Information

  • Inspection Title

  • Document No.

  • Conducted on

  • Prepared by

  • General housekeeping is good

  • Take photo of problem area

  • Comment

  • Slip, trip, fall hazards

  • Take photo of problem area

  • Comment

  • Mats/rugs secure

  • Take photo of problem area

  • Comment

  • Drawers/cupboards closed

  • Take photo of problem area

  • Comment

  • Adequate ventilation

  • Take photo of problem area

  • Comment

  • Ventilation clean

  • Take photo of problem area

  • Comment

  • Fire hoses/extinguishers checked

  • Take photo of problem area

  • Comment

  • Equipment clearly marked

  • Take photo of problem area

  • Comment

  • Fire equipment clear of blockage

  • Take photo of problem area

  • Comment

  • Sufficient illumination level

  • Take photo of problem area

  • Comment

  • Any burnt out bulbs

  • Take photo of problem area

  • Comment

  • Emergency lighting operating

  • Take photo of problem area

  • Comment

  • Locked or barred exits

  • Take photo of problem area

  • Comment

  • Adequately illuminated exits

  • Take photo of problem area

  • Comment

  • Exterior surfaces clear for prompt exit

  • Take photo of problem area

  • Comment

  • Exit map for all locations

  • Take photo of problem area

  • Comment

  • Nothing blocking exits

  • Take photo of problem area

  • Comment

  • Tools properly grounded/good condition

  • Take photo of problem area

  • Comment

  • Proper PPE's

  • Take photo of problem area

  • Comment

  • Potential for repetitive strain injury

  • Take photo of problem area

  • Comment

  • Loose hair or clothing

  • Take photo of problem area

  • Comment

  • Labels clear

  • Take photo of problem area

  • Comment

  • Proper storage

  • Take photo of problem area

  • Comment

  • Extension cords in good condition

  • Take photo of problem area

  • Comment

  • Extension cord in good condition

  • Take photo of problem area

  • Comment

  • Any unsafe practices observed

  • Take photo of problem area

  • Comment

  • Inspector 1

  • Inspector 2

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.