Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Outside Grounds

  • Are walkways clear of obstacles that could cause a tripping hazard?

  • Are parking lots free of tripping hazards?

  • Are parking lots free of obstruction for vehicles to pass through aisles?

  • Are walkways, parking lots, and stairs kept free of snow and ice?

  • Is parking lot lighting adequate?

  • Are walkways & parking lots free of trash?

  • Are smoking areas clean of cigarette buds & trash

Housekeeping

  • Are floors and aisleways kept clean?

  • Is bulk storage stacked according to recommendations on packaging (i.e. number of units stacked on top of each other)?

  • Are any bulk storage units leaning/callapsing?

  • Are floors and walkways free of slip/trip/fall hazards?

  • Are all tools and cleaning materials stored in their proper places?

Fire Safety

  • Are all EXIT ways clear and unobstructed?

  • Are all EXIT signs lighted?

  • Are fire extinguishers inspected monthly?

  • Are all fire extinguishers clear and unobstructed?

  • Does the emergency lighting operate?

  • Are all fire doors (stairway doors) kept closed?

  • Is the evacuation plan up-to-date?

  • Are the evacuation routes posted?

  • Is all staff trained on the evacuation plan?

  • Are emergency numbers posted?

  • Have the evacuation wardens been properly trained?

Electrical Safety

  • Are all electrical outlet covers in place?

  • Are all cords out of the way of walking surfaces?

  • Are all cords and plugs in good condition?

  • Is the use of extension cords prohibited?

  • Do all electrical cords look safe (not frayed or cut)?

  • Are all "breaker panels" marked?

  • Is all equipment properly grounded?

  • Are ground fault circuit inperrupters (GFCI) within 6 feet of sinks?

  • Is there at least 3 foot clearance in front of breaker panels?

Chemical Hazards

  • Is the chemical inventory up-to-date?

  • Are safety data sheets available and current?

  • Do outside companies supply SDS's when working in or around the building with chemicals?

Severe Weather

  • Is there adequate shelter available for all associates?

  • Is the shelter well identified and marked?

  • Does this facility have access to a weather radio?

  • Does this facility have a severe weather alarm or alert to notify associates?

  • Are alert sirens, or means of notification, in working condition?

First Aid

  • Are first aid kits properly stocked & marked?

  • Are Bloodborne Pathogen (BBP) spill kits available and up-to-date?

  • Does this facility have one designated first responder for each shift?

  • Are the first responders up-to-date on training?

  • Does this facility have an AED and is it being checked monthly to ensure it is functional?

Personal Protective Equipment

  • Are PPE assessments completed at this facility and up-to-date?

  • Does the facility have all required PPE?

  • Have all the associates in this facility been properly trained on PPE?

  • Do all associates know how to get the proper PPE?

  • Are associates using the proper PPE for the job?

Forklifts & Battery Charging Areas

  • Are forklift inspection sheets filled completed each shift?

  • Are forklifts placed out of service if they are in need of repair, defective, or in any way unsafe?

  • Are proper eye wash stations provided in forklift battery charging areas (15 minute continuous flow required)

  • Are eyewash stations properly inspected (fluid changed every 90 days if not a cartridge system)?

Other Findings / Hazards (use to identify hazards that may not be found in the previous sections)

  • Finding #1

  • Finding #2

  • Finding #3

  • Finding #4

  • Finding #5

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.