Title Page

  • Client / Site

  • Date and Time of Inspection

  • Inspected by

  • Location

General Information

  • Number of Employees

  • Description of work to be performed

  • Take a photo of the work area


  • Have all staff conducted the ELMO Workplace Health and Safety Awareness (EGSC) that includes information on safe working postures?

  • Are all staff knowledgeable about ergonomics and ways to mitigate ergonomic risks in the workplace?

  • Are staff aware that they need to report ergonomic symptoms?

  • Are rotation or rest breaks used to reduce time in awkward postures?

  • Does work scheduling minimize excessive overtime that causes fatigue?

  • Is there enough staff to do individual workloads?

  • Can the work be performed without twisting or overly bending the lower back?

  • Are all staff protected against eyestrain or glare in the process of doing their job?

  • Are neck and shoulders relaxed when performing tasks?

  • Are staff comfortable without experiencing any pressure points on any part of their body (wrists, forearms, back of thighs)?

  • Are all pieces of furniture or equipment adjusted, positioned, and arranged to minimize strain on all parts of the body?

  • Are all pieces of furniture or equipment in good working order?

  • Are workstations set up adequately?

Surfaces for Walking and Working

  • Are working and walking surfaces clean and dry?

  • Are working surfaces unobstructed?

  • Are walking surfaces even?

Materials Handling

  • Do materials have handles to help carry loads?

  • Are there carts, trollies, or other aids readily available for moving materials?

  • Are all materials delivered as close as possible to where they will be used?

  • Are all materials stored at waist height?

  • Are all loads labeled with their weight?


  • Are the seats well-designed, easy to adjust, and comfortable?

  • Do staff have to lean forward to see/do their work when working?


  • Recommendations

  • Overall Assessment

  • Full Name and Signature

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.