Information
Facility / Audit Information
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Facility Name:
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General Manager:
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Auditor Name:
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Select Date / Time Facility SAFETY Walk started (before selecting START below)
Assessment Criteria
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Grade Safety Walk elements using the following standard:
Green - Excellent condition during inspection
Yellow - Minor discrepancies exist
Red - Significant issues observed and noted
N/A - Not Applicable or Not Observed
Safety Walk Auditor is encouraged to take pictures in support of RED assessment grades. -
1. Cords and hoses are in good condition.
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Enter reason for grade.
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2. Cords and Hoses are properly stored and arranged to prevent tripping hazard.
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Enter reason for grade.
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3. Extension cords are only being used as a temporary power source.
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Enter reason for grade.
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4. Pallets are wrapped and stored properly in designated warehouse locations.
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Enter reason for grade.
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5. Floors are swept and in good condition, free of water, ice, debris and dirt.
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Enter reason for grade.
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6. All warehouse lights are in proper working order.
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Enter reason for grade.
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7. Exit doors and fire extinguishers are not blocked and accessible for use.
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Enter reason for grade.
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8. MHE operators observed following safe operating practices and procedures.
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Enter reason for grade.
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Practices include:
Sounding Horns
Stopping at intersections
Observing right-of-way
Maintaining safe travel distances from pedestrians
Operating with body parts in MHE cab
Demonstrating proper MHE operation when traveling loaded / unloaded -
9. Lift Truck Operators give proper distinctions when putting pallets away and bringing pallets down from upper storage locaitons.
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Enter reason for grade.
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10. Check racking for any equipment-related damage that may not have been reported. Report any suspected abuse to equipment and facility.
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Enter reason for grade.
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11. LTO's observed using Fall Prevention systems properly, when appropriate.
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Enter reason for grade.
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12. Personnel Protective Equipment (PPE) is up to code and stored in properly location, when not in use.
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Enter reason for grade.
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13. Associates observed using proper lifting techniques, as appropriate to work assignment.
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Enter reason for grade.
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14. All visitors are wearing safety vest or orange jackets.
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Enter reason for grade.
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15. Are all restricted access area doors locked and secure. <br><br>M1 - Plant Room, High Voltage Area<br>M2 - Roof Access, Comms Room
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Enter reason for grade.
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16. Is the Bonded area locked and secure. <br>
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Enter reason for grade.
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17. Are all emergency exit doors closed and secure.
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Enter reason for grade.
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Date / Time Facility SAFETY Walk completed:
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Take note of the number of points scored, before proceeding to next section.
Acknowledgement
Overall Assessment
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Grading Overall Assessment (Maximum points attainable from Audit Section - 34)
Overall GREEN - 31 to 34points (90-100%)
Overall YELLOW - 26 to 30 points (75-89%)
Overall RED - 25 points or less (< 75%) -
Overall Assessment based on Safety element grades:
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Justification for RED assessment.
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Signature of Safety Auditor:
Acknowledgement
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Reviewed and concur with SAFETY Walk assessment.
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Reviewed and do not concur with SAFETY Walk assessment.
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Reason for not concurring:
Agreed SAFETY Walk deficiencies, requiring immediate corrective action.
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Are there deficiencies requiring immediate corrective action? (On for Yes)
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Item 1. (check, if required)
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Item 1. discrepancy:
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Assigned to:
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Item 2. (check, if required)
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Item 2. discrepancy:
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Assigned to:
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Item 3. (check, if required)
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Item 3. discrepancy:
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Assigned to:
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Signature of General Manager:
