Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Posters

  • Emergency Evacuation Plan Posted?

  • RIGHT TO KNOW POSTER PRESENT?

  • PEOSH POSTER PRESENT?

OSHA 300 LOG

  • Current OSHA 300A annual summary present?

  • Current Monthly Summary Present in File?

  • OSHA 300 LOG FILE MAINTAINED?

  • Heating ventilation and air condition maintenance records kept for the past three years?

  • HVAC system visually clean with no dust accumulations?

Right to Know

  • Hazardous Substance Fact Sheets Available?

  • Safety Data Sheets Available?

  • Current Right to Know Survey Present?

  • Right to Know Central File Present?

Hazard Communication

  • Written Hazard Communication Plan Available?

  • Is the PPE hazard assessment table inclusive of all substances being used?

  • Have all employees been trained within the last 2 years?

  • Janitorial frequency appropriate to maintain facility in a sanitary condition?

  • Does the facility manager know who the water company is?

  • Are there water test results available?

  • Are there security panic button installed?

  • Adequate police response to the facility?

  • On site police or security present?

Fire Alarm System

  • Fire alarm annual inspection current?

  • Is the fire alarm system normal?

  • Is the fire alarm system powered?

Sprinkler System

  • No storage within 18 inches of sprinkler head?

  • No storage within 24 inches of the the ceiling?

  • Sprinkler system annual inspection current?

Doors and Means of Egress

  • Means of egress free from obstruction?

  • Exit discharge clear?

  • Locks operate without special knowledge?

  • Fire doors unchocked?

  • Fire doors open and latch properly?

Emergency Exit Signs and Lights

  • Exit Signs are illuminated?

  • Exit Signs are not obstructed from view?

  • Battery back up power working properly?

  • Evacuation battery backup lights working properly?

  • Exit sign and light monthly check log maintained?

Emergency Generator

  • Annual test documentation available?

Fire Extinguishers

  • Properly mounted?

  • Monthly inspection tag signed and dated?

  • Unobstructed access?

  • Annual inspection current?

Emergency Eye Wash Stations

  • Station available?

  • Identification sign clearly visible?

  • Unobstructed access?

  • 6-month maintenance record available?

Rest Room (Mens)

  • Orderly appearance?

  • Fixtures clean?

  • Partitions in good repair?

  • Floor in good condition with no leaks?

  • Hot, cold, or tepid water available?

  • Outlets protected by GFCI?

  • GFCI outlets working?

  • Adequate ventilation?

  • Adequate lighting?

  • Air vents clean?

Rest Room (Ladies)

  • Orderly appearance?

  • Fixtures clean?

  • Partitions in good repair?

  • Floor in good condition with no leaks?

  • Hot, cold, or tepid water available?

  • Outlets protected by GFCI?

  • GFCI outlets working?

  • Adequate ventilation?

  • Adequate lighting?

  • Air vents clean?

First Aid Supplies

  • Identification sign present?

  • AED Functional?

  • Adequate supplies available?

Sanitation

  • Employee areas clean?

  • Under counter areas clean?

  • Customer areas clean?

  • Work areas free of visible insects?

  • Limited or no plants present?

  • Food stuffs stored appropriately?

  • Break room garbage cans have lids?

  • Pest control records available?

Break/Lunch Room

  • Orderly appearance?

  • Clean?

  • Furniture in good repair?

  • Water fountain clean?

  • No storage within 24 inches of ceiling?

Mechanical/Telephone/CPU Room

  • Door labeled and working properly?

  • Fire extinguisher located within 75 feet?

  • Fire extinguisher compliant?

  • No storage or obstruction present?

  • Clean?

  • Adequately illuminated?

  • Electrical panels and circuits labeled/identified?

  • No defective or unused electrical equipment present?

  • No defective or unused mechanical equipment present?

  • Other?

  • Other?

Storage Room

  • Orderly appearance?

  • Fire extinguisher located within 75 feet?

  • Aisles are unobstructed and clearly marked?

  • Storage is secured against collapse?

  • Racks are bolted to the wall?

  • No storage within 24 inches of the ceiling?

  • No defective or unused equipment?

  • Other?

  • Other?

Building Exterior/Grounds

  • Exits are clear?

  • Exit discharge from building to assembly areas are clear?

  • No tripping hazards present?

  • Adequate vegetation control?

  • Other?

  • Other?

  • Signature

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.