in the past fiscal month

  • What percentage of PM and CPM wee inspected in the past fiscal year

  • Are all maintenance repair parts entered into Maximo as inventory

  • Is cycle counting being compleat every fiscal month

  • What were the results of your last maintenance physical inventory audit

  • What is the dollar value of all of your parts store rooms

  • What strategies do you use to keep maintenance inventory as low as possible without sacrificing downtime due to lack of inventory

Health / Safety

Health / Safety

Safety Training

  • Is all of your safety training for your department up to date

  • Are all of your PIV safety observations complete

  • Are all of your lock out tag out semi annual observations complete

  • Who conducts the maintenance department safety training

  • Who conducts the maintenance department safety observations on PIV and Lock Out Tag Out

  • Do you post safe work days within the maintenance department

Fall Protection

  • Do all mechanics have personal fall protection equipment assigned to them

  • Do any custodians required to work in areas requiring fall protection have their own personal fall protection equipment assigned to them

  • Are all fall protection employees compliant with the weight restrictions on their equipment

  • Can all tags on fall protection equipment be easily read

  • Are all fall protection equipment in Maximo and being PM per OSHA requirements

Arc Flash

  • Has an arc flash study been conducted on all electrical equipment and distribution panels within the DC

  • Are arc flash stickers applied to all electrical equipment and panels within the DC

  • Have all maintenance employees been trained in arc flash safety

  • Is arc flash safety gear readily available to all employees who's job require it

  • Are arc flash gloves tested by a third party or replaced every six months and documented

Lift Equipment

  • Are all scissor and snorkel lifts safety inspected at least annually by a third party and documented

  • Have all safety recommendations from 3rd party inspector on scissor and snorkel lifts been completed and documented

Elevator

  • Does DC have an elevator

  • Is elevator inspection tag current

  • Elevator repairs are only allowed to be done by licensed elevator company

FM Global Insurance

  • When was your last FM Global insurance audit

  • Have all FM Global audit recommendations been completed and documented

Fire Protection

  • When was your last fire protection annual inspection completed

  • Have all fire protection annual inspection recommendations been completed and documented

Back Flow Preventors

  • Have back flow preventers on potable water been inspected in the past year

  • Is their documentation available for back flow preventers available for review

Building Maintenance

Building Maintenance

  • Do you utilize Grainger as your MRO supplier

  • How often is vibration analysis completed

  • Have all vibration analysis recommendations been properly addressed

  • How often is infrared analysis conducted

  • Have all infrared analysis recommendations been properly addressed

  • Are back up generators on a PM program

  • How often are generators PM'ed

  • Are backup generators ran under building load for 30 minutes at least once per month

  • Does your DC have a roof maintenance program

Action Plans

Action Items

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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.