Information

  • Audit Title

  • Client / Site

  • Program(s)

  • Date of Inspection

  • Inspected by

1 EMPLOYER POSTING

  • 1.3 Where employees may be exposed to any toxic substances or harmful physical agents, has appropriate information concerning employee access to medical and exposure records and material safety data sheets (MSDS) been posted or otherwise made readily available to affected employees?

  • 1.1 Is the required OSHA workplace poster displayed in a prominent location where all employees are likely to see it?

  • 1.2 Are emergency telephone numbers posted where they can be readily found in case of emergency?

  • 1.4 Are signs concerning “Exiting from buildings”, room capacities, floor loading, biohazards, exposures to X-ray, microwave, or other harmful radiation or substances posted where appropriate?<br>

  • 1.5 Is the summary of occupational injuries and illnesses posted in the month of February?<br>

2 RECORDKEEPING

  • 2.1 Are all occupational injuries and illnesses, except minor injuries requiring only first aid, being recorded as required on the OSHA 300 log?<br>

  • 2.3 Are employee training records kept and accessible for review by employees, when required by OSHA standards?<br>

  • 2.4 Have arrangements been made to maintain required records for the legal period of time for each specific type of record? (Some records must be maintained for at least 40 years?<br>

3 SAFETY & HEALTH PROGRAM

  • 3.1 Do you have an active safety and health program in operation that deals with general safety and health program elements as well as the management of hazards specific to your worksite?<br>

  • 3.2 Is one person clearly responsible for the overall activities of the safety and health program?<br>

  • 3.3 Do you have a safety committee or group made up of management and employee representatives that meets regularly and reports in writing on its activities?<br>

  • 3.4 Do you have a working procedure for handling in-house employee complaints regarding safety and health?<br>

  • 3.5 Are you keeping your employees advised of the successful effort and accomplishments you and/or your safety committee have made in ensuring they will have a workplace that is safe and healthful?

4 MEDICAL SERVICES & FIRST AID

  • 4.1 Is there a hospital clinic or infirmary for medical care in proximity of your workplace?<br>

  • 4.2 If medical and first aid facilities are not in proximity of your workplace, is at least one employee on each shift currently qualified to render first aid?<br>

  • 4.3 Have all employees who are expected to respond to medical emergencies as part of their work [(1) received first aid training; (2) had hepatitis B vaccination made available to them; (3) had appropriate training on procedures to protect them from bloodborne pathogens including universal precautions; and (4) have available and understand how to use appropriate personal protective equipment to protect against exposure to bloodborne diseases?]

  • 4.5 Are medical personnel readily available for advice and consultation on matters of employees’ health?<br>

  • 4.6 Are emergency phone numbers posted?<br>

  • 4.7 Are first aid kits easily accessible to each work area, with necessary supplies available, periodically inspected and replenished as needed?<br>

  • 4.9 Are means provided for quick drenching or flushing of the eyes and body in areas where corrosive liquids or materials are handled?<br>

5 GENERAL WORK ENVIRONMENT

  • 5.1 Are all worksites clean and orderly?

  • 5.2 Are work surfaces kept dry or appropriate means taken to assure the surfaces are slip-resistant?

  • 5.3 Are all spilled materials or liquids cleaned up immediately?

  • 5.11 Are the minimum number of toilets and washing facilities provided?

  • 5.12 Are all toilets and washing facilities clean and sanitary?

  • 5.13 Are all work areas adequately illuminated?

  • 5.14 Are pits and floor openings covered or otherwise guarded?

6 PERSONAL PROTECTIVE EQUIPMENT

  • 6.1 Are protective goggles or face shields provided and worn where there is any danger of flying particles or corrosive materials?

  • 6.7 Is appropriate foot protection required where there is the risk of foot injuries from hot, corrosive, poisonous substances, falling objects, crushing or penetrating actions?

  • 6.12 When lunches are eaten on the premises, are they eaten in areas where there is no exposure to toxic materials or other health hazards?

7 WALKWAYS

  • 7.1 Are aisles and passageways kept clear?

  • 7.2 Are aisles and walkways marked as appropriate?

  • 7.3 Are wet surfaces covered with non-slip materials?

  • 7.4 Are holes in the floor, sidewalk or other walking surface repaired properly, covered or otherwise made safe?

  • 7.5 Is there safe clearance for walking in aisles where motorized or mechanical handling equipment is operating.

  • 7.6 Is there safe clearance for walking in aisles where motorized or mechanical handling equipment is operating.

  • 7.7 Are materials or equipment stored in such a way that sharp projectiles will not interfere with the walkway?<br>

11 EXITING OR EGRESS

  • 11.1 Are all exits marked with an exit sign and illuminated by a reliable light source?

  • 11.2 Are the directions to exits, when not immediately apparent, marked with visible signs?

  • 11.3 Are doors, passageways or stairways, that are neither exits nor access to exits and which could be mistaken for exits, appropriately marked "NOT AN EXIT", "TO BASEMENT", "STOREROOM", and the like?

  • 11.4 Are exit signs provided with the word "EXIT" in lettering at least 5 inches high and the stroke of the lettering at least 1/2 inch wide?

  • 11.5 Are exit doors side-hinged?

  • 11.6 Are all exits kept free of obstructions?

  • 11.8 Are there sufficient exits to permit prompt escape in case of emergency?

  • 11.9 Are special precautions taken to protect employees during construction and repair operations?

  • 11.10 Is the number of exits from each floor of a building, and the number of exits from the building itself, appropriate for the building occupancy load?

  • 11.13 Where exiting will be through frameless glass doors, glass exit doors, storm doors, and such are the doors fully tempered and meet the safety requirements for human impact?

12 EXIT DOORS

  • 12.1 Are doors that are required to serve as exits designed and constructed so that the way of exit travel is obvious and direct?

  • 12.2 Are windows that could be mistaken for exit doors, made inaccessible by means of barriers or railings?

  • 12.3 Are exit doors openable from the direction of exit travel without the use of a key or any special knowledge or effort, when the building is occupied?

  • 12.4 Is a revolving, sliding or overhead door prohibited from serving as a required exit door?

  • 12.5 Where panic hardware is installed on a required exit door, will it allow the door to open by applying a force of 15 pounds or less in the direction of the exit traffic?

  • 12.7 Where exit doors open directly onto any street, alley or other area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?

  • 12.8 Are doors that swing in both directions and are located between rooms where there is frequent traffic, provided with viewing panels in each door?

13 PORTABLE LADDERS

  • 13.1 Are all ladders maintained in good condition, joints between steps and side rails tight, all hardware and fittings securely attached, and moveable parts operating freely without binding or undue play?

  • 13.2 Are non-slip safety feet provided on each ladder?

  • 13.3 Are non-slip safety feet provided on each metal or rung ladder?

  • 13.4 Are ladder rungs and steps free of grease and oil?

  • 13.5 Is it prohibited to place a ladder in front of doors opening toward the ladder except when the door is blocked open, locked or guarded?

  • 13.6 Is it prohibited to place ladders on boxes, barrels, or other unstable bases to obtain additional height?

  • 13.7 Are employees instructed to face the ladder when ascending or descending?

  • 13.8 Are employees prohibited from using ladders that are broken, missing steps, rungs, or cleats, broken side rails or other faulty equipment?

  • 13.9 Are employees instructed not to use the top 2 steps of ordinary stepladders as a step?

  • 13.10 When portable rung ladders are used to gain access to elevated platforms, roofs, and the like does the ladder always extend at least 3 feet above the elevated surface?

  • 13.11 Is it required that when portable rung or cleat type ladders are used the base is so placed that slipping will not occur, or it is lashed or otherwise held in place?

  • 13.12 Are portable metal ladders legibly marked with signs reading "CAUTION" "Do Not Use Around Electrical Equipment" or equivalent wording?

  • 13.13 Are employees prohibited from using ladders as guys, braces, skids, gin poles, or for other than their intended purposes?

  • 13.14 Are employees instructed to only adjust extension ladders while standing at a base (not while standing on the ladder or from a position above the ladder)?

  • 13.15 Are metal ladders inspected for damage?

  • 13.16 Are the rungs of ladders uniformly spaced at 12 inches, center to center?

14 HAND TOOLS & EQUIPMENT

  • 14.1 Are all tools and equipment (both, company and employee-owned) used by employees at their workplace in good condition?

  • 14.3 Are broken or fractured handles on hammers, axes and similar equipment replaced promptly?

  • 14.6 Are employees made aware of the hazards caused by faulty or improperly used hand tools?

  • 14.7 Are appropriate safety glasses, face shields, and similar equipment used while using hand tools or equipment that might produce flying materials or be subject to breakage?

  • 14.9 Are tool handles wedged tightly in the head of all tools?

  • 14.10 Are tool cutting edges kept sharp so the tool will move smoothly without binding or skipping?

  • 14.11 Are tools stored in dry, secure location where they won't be tampered with?

15 PORTABLE (POWER OPERATED) TOOLS & EQUIPMENT

  • 15.2 Are power tools used with the correct shield, guard or attachment recommended by the manufacturer?

  • 15.5 Are rotating or moving parts of equipment guarded to prevent physical contact?

  • 15.6 Are all cord-connected, electrically operated tools and equipment effectively grounded or of the approved double insulated type?

  • 15.7 Are effective guards in place over belts, pulleys, chains, and sprockets, on equipment such as concrete mixers, air compressors, and the like?

  • 15.8 Are portable fans provided with full guards or screens having openings 1/2 inch or less?

  • 15.9 Is hoisting equipment available and used for lifting heavy objects, and are hoist ratings and characteristics appropriate for the task?

  • 15.10 Are ground-fault circuit interrupters provided on all temporary electrical 15 and 20 ampere circuits, used during periods of construction?

  • 15.11 Are pneumatic and hydraulic hoses on power-operated tools checked regularly for deterioration or damage?

28 ENVIRONMENTAL CONTROLS

  • 28.1 Are all work areas properly illuminated?

  • 28.2 Are employees instructed in proper first aid and other emergency procedures?

  • 28.3 Are hazardous substances identified which may cause harm by inhalation, ingestion, skin absorption or contact?

  • 28.4 Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment, such as ammonia, chlorine, epoxies, and caustics?

  • 28.5 Is employee exposure to chemicals in the workplace kept within acceptable levels?

  • 28.6 Can a less harmful method or product be used?

  • 28.7 Is the work area's ventilation system appropriate for the work being performed?

  • 28.17 Is vacuuming with appropriate equipment used whenever possible rather than blowing or sweeping dust?

  • 28.19 Are all local exhaust ventilation systems designed and operating properly such as airflow and volume necessary for the application? Are the ducts free of obstructions or the belts slipping?

  • 28.20 Is personal protective equipment provided, used and maintained wherever required?

  • 28.22 Are restrooms and washrooms kept clean and sanitary?

  • 28.23 Is all water provided for drinking, washing, and cooking potable?

  • 28.24 Are all outlets for water not suitable for drinking clearly identified?

  • 28.25 Are employees' physical capacities assessed before being assigned to jobs requiring heavy work?

  • 28.26 Are employees instructed in the proper manner of lifting heavy objects?

  • 28.29 Are employees working on streets and roadways where they are exposed to the hazards of traffic, required to wear bright colored (traffic orange) warning vest?

30 FIRE PROTECTION

  • 30.1 Do you have a fire prevention plan?

  • 30.2 Does your plan describe the type of fire protection equipment and/or systems?

  • 30.3 Have you established practices and procedures to control potential fire hazards and ignition sources?

  • 30.4 Are employees aware of the fire hazards of the material and processes to which they are exposed?

  • 30.5 Is your local fire department well acquainted with your facilities, location and specific hazards?

  • 30.6 If you have a fire alarm system, is it tested at least annually?

  • 30.7 If you have a fire alarm system, is it certified as required?

  • 30.17 Are portable fire extinguishers provided in adequate number and type?

  • 30.18 Are fire extinguishers mounted in readily accessible locations?

  • 30.19 Are fire extinguishers recharged regularly and noted on the inspection tag?

  • 30.20 Are employees periodically instructed in the use of extinguishers and fire protection procedures?

31 HAZARDOUS CHEMICAL EXPOSURES

  • 31.3 Is employee exposure to chemicals kept within acceptable levels?

  • 31.4 Are eye wash fountains and safety showers provided in areas where corrosive chemicals are handled?

  • 31.5 Are all containers, such as vats and storage tanks labeled as to their contents--e.g. "CAUSTICS"?

  • 31.6 Are all employees required to use personal protective clothing and equipment when handling chemicals (i.e.gloves, eye protection, and respirators)?

  • 31.7 Are flammable or toxic chemicals kept in closed containers when not in use?

  • 31.10 Have standard operating procedures been established and are they being followed when cleaning up chemical spills?

  • 31.13 Are employees prohibited from eating in areas where hazardous chemicals are present?

  • 31.14 Is personal protective equipment provided, used and maintained whenever necessary?

  • 31.29 Is vacuuming used, rather than blowing or sweeping dusts whenever possible for clean up?

32 HAZARDOUS SUBSTANCES COMMUNICATION

  • 32.1 Is there a list of hazardous substances used in your workplace?

  • 32.2 Is there a written hazard communication program dealing with Material Safety Data Sheets (MSDS) labeling, and employee training?

  • 32.3 Who is responsible for MSDSs, container labeling, employee training?

  • 32.4 Is each container for a hazardous substance (i.e. vats, bottles, storage tanks,) labeled with product identity and a hazard warning (communication of the specific health hazards and physical hazards)?

  • 32.5 Is there a Material Safety Data Sheet readily available for each hazardous substance used?

  • 32.6 How will you inform other employers whose employees share the same work area where the hazardous substances are used?

  • 32.7 Is there an employee training program for hazardous substances?

  • 32.8 Does this program include: An explanation of what an MSDS is and how to use and obtain one?

  • 32.9 Does this program include: MSDS contents for each hazardous substance or class of substances?

  • 32.10 Does this program include: Explanation of "Right to Know"?

  • 32.11 Does this program include: Identification of where employees can see the employer's written hazard communication program and where hazardous substances are present in their work area?

  • 32.12 Does this program include: The physical and health hazards of substances in the work area, how to detect their presence, and specific protective measures to be used?

  • 32.13 Does this program include: Details of the hazard communication program, including how to use the labeling system and MSDSs?

  • 32.14 Does this program include: How employees will be informed of hazards of non-routine tasks, and hazards of unlabeled pipes?

33 ELECTRICAL

  • 33.1 Are your workplace electricians familiar with the Cal/OSHA Electrical Safety Orders?

  • 33.3 Are all employees required to report as soon as practicable any obvious hazard to life or property observed in connection with electrical equipment or lines?

  • 33.5 When electrical equipment or lines are to be serviced, maintained or adjusted, are necessary switches opened, locked-out and tagged whenever possible?

  • 33.6 Are portable electrical tools and equipment grounded or of the double insulated type?

  • 33.7 Are electrical appliances such as vacuum cleaners, polishers, vending machines grounded?

  • 33.8 Do extension cords being used have a grounding conductor?

  • 33.9 Are multiple plug adapters prohibited?

  • 33.10 Are ground-fault circuit interrupters installed on each temporary 15 or 20 ampere, 120 volt AC circuit at locations where construction, demolition, modifications, alterations or excavations are being performed?

  • 33.12 Is exposed wiring and cords with frayed or deteriorated insulation repaired or replaced promptly?

  • 33.13 Are flexible cords and cables free of splices or taps?

  • 33.14 Are clamps or other securing means provided on flexible cords or cables at plugs, receptacles, tools, and equipment and is the cord jacket securely held in place?

  • 33.15 Are all cord, cable and raceway connections intact and secure?

  • 33.16 In wet or damp locations, are electrical tools and equipment appropriate for the use or location or otherwise protected?

  • 33.17 Is the location of electrical power lines and cables (overhead, underground, underfloor, other side of walls) determined before digging, drilling or similar work is begun?

  • 33.18 Are metal measuring tapes, ropes, handlines or similar devices with metallic thread woven into the fabric prohibited where they could come in contact with energized parts of equipment or circuit conductors?

  • 33.19 Is the use of metal ladders prohibited in area where the ladder or the person using the ladder could come in contact with energized parts of equipment, fixtures or circuit conductors?

  • 33.20 Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?

  • 33.22 Do all interior wiring systems include provisions for grounding metal parts of electrical raceways, equipment and enclosures?

  • 33.23 Are all electrical raceways and enclosures securely fastened in place?

  • 33.24 Are all energized parts of electrical circuits and equipment guarded against accidental contact by approved cabinets or enclosures?

  • 33.25 Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?

  • 33.26 Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs or plates?

  • 33.27 Are electrical enclosures such as switches, receptacles, junction boxes, etc., provided with tight-fitting covers or plates?

  • 33.28 Are disconnecting switches for electrical motors in excess of two horsepower, capable of opening the circuit when the motor is in a stalled condition, without exploding? (Switches must be horsepower rated equal to or in<br>excess of the motor hp rating).

  • 33.30 Is each motor disconnecting switch or circuit breaker located within sight of the motor control device?

  • 33.31 Is each motor located within sight of its controller or the controller disconnecting means capable of being locked in the open position or is a separate disconnecting means installed in the circuit within sight of the<br>motor?

  • 33.32 Is the controller for each motor in excess of two horsepower, rated in horsepower equal to or in excess of the rating of the motor is serves?

  • 33.33 Are employees who regularly work on or around energized electrical equipment or lines instructed in the cardiopulmonary resuscitation (CPR) methods?

37 MATERIAL HANDLING

  • 37.1 Is there safe clearance for equipment through aisles and doorways?

  • 37.2 Are aisleways designated, permanently marked, and kept clear to allow unhindered passage?

  • 37.3 Are motorized vehicles and mechanized equipment inspected daily or prior to use?

  • 37.4 Are vehicles shut off and brakes set prior to loading or unloading?

  • 37.9 Are hand trucks maintained in safe operating condition?

  • 37.17 Are Material Safety Data Sheets available to employees handling hazardous substances?

38 TRANSPORTING EMPLOYEES & MATERIALS

  • 38.1 Do employees who operate vehicles on public thoroughfares have valid operator's licenses?

  • 38.2 When seven or more employees are regularly transported in a van, bus or truck, is the operator's license appropriate for the class of vehicle being driven?

  • 38.3 Is each van, bus or truck used regularly to transport employees, equipped with an adequate number of seats?

  • 38.4 When employees are transported by truck, are provision provided to prevent their falling from the vehicle?

  • 38.5 Are vehicles used to transport employees, equipped with lamps, brakes, horns, mirrors, windshields and turn signals in good repair?

  • 38.6 Are transport vehicles provided with handrails, steps, stirrups or similar devices, so placed and arranged that employees can safely mount or dismount?

  • 38.7 Are employee transport vehicles equipped at all times with at least two reflective type flares?

  • 38.8 Is a full charged fire extinguisher, in good condition, with at least 4 B:C rating maintained in each employee transport vehicle?

  • 38.9 When cutting tools with sharp edges are carried in passenger compartments of employee transport vehicles, are they placed in closed boxes or containers which are secured in place?

  • 38.10 Are employees prohibited from riding on top of any load, which can shift, topple, or otherwise become unstable?

42 EMERGENCY ACTION PLAN

  • 42.1 Are you required to have an emergency action plan?

  • 42.2 Does the emergency action plan comply with requirements of T8CCR 3220(a)?

  • 42.3 Have emergency escape procedures and routes been developed and communicated to all employers?

  • 42.4 Do employees, who remain to operate critical plant operations before they evacuate, know the proper procedures?

  • 42.5 Is the employee alarm system that provides a warning for emergency action recognizable and perceptible above ambient conditions?

  • 42.6 Are alarm systems properly maintained and tested regularly?

  • 42.7 Is the emergency action plan reviewed and revised periodically?

  • 42.8 Do employees know their responsibilities: For reporting emergencies?

  • 42.9 Do employees know their responsibilities: During an emergency?

  • 42.10 Do employees know their responsibilities: For conducting rescue and medical duties?

43 INFECTION CONTROL

  • 43.1 Are employees potentially exposed to infectious agents in body fluids?

  • 43.2 Have occasions of potential occupational exposure been identified and documented?

  • 43.3 Has a training and information program been provided for employees exposed to or potentially exposed to blood and/or body fluids?

  • 43.4 Have infection control procedures been instituted where appropriate, such as ventilation, universal precautions, workplace practices, and personal protective equipment?

  • 43.5 Are employees aware of specific workplace practices to follow when appropriate? (Hand washing, handling sharp instruments, handling of laundry, disposal of contaminated materials, reusable equipment.)

  • 43.6 Is personal protective equipment provided to employees, and in all appropriate locations?

  • 43.8 Are facilities/equipment to comply with workplace practices available, such as hand-washing sinks, biohazard tags and labels, needle containers, detergents/disinfectants to clean up spills?

  • 43.9 Are all equipment and environmental and working surfaces cleaned and disinfected after contact with blood or potentially infectious materials?

  • 43.11 Has medical surveillance including HBV evaluation, antibody testing and vaccination been made available to potentially exposed employees?

  • 43.12 Training on universal precautions?

  • 43.13 Training on personal protective equipment?

  • 43.14 Training on workplace practices, which should include blood drawing, room cleaning, laundry handling, clean up of blood spills?

  • 43.15 Training on needlestick exposure/management?

  • 43.16 Hepatitis B vaccinations?

44 ERGONOMICS

  • 44.1 Can the work be performed without eyestrain or glare to the employees?

  • 44.2 Does the task require prolonged raising of the arms?

  • 44.3 Do the neck and shoulders have to be stooped to view the task?

  • 44.4 Are there pressure points on any parts of the body (wrists, forearms, back of thighs)?

  • 44.5 Can the work be done using the larger muscles of the body?

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

  • 44.7 Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion asks?

  • 44.8 Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?

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

INSPECTOR'S OBSERVATIONS

  • Unsafe act(s) observed by inspector during inspection.

  • Unsafe Act
  • Select who was involved

  • Name

  • Contact Information

  • Description of unsafe act

  • Photo

  • Draw

  • Name

  • Company

  • Description of unsafe act

  • Photo

  • Draw

  • Name

  • Department or Area

  • Equipment, machine or process involved

  • Description of unsafe act

  • Photo

  • Draw

  • Discussed with employee and reported to supervisor or manager

  • Employee Signature

  • Superviosr or Manager Signature

  • Unsafe condition(s) observed by inspector during inspection.

  • Unsafe Condition
  • Department or Area

  • Select unsafe condition observed

  • Photo

  • Drawing

  • Reported to Supervisor or Manager

  • A plan was made to correct the unsafe condition(s)

  • Supervisor or Manager Signature

PRIOR INSPECTIONS

  • Have the corrective action(s) from previous inspection(s) been completed?

  • Great Job! The previous item(s) were not observed at the time of this audit. Nevertheless please verify that all items, issues, unsafe acts or unsafe conditions have been corrected through engineering, administrative, PPE, training or other controls.

  • ATTENTION! Items observed on this inspection were repeat observances or uncorrected issues. It is imperative that all items be corrected to insure the safety of your staff and reduce risk of accidents or violations. If you need assistance or would like to discuss any item please call Steve Ramsey @ 781-0352, 1010

CORRECTIVE ACTIONS

  • Corrective action(s) from this inspection

  • Corrective Action
  • Reference number

  • Corrective action

  • Priority

  • Targeted completion date

  • Discussed with staff after completion of inspection?

  • Staff
  • Comments

  • Staff signature

  • Inspector signature

  • Actual completion date

  • Signature of supervisor verifying completion of corrective action

INSPECTION COMPLETED BY

  • Add signature

  • Select date

FACILITY MANAGEMENT

  • Add signature

  • Select date

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