Title Page

  • Site conducted

  • Inspection Location

  • Health and Safety Representative

  • Accompanied By

  • Date of Inspection

Description and Risk Level

  • 1 - Priority (Action Immediate)
    2 - Residual (Action within 24 hours)
    3 - Initial (Action within 7 days)


  • Surfaces even, e.g. no holes or loose flooring

  • Slippery areas clean and dry

  • Stock and materials stored out of the way

  • Floor openings covered when not in use

  • Floor markings clear and are in good order


  • Wide enough for good traffic

  • Clear of boxes, materials and rubbish

  • Clear of trolleys and hand trucks etc

  • Clear electrical leads and equipment

  • Vision Unobstructed


  • Fire warden helmet present, check fire hose and extinguisher for appropriate tagged date in fire cupboard

  • Extinguishers in place, pressure ok, recently serviced and clearly marked for type of fire.

  • Fire exit signs pointing the correct way and working

  • Exit doors easily opened from inside

  • Exit doors clear of obstructions

  • Fire instructions available and displayed

  • Paths of travel to exits are clear of obstructions

  • Emergency devices easily accessed

  • Sprinklers unobstructed


  • Adequate illumination

  • Good light reflection from walls and ceilings

  • Light fittings clean and in good repair


  • Not worn or broken

  • Handrails in good order

  • Landings clear of obstructions

  • Edges or approaches to stairs not raised or uneven

  • Anti-slip materials in good condition


  • Suitable for purpose, e.g. height and type

  • No broken or missing rungs or other defects

  • Stored in proper place


  • Dangerous goods correctly stowed and SDS's and emergency instructions available

  • Storage designed to minimise lifting problems

  • Heavy items stored on lower shelves

  • Material stored in racks and bins

  • Shelves free of dust and rubbish

  • Stacks stable with good foundations

  • Pallets safely stacked and in good condition


  • No broken plugs, sockets or switches

  • No exposed conductors or inner cores

  • No frayed of defective leads

  • Portable electrical equipment fitted with a current test tag and in good repair

  • No exposed temporary leads on floors


  • Washrooms clean

  • Toilets clean

  • Mealrooms clean and tidy


  • Cabinets and contents clean and orderly and within use by date

  • Emergency numbers displayed


  • Bins located at suitable points around area

  • Combustible refuse removed


  • Are people in the work area you are inspecting adhering to all OH & S requirements and conforming to Safe Work procedures?

  • Is the appropriate PPE for the area being worn?


  • Are all safety signs in the area visible and adequate?


  • Is a Hazard Report required as a result of this Workplace Inspection Report?

  • Click on the link to report online: https://pov-incidents.nogginoca.com

  • contact WHS team at whs@parliament.vic.gov.au (mailto:whs@parliament.vic.gov.au)

  • ***Notification sent to Maintenance***

  • Signature

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