DWM Facility Inspection 1.0

• Site conducted

  Select

• Document No.

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

• Facility

  Select

• Facility number and/or name i.e (TWAS BLDG 101) or (BLDG 101)

• Client / Site

• Personnel

Fire Protection

• Annual Fire Inspection (Email report to Safety Manager. Create actions based off your discrepancies)

  Yes

  No

  N/A

• Are fire extinguishers mounted, identified and placed so that they are readily accessible to employees?

  Yes

  No

  N/A

• Does the facility have fire extinguishers provided in adequate number and type?

  Yes

  No

  N/A

• Does the facility have a fire protection system that is operational?

  Yes

  No

  N/A
Fire extinguishers

• Is the fire extinguisher charged?

  Yes

  No

  N/A

• Has the fire extinguisher tag been signed for the month?

  Yes

  No

  N/A

• Add media

  Media

First Aid

• Does the facility have First Aid Kits accessible to the employees?

  Yes

  No

  N/A
First Aid Kits

• Is the First Aid Kit adeqautley stocked?

  Yes

  No

  N/A

• Please contact vendor to order more supplies!

• Are all items current (not expired)?

  Yes

  No

  N/A

• Is the First Aid Kit properly secured and visible to employees?

  Yes

  No

  N/A

AED

• Does the facility have an adequate amount of AEDs available to employees?

  Yes

  No

  N/A

• Please use the Check AED app to inspect AEDs

Housekeeping

• Is the facility kept clean?

  Yes

  No

  N/A

• Is an adequate cleaning schedule maintained? i.e Trash removed, dust, and cleaning.

  Yes

  No

  N/A

• Is storage restricted to designated areas?

  Yes

  No

  N/A

Walking Surfaces

• Are the walking surfaces adequately lit?

  Yes

  No

  N/A

• Are all walking surfaces in the work place kept free form protrusionon or slips, trips and fall hazards

  Yes

  No

  N/A

• Abate the hazard, notify personnel and forward to facility maintenance!

• Walking Surface Hazard/Slips, Trips and Fall Hazards.

Walking Surface Hazard

• Information (Location and Hazard)

• Hazard

  Media

Handrails, Guardrails and Stairs

• Are covers and /or guardrails provided to protect personnel from the hazards of any opening?

  Yes

  No

  N/A

• Are handrails provided serviceable?

  Yes

  No

  N/A

• Notify facility maintenance!

Guardrail Discrepancy

• undefined

• Hazard

  Media

Hazardous Communication

• Hazardous Communications (Complete if the facility has chemicals)

  
HazComm Check

• Are Safety Data Sheets accessible to employees at all times?

  Yes

  No

  N/A

• Is there an SDS for each chemical employees are exposed too?

  Yes

  No

  N/A

• Are chemical containers properly labeled?

  Yes

  No

  N/A

• Are hazardous materials and flammable liquids properly stored?

  Yes

  No

  N/A

Electrical

• Do electrical access panels have the appropriate clearance?

  Yes

  No

  N/A

• Are cold and heat producing items plugged directly into outlets? (Refrigerators, Heaters, Coffee Pots, or Microwaves?

  Yes

  No

  N/A

• Are all electrical wires, cords or outlets serviceable ?

  Yes

  No

  N/A
Electrical Hazard

• Abate and forward to facility maintenance!

• Location and hazard

• Add media

  Media

Eye Wash Stations

Eye Wash Station

• Are nozzles and eye cups covered to prevent contamination?

  Yes

  No

  N/A

• Is the station access clear?

  Yes

  No

  N/A

• Is the station inspected as required?

  Yes

  No

  N/A

Exits

• Are exit doors unlocked and accessible during working hours?

  Yes

  No

  N/A

• Are exits marked properly? (Signs and lighting)

  Yes

  No

  N/A

• Do exit doors open in the direction of egress?

  Yes

  No

  N/A
Exit Discrepancy

• Exit Hazard

  Media

• Location and Hazard

Miscellaneous

• Does the building appear to be in good repair? FOWARD ALL WORK ORDER REQUEST TO FACILITIES MAINTENANCE VIA THE DROP BOX AND TRACK AS AN ACITON

  No

  Yes

• Does the facility have ice machines

  No

  Yes

• Is the ice machine producing condensation or leaking? (Look for possible sources of moisture around the machine i.e uninsulated lines)

  No

  Yes

• Is the ice machine dirty or contaminated?

  No

  Yes

• Is the ice machined on maintenance schedule? (i.e line and filter replacement)

  No

  Yes

• Is the facility free from mold

  No

  Yes

• Source of mold growth?

  Water Leak

  Moisture/Dampness

  Unknown

Comments

• Comments

• Safety Officer Signature

  Sign