Facility Internal Inspection Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

BUILDING SECURITY

• Is there an exit checklist to ensure building is secure when unoccupied?

  Yes

  No

  N/A

• Are all exterior windows in good working order and lockable?

  Safe

  At Risk

  N/A

• Is there a visitor reporting instruction clearly posted at entrance ways?

  Yes

  No

  N/A

• Is there a main contact number posted on the outside of the entrance for emergency access?

  Yes

  No

  N/A

FIRE SAFETY

• Is there an emergency evacuation plan posted denoting emergency routes?

  Safe

  At Risk

  N/A

• Are there fire extinguishers located at the exit points and in fire risk areas?

  Safe

  At Risk

  N/A

• Are fire extinguisher proper type and regularly inspected?

  Safe

  At Risk

  N/A

• Are emergency responders contact numbers clearly posted for occupants (fire, police)?

  Yes

  No

  N/A

ELECTRICAL

• Are all emergency and exterior lighting in good working order?

  Safe

  At Risk

  N/A

• Electrical panels equipped with required covers and properly marked?

  Safe

  At Risk

  N/A

• Do electrical panels have proper clearance in accordance with safety standards?

  Safe

  At Risk

  N/A

• Do coffee pots have the required automatic shut off feature?

  Safe

  At Risk

  N/A

• Is computer and electronic equipment properly protected from electrical surges?

  Safe

  At Risk

  N/A

• Ground fault interrupters being used around all water sources (restrooms, kitchens)?

  Safe

  At Risk

  N/A

FLOOR & DOOR (s)

• Are carpet areas in good condition and free of trip hazards due to torn or worn areas?

  Safe

  At Risk

  N/A

• Are shop floors properly marked for walkways?

  Yes

  No

  N/A

• Are floors free of trip hazards and in good condition?

  Safe

  At Risk

  N/A

• Are exterior doors in good working order and lockable?

  Safe

  At Risk

  N/A

• Are interior doors in good condition, shut properly?

  Yes

  No

  N/A

• Are overhead doors in good working order and properly maintained?

  Yes

  No

  N/A

HOUSEKEEPING

• Work Areas are kept in a neat and professional appearance?

  Yes

  No

  N/A

• Material storage areas are well organized and properly marked?

  Yes

  No

  N/A

• Scrap waste and replaced parts are disposed of in proper containers?

  Yes

  No

  N/A

• Passageways and walkways are clear of debris, material and parts?

  Yes

  No

  N/A

• Stationary Equipment is kept clean, free of debris, dust and scrap?

  Yes

  No

  N/A

WELDING AND BURNING

• Gas cylinders stored upright?

  Yes

  No

  N/A

• Proper separating distances between fuels & oxygen?

  Safe

  At Risk

  N/A

• Goggles or shields used?

  Yes

  No

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Hoses in good condition and regulators off when not in use?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats used when required?

  Yes

  No

  N/A

• Safety glasses or shield being worn when appropriate?

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

STATIONARY EQUIPMENT

• Are proper safety guards attached and used when operating equipment?

  Safe

  At Risk

  N/A

• Is equipment maintained in a professional, clean manner?

  Yes

  No

  N/A

• Does equipment have a PM tag denoting maintenance upkeep?

  Safe

  At Risk

  N/A

• Are operating instruction posted and legible?

  Safe

  At Risk

  N/A

Signature

• QCAM

  Sign

• Safety Manager

  Sign

• General manager

  Sign