Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

BUILDING SECURITY

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

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

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

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

FIRE SAFETY

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

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

  • Are fire extinguisher proper type and regularly inspected?

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

ELECTRICAL

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

  • Electrical panels equipped with required covers and properly marked?

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

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

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

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

FLOOR & DOOR (s)

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

  • Are shop floors properly marked for walkways?

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

  • Are exterior doors in good working order and lockable?

  • Are interior doors in good condition, shut properly?

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

HOUSEKEEPING

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

  • Material storage areas are well organized and properly marked?

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

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

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

WELDING AND BURNING

  • Gas cylinders stored upright?

  • Proper separating distances between fuels & oxygen?

  • Goggles or shields used?

  • Fire extinguishers readily available?

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

PERSONAL PROTECTIVE EQUIPMENT

  • Hard hats used when required?

  • Safety glasses or shield being worn when appropriate?

  • Respirators used when required? Proper respirator documentation available?

  • Hearing protection being worn when required?

STATIONARY EQUIPMENT

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

  • Is equipment maintained in a professional, clean manner?

  • Does equipment have a PM tag denoting maintenance upkeep?

  • Are operating instruction posted and legible?

Signature

  • QCAM

  • Safety Manager

  • General manager

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.