EricHoehn1234

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

• Personnel in attendance

Safety

• Is medical help readily available?

  Yes

  No

  N/A

• Is there an on-site medical office?

  Yes

  No

  N/A

• Are adequate first-aid supplies available?

  Yes

  No

  N/A

• Eye wash stations?

  Yes

  No

  N/A

• Are first-aid supplies and eye wash stations clearly marked?

  Yes

  No

  N/A

• Are all incidents and accidents properly reported, investigated and documented?

  Yes

  No

  N/A

• Are they willing to fill out the LAUNCH investigation form?

  Yes

  No

  N/A

• Are they willing to get supervisor and witness statements after an incident happens?

  Yes

  No

  N/A

• Are Safety Inspections conducted according to standard law?

  Yes

  No

  N/A

• Are Safety Meetings conducted?

  Yes

  No

  N/A

• How often are the safety meetings? Is it for all employees?

• Are Hazard Control Logs posted throughout the workplace?

  Yes

  No

  N/A

• Safety posters? Safety treads/rugs?

  Yes

  No

  N/A

• Is the safety bulletin board current?

  Yes

  No

  N/A

• Is driving part of the job? Driving safety program? If employees have to drive for work we become responsible for their safety while driving.

  Yes

  No

  N/A

• Explain driving training.

• Are all forklift drivers required to be certified before operating machinery?

  Yes

  No

  N/A

• Do they train employees to operate powered industrial vehicles? Employees must be certified for each type of vehicle that they are authorized to operate.

  Yes

  No

  N/A

• Explain types of training they offer.

• What is the client’s safety program?

• Is light duty work available if employee is injured?

  Yes

  No

  N/A

• List details of light duty work if given.

• Safety training on equipment? (Example: Lifts, Harnesses, Ladders)

  Yes

  No

  N/A

• How is the safety training documented for the employees?

• Review OSHA Logs for past three years? (types of injuries, lost time days, light duty days)

• Review the past 3 years of OSHA logs. Take note of the types of injuries, the amount of lost time days, and the amount of light duty days.

• Add media

  Media

• Mod rate for the past three years?

• Experience Mod rate refers to their workers' comp insurance rate. It is found on the second page of their annual NCCI report. The Mod rate reflects the past three years of claims activities.

• Problem areas?

• Locations of incidents that occur at site?

• How often do these incidents occur?

• Safety comments...

• Safety Images

  Media

Work Area Walkthrough

• Presence of litter or spilled liquid on the floor; lack of general housekeeping?

  Yes

  No

  N/A

• Any cord tripping hazard?

  Yes

  No

  N/A

• Catwalk or high reach areas observed? Properly railed? Proper tie down?

  Yes

  No

  N/A

• Are stairwells well lit? Marked?

  Yes

  No

  N/A

• Are stairway banisters, treads and/or risers in good condition? Good traction?

  Yes

  No

  N/A

• Are all walkways clearly marked and free of debris?

  Yes

  No

  N/A

• Are all OSHA guidelines being followed for PPE?

  Yes

  No

  N/A

• What type work shoes are required?

• Does required PPE change for each job position?

  Yes

  No

  N/A

• If yes, explain.

• Signs for PPE required in areas clearly marked?

  Yes

  No

  N/A

• Are work areas monitored by security cameras?

  Yes

  No

  N/A

• Are emergency numbers for medical, fire, law enforcement and ambulance posted on visible spot?

  Yes

  No

  N/A

• Are fire exits clearly marked and free of debris?

  Yes

  No

  N/A

• Employees aware of the locations of the exits, alarms, and extinguishers?

  Yes

  No

  N/A

• Are fire extinguishers readily available?

  Yes

  No

  N/A

• Are the fire extinguisher tags expired?

  Yes

  No

  N/A

• Are fire drills conducted frequently?

  Yes

  No

  N/A

• Are 'Hot' items marked?

  Yes

  No

  N/A

• Are flammable materials stored near machinery or heat sources?

  Yes

  No

  N/A

• Are features of fire protection kept clean and in good working order?

  Yes

  No

  N/A

• Are doors to enclosed stairwells kept closed at all times?

  Yes

  No

  N/A

• Exits clear of debris/boxes, etc?

  Yes

  No

  N/A

• Work area comments....

• Work area images

  Media

Outside the Facility

• Are company parking lots well lit and clearly marked?

  Yes

  No

  N/A

• Is parking easily accessible?

  Yes

  No

  N/A

• Is there a parking lot or street parking?

  Parking Lot

  Street Parking

• Is the area known for thefts or robberies? (Think about if you feel safe walking around through the neighborhood where the facility is located)

  Yes

  No

  N/A

• Do employees have to cross a street to get to their job? If yes, is this a side street or a busy street?

  Yes

  No

  N/A

• If yes, is this a side street or a busy street?

  Side Street

  Main Road

  Traffic varies with time of day

• Are there security cameras in the parking lot?

  Yes

  No

  N/A

• Is there a designated smoking area for workers?

  Yes

  No

  N/A

• Where is the smoking area? Describe if possible.

• Outdoor comments....

• Outdoor Images

  Media

End Walkthrough

• What is your overall impression?

• List at least one positive thing that you took away from this walkthrough.

• List at least one concern that you have from this walkthrough (no place is perfect).

• Add signature

  Sign

• Select date

  Date