Title Page

  • Location
  • Site conducted

  • Conducted on

  • Prepared by

Untitled Page

Sanitation

  • Waste receptacles in restrooms and lunch area.

  • Soap and sanitary towels available.

  • All areas clean, orderly, and sanitary.

  • Trash removed or in proper container.

Exits

  • Exit signs are installed, well marked, legible.

  • Exits are unlocked and unobstructed.

  • Exit doors swing in outward direction.

  • Exit door have door closures installed.

  • When exit doors are open, do they block other exits or passageways.

Fire Safety & Equipment

  • Fire Department/EMS phone numbers posted.

  • Fire alarms/smoke detectors are adequate, well marked and functional.

  • Fire extinguishers are properly located, mounted, unobstructed, and operational.

  • Fire extinguishers are inspected monthly for location, damage, and discharge.

  • Fire extinguishers have tags with inspection dates listed.

  • Location of hose outlets are accessible for fire fighting.

  • Portable fire extinguishers are adequate for maximum fire suppression.

  • Employees receive training on proper use of fire extinguishers.

Untitled Page

Illumination

  • Lighting is adequate for the type of work being done.

  • Emergency lighting is available in case of power failure.

  • Temporary lights are equipped with guards.

Ladders

  • Good condition - no broken rungs , rubber footings present.

  • Defective ladders are tagged until repaired or destroyed so that workers and others won’t re-use them and be injured by them.

Storage

  • Storage areas are clean and materials are properly stacked.

  • Sharp protections / edges present.

  • Shelving is stable and secure.

  • Adequate space is provided for material storage.

  • Flammables / solvents are properly stored.

Grounds

  • Walkways are unobstructed and in good condition.

  • Locks to gates are in place and functional.

  • Tripping hazards are present.

  • Outside lighting is functional.

  • Equipment is stored in a neat manner.

  • Housekeeping is acceptable and kept up.

Accident Prevention / Warning Signs

  • Danger signs and notices are posted near immediate hazards.

  • Warning signs are posted where potential hazards exist.

Untitled Page

Protective Equipmemt

  • Protective equipment is available where required. IE., gloves, goggles, faces shields, Hardhats.

  • Approved eye protection is being worn where required.

  • Approved hearing protection is being worn where required.

First Aid

  • There is a designated First Aid Attendant available to promptly administer care as needed.

  • Employees are trained and certified in first aid, and aware of the location of first aid supplies.

  • First aid kits are properly located and stocked. Checked monthly.

  • Emergency telephone numbers are posted and readily available in case of an emergency.

Hazardous Materials when applicable

  • Chemicals are properly labled.

  • Emergency spill procedures posted.

  • Emergency spill kit is available.

  • SDS available and up to date.

  • Emergency eye wash solution or station is available and operational.

  • Inventory of all hazardous materials is kept and available.

  • Chemical storage areas are continuously ventilated.

  • Chemical fume cabinets are functioning properly.

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.