Facility Inspection Form

• Site conducted

  Select

• Facility

• Facility Address
  Address

• Date

  Date

• Inspector

• Accompanied by

Emergency Exits/Exit Corridors/Stairwells

• Emergency Exit Maps Posted

  Yes

  No

  N/A

• Emergency Exit Signs Present and Illuminated

  Yes

  No

  N/A

• All Exits Unobstructed

  Yes

  No

  N/A

• All Pull Stations Clearly Marked and Unobstructed

  Yes

  No

  N/A

• All Aisles/Corridors Unobstructed to Allow Evacuation

  Yes

  No

  N/A

• Are Stairs Free of Litter or Spills

  Yes

  No

  N/A

• Is Stairwell(s) Adequately Lit

  Yes

  No

  N/A

• Signs in Stairwell(s) Posted and Legible

  Yes

  No

  N/A

Fire Extinguishers

• Fire Extinguishers Clearly Marked and Unobstructed

  Yes

  No

  N/A

• Fire Extinguishers Charged, Inspected, and Tagged

  Yes

  No

  N/A

Walking Surfaces

• Is Carpet Maintained and Free of Trip Hazards

  Yes

  No

  N/A

• Interior Walkways Free of Trip Hazards

  Yes

  No

  N/A

• Exterior Walkways Free of Trip Hazards

  Yes

  No

  N/A

• Handrails, Treads, and Risers in Good Condition

  Yes

  No

  N/A

• Signs Posted to "Use Handrails" or "Watch Your Step"

  Yes

  No

  N/A

Electrical Hazards

• Grounds in Place on All Electrical Equipment

  Yes

  No

  N/A

• All Breakers Marked

  Yes

  No

  N/A

• Breaker Boxes Accessible

  Yes

  No

  N/A

• Covers on Breaker Boxes

  Yes

  No

  N/A

• J-Box's Covered in Good Condition

  Yes

  No

  N/A

• Electrical Cords in Good Condition

  Yes

  No

  N/A

• Signs Posted for Electrical Hazards

  Yes

  No

  N/A

Chemical/Fire Hazards

• All Chemical Containers Labeled

  Yes

  No

  N/A

• SDS Available for All Employees

  Yes

  No

  N/A

• Flammables Stored Away from Ignition Sources

  Yes

  No

  N/A

• Eye Station(s) in Working Condition

  Yes

  No

  N/A

• First Aid Kit Available on Premises

  Yes

  No

  N/A

• Compressed Gas Cylinders Restrained Outside

  Yes

  No

  N/A

• Signs Posted for Chemical or Fire Hazards

  Yes

  No

  N/A

• Are Employees Trained Annually in Hazardous Communication

  Yes

  No

  N/A

Hand Tools and Powered Equipment

• All Hand Tools in Good Condition

  Yes

  No

  N/A

• All Power Tools in Good Condition

  Yes

  No

  N/A

• All Guards Present on Powered Equipment

  Yes

  No

  N/A

• Signs Posted Reminding Employees to Use PPE

  Yes

  No

  N/A