Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Monthly Inspection & Meeting Minutes

  • Is the monthly inspection completed OR scheduled to be completed? If scheduled, indicate date. If completed, check to see if it is posted on the safety board or in the safety binder.

  • Has the safety committee (if applicable) met OR scheduled to meet? If yes, indicate date.

Health & Safety Board or Binder

  • Is the map to the nearest hospital posted on the safety board or in the safety binder?

  • Are names of the committee members (4 people) or safety representative posted?

  • Are the name(s) and certificate(s) of the First Aid attendant(s) posted? Not expired?

  • Is the Occupational Health and Safety Guideline posted?

  • Is the In Case of Injury or Illness At Work Document posted?

  • Is the First Aid Poster posted with instructions on how to contact attendants?

  • Is the Evacuation Assembly Point posted?

  • Is the Employee Assistance Plan (EAP) posted?

  • Is the Respect in the Workplace - [Free of] Discrimination and Harassment Policy posted?

  • Is the JHSC Monthly Inspection Checklist posted?

  • Is the JHSC Monthly Meeting Minutes (Board only) posted?

  • Is the Notice to Workers (Location of Act and Regulation) posted?

First Aid

  • Are the First Aid kits stocked and complete according to the contents list? Indicate which items need to be replaced (if any)

  • Are the First Aid Records kept in a binder and maintained?

72 Hour Emergency Kits/Cabinet

  • Is the 72 Hour Emergency Kit intact with no damage or use?

  • Has the 72 Hour Emergency kit/cabinet been reviewed by a Safety rep or JHSC member to ensure supplies haven’t expired and nothing is missing?

  • For those locations with a cabinet, is the 72 Hour Emergency Kit locked? Is the key easily accessible?

  • Is the AED visible and in good working order? (ie: batteries and pads not expired)

Emergency Procedures

  • Is the evacuation floor plans (Placard) posted in a visible location?

  • Ensure Vault Escape Procedures are posted and clearly visible to all employees (inside vault).

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.