Information
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Department
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Shift
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Conducted on
1.0 Previous Inspection
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1.1 Has the last inspection been reviewed?<br>
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1.2 Are there any outstanding actions?<br>
2.0 Workplace Conditions
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2.1 Housekeeping (all areas of employment, passageways, storerooms, service room must be kept clean, orderly, and sanitary)<br>
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2.2 Floors, Aisles, Passageways, Ceilings, Walls, Doors (clean/free of nails, splinters/free of trip&fall hazards/openings covered or barricaded)<br>
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2.3 Lighting (clean/good condition/illuminates work area) <br>
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2.4 Warning Devices (fire/emergency alarm functional, hazard warning on vehicles or moving equipment, hazard warning, signs, and labels, danger, caution, instructions on equipment, LOTO for out of use)<br>
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2.5 PPE (available where needed, ready to use, sanitary conditions)<br>
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2.6 Ladders (good conditions:not broken, no missing bolts, steps in good condition, balancing correctly, wheels in good condition, non-slip safety feet, properly stored)<br>
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2.7 Platforms/Elevated Surfaces (safe access to platforms, railing and toe boards on platforms above 4 ft)<br>
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2.8 Stairs (handrails/guardrails in good condition, well lighted, unobstructed steps and landings)<br>
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2.9 Racks (beams/columns/struts in good condition, materials stacked correctly, no damaged ingredients)<br>
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2.10 Confined Spaces (spaces identified/isolated/locked out/tagged/ventilated before entry, company procedure for entry and cleaning, permits completed, PPE in use)<br>
3.0 Emergency/Fire Safety
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3.1 Exits/Egress (clearly marked, free of debris, stairway doors are kept closed)
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3.2 Fire Extinguishers (marked, fully charged, activation pin inserted, inspection date within 1 yr, unobstructed, hose and container in good condition)
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3.3 Evacuation Procedure/Plan (posted and updated)
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3.4 Fire Alarms (marked, illuminated)<br>
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3.5 Fire Sprinklers (18 inches of clearance below) <br>
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3.6 Eye Wash/Shower Stations (working properly, not blocked)
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3.7 AED (Green check mark displaying)
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3.8 First Aid Cabinets (fully stocked, no expired items)
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3.9 Chemical Handling/Storage/PPE (in correct cabinet, cabinet secure, flammable cabinets not damaged)
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3.10 Electrical Outlets/Panels (no overloaded outlets, electrical panels closed, only authorized employees working on electrical panels with correct PPE)
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3.11 Electrical cords (in good conditions, no tripping or electrical hazards)
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3.12 Arc Flash (PPE in use, barricades/caution tape in use, Arc Flash procedures being followed)
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3.13 Welding, Cutting, Brazing (equipment in good condition, employees wearing correct PPE, no gas leaks, Hot Work Permit completed)
4.0 Machinery
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4.1 Machines/Guarding (guards in place while in operation, dock locks functioning properly, malfunctions have been reported, LOTO in place, LOTO Procedure available)<br>
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4.2 Shutoff/Emergency Stop (working properly, red, not obstructed)<br>
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4.3 New Machinery (safety devices in working condition, New Equipment Checklist completed)<br>
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4.4 Hand Tools (tools in good condition, no broken handles, blades stored or disposed properly)<br>
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4.5 Powered Tools (safety guards in place, damaged tools placed out of service or disposed properly)<br>
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4.6 Lockout Systems (LOTO Procedure Sheet displayed, Authorized/Affected employees trained on LOTO procedures)<br>
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4.7 Work Area (good repairs, sufficient clearance, signs marking)<br>
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4.8 Batteries/Battery Changing Station (batteries in good/clean condition, charging units/cables in good condition)<br><br>
5.0 Material Handling
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5.1 Powered Industrial Trucks (only trained/authorized employees operating, reverse warning horn functioning, loads carried at low heights)<br>
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5.2 Handling Aids (dollies;carts in good condition, properly stored)<br>
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5.3 Pallets (in good condition, placed in designated location, damaged pallets placed in designated location)<br>
6.0 Safety Behaviors
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6.1 Lifting (sizes up load, no lifting over 50 lbs, practices proper lifting techniques)<br><br>
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6.2 PPE (using safety glasses, ear plugs properly, safety shoes if required)<br><br>
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6.3 Caution Signs (Wet Floor Signs, Work Above Signs, Caution Tape)<br><br>
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6.4 Fire Safety (employees know locations of fire extinguishers/Fire alarms, employees know emergency exit routes)<br><br>
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6.5 Personal Clothing (no loose shirts/pants)<br><br>
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6.6 Accident/Incident Reporting (employees understand who to report accidents/incidents)<br><br>
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6.7 Operating Machinery (safety rules and procedures followed, dock locks in use when entering trailer, no metal jewelry when serving machinery, no bypassing of guards)<br><br>
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6.8 Ladder Safety (maintain 3-point contact, no standing on top 2 steps)<br><br>
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6.9 Powered Industrial Truck Use (sound horn at intersections/doorways/employees, Pre-Use Inspection completed, rules followed)<br><br>
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6.10 Monthly Safety Topics (employees understand safety topics, employee practice safety rules)<br><br>
Sign Off
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Auditor
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Department Representative