Information

  • Inspection Title

  • Audit Area

  • Shift

  • Conducted on

  • Your Current Department

  • Prepared by

  • Location

Previous inspection

  • First time auditing area?

  • Are there any outstanding actions from previous audits?

General Safety

  • ANSI approved safety glasses with side shields worn by all employees?

  • Other applicable PPE inspected and worn correctly? (Hearing protection, cut-resistant sleeves/gloves, etc.)

  • Is the area free from water or any other substances that could create a slip, trip, or fall hazard?

  • Take picture of finding

  • Wet floor signs are available? Wet floor signs are stored in the proper place when not in use?

  • Are all ladders properly secured when not in use?

  • Take picture of ladder not properly stored.

Hazard Communication

  • Does area have a flammable liquid storage cabinet?

  • Are chemicals properly stored? (i.e flammable stored in fire rated cabinet, no items stored on top, cabinet grounded)

  • Take picture of finding

  • Does the flammable cabinet contain combustible materials?

  • Take picture of combustables

  • Are flammable cabinet doors shut when not in use?

  • Take picture of open flammable cabinet

  • Are items stored on top of flammable cabinet?

  • Take picture of items stored on top of flammable cabinet

  • Are all secondary containers labeled correctly and legible?

  • Take picture of finding

  • Is correct PPE worn when handling chemicals? (Where required)

  • Do employees know the chemical and physical hazards associated with the chemicals they are using? (Where Applicable)

  • INTERVIEW EMPLOYEE(S)

  • Interview(s)

  • Employee
  • Employee Name

  • Job Title

  • Chemical Physical Hazards - Hazard Pictograms

  • Physical Health Hazards

Machines and Guarding

  • Is Pre-Shift inspection completed and signed by Operator and Supervisor? (Where applicable)

  • Take picture of inspection

  • Take a picture of incorrect pre-shift inspection and assign action to correct finding

  • Are work guidances posted and do they include PPE requirements and safety awareness? (Where applicable)<br><br>

  • Take picture of work guidance(s)

  • Take picture of incorrect work guidance and assign action to correct finding

  • Are Lock-Out Tag-Out procedures posted? (Where applicable)<br><br>

  • Take picture of LOTO Procedure(s)

  • Take picture of missing procedure and assign action to correct finding.

  • Are LOTO locks attended and controlled by assigned operator? (No LOTO locks can be left unauthorized with key present)

  • Take a picture of uncontrolled or unattended LOTO lock and assign action to correct finding

  • Are all machine entrapment procedures posted? (Where applicable)

  • Take picture of entrapment procedure

  • Are all machine safe guards in place and not damaged? (Light Curtains, E-Stops, Presence Sensing Devices, Safety Awareness Chains) (Where applicable)

  • Take picture of missing or damaged presence sensing device.

Fire Protection and Emergency Exits

  • Are fire extinguishers accessible and tag current within one month of today's date? <br>NOTE: There should be nothing stored or staged within three feet of the fire extinguisher.

  • Take picture of fire extinguisher with tag to date

  • Take picture of blocked fire extinguisher or out of date tag. Assign action to correct finding.

  • Are emergency exit signs illuminated?

  • Take picture of non-illuminated sign and assign action to correct finding.

  • Is there a clear pathway to the exits?

  • Take picture of what is blocking pathway to exit. Assign action to correct finding.

  • Are evacuation maps posted in area?

  • Take picture of evacuation map in area

  • Are all gas cylinders secured to the wall and are protective caps in place when not in use? (Where applicable)

  • Take picture of missing protective caps or unsecured gas cylinder(s) and assign action to correct finding.

  • Add media

Electrical Safety

  • Are there electrical panels available within the work area?

  • Are all electrical panel doors closed and with nothing stored within 3 feet in front of them?

  • Take picture of electrical panel

  • Are electrical cords free of cuts, nicks and bare wires?

  • Take picture of electrical cord with cuts, nicks, or bare wires

  • Are extension cords being used in work area?

  • Take picture of extension cord used

Forklift and Rack Safety

  • Is pre-shift forklift checklist completed by forklift operator with no findings? (Assign action if not completed)

  • Take picture of the pre-shift checklist

  • Are forklift operators sounding horns at intersections, corners and when in reverse?

  • Are forklifts operated safely at all times?<br>NOTE: Check for seatbelts, excessive speed, sudden stopping and turning.

  • Are racks and pallet decking available within the audit area?

  • Are any racks or pallet decking damaged?

  • Are all weight limits posted on all pallet decking within audit area?

Employee Communication and Suggestions

  • Are there any additional employee safety concerns?

  • Describe the employee safety concern.

  • Employee Name and Job Title

  • Are there any additional safety concerns within work area? (If yes, create action describing additional safety concern)

Sign Off

  • Auditor's signature

  • Area Supervisor or Manager 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.