Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1.0 Arctic corridor
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1.1 Housekeeping complete?
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1.2 Exit sign illuminated?
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1.3 Doors free of obstruction?
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1.4 Emergency lights have been tested and inspection sticker is current?
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All fire rated doors shall be able to latch unassisted when released? (test out all fire rated doors, down stairs and upstairs in this dorm - these doors are located at the front, middle and back of the dorm - including the exit doors)
2.0 Stair Cases
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2.1 Free of obstructions
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2.2 Emergency evacuation maps posted?
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2.3 No smoking signs posted?
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2.4 Exit sign illuminated?
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2.5 Emergency lights have been tested and inspection sticker is current?
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2.6? Stairway railing is firmly attached and in good condition.
3.0 Dorm Hallway
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3.1 Exit sign illuminated?
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3.2 Fire extinguisher present and ready?
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3.3 Water cooler area clean and free of obstructions?
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3.4 Water cooler electrical cord quaterly inspection tag upto date?
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3.5 Midway exit clear and clean with signage ?
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3.6 Storage room clean with dirty and clean laundry separated ?
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3.7 Emergency exit doors kept closed ?
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3.8 Doors to rooms closed ?
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3.9 Emergency lights have been tested and inspection sticker is current?
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3.10 Ensure Security Phone is operating (call security as test)
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3.11 Ensure Emergency Exit Door is shut and latching secured
4.0 Laundry Room
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4.1 Door closed ?
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4.2 Sharps container present?
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4.3 Housekeeping complete ?
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4.4 MSDS binder present and upto date?
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4.5 Lint removed from dryers?
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4.6 Chemicals stored properly?
5.0 Housekeeping Room
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5.1 Spray bottles properly labeled ?
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5.2 Vacuum cleaner electrical cord inspected (i.e updated inspection tags)?
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5.3 Room clean and orderly?
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5.4 MSDS binder present and upto date?
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5.6 PPE available? (gloves, masks' and glasses)
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5.5 Cart in good working order?
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5.7 No personal luggage stored in Housekeeping room ?
6.0 Mechanical/Electrical Room
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6.1 Fire extinguisher ready and available for use?
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6.2 Room free and clear of debris?
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6.3 Taps in off position with no signs of leaks?
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6.4 Nothing to the right of the hatched black/yellow tape?
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6.5 Chemicals stored on floor to the sink?
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6.6 Mops hanging on proper hangers?
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6.7 Eye wash stations mounted and visible?
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6.8 Carts stored properly with no linens in it?
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6.9 Carbon monoxide detector green and not beeping?
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6.10 Water tank clear and clean?
10.0 Observations
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Comments/ Observations
Corrective Actions
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Action Owner Due Date
Inspection Review
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HSE review
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Management Review
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Front Line Supervisor
