• Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Signature of preparer

  • Location
  • Personnel

1.0 - Previous Inspection

  • Are there any outstanding actions pending?

2.0 - General Area

  • Exterior of building does not have any issues?

  • Floor surfaces are even and uncluttered?

  • Walkways are adequate (3ft. wide) and are well defined?

  • Adequate lighting for the work being performed?

  • Burnt out bulbs have been replaced?

  • Stored items are in their designated storage area?

  • Stairways and landing areas are clear, railings are in good condition?

3.0 - Emergency & Fire Prevention

  • Evacuation plan displayed and understood by all personnel?

  • Fire extinguishers are in place and are clearly marked?

  • Fire extinguishers are charged and have been inspected?

  • Emergency exits are clearly marked?

  • Exits are clear of obstructions?

  • Fire or emergency alarm tested?

4.0 - First Aid

  • First Aid kits are clearly marked?

  • Contents are regularly checked for availability and expiration?

  • Emergency numbers are clearly displayed?

  • AED is ready and up to date?

5.0 - Electrical

  • Electrical Panels are labeled and clear of obstruction?

  • 3 pronged or grounded extension cords are used?

  • No broken prongs, plugs, sockets, or switches?

  • Wall outlets covered with no cracks?

  • No frayed or twisted leads?

  • Light fixtures have protective housing?

6.0 - Chemical Safety

  • Material Safety Data Sheets (MSDS) for all chemicals?

  • All containers labeled correctly?

  • Unused substances disposed of?

  • If applicable, are special storage conditions followed (hazardous or flammable)?

  • If required, PPE are available and used?

  • Are eye wash and showers available and easily accessible?

  • Have eye wash or showers been tested?

7.0 - Ladders & Step Stools

  • Are ladders industrial rated?

  • Are ladders or step stools in good condition?

  • Are ladders or step stools used according to instructions?

  • Are safety and instruction labels affixed to ladders?

8.0 - Rubbish Removal

  • Trash receptacles located in suitable positions around work area?<br>

  • Bins emptied regularly?

  • Oily rags and combustible refuse in covered metal containers?

  • Plastics & Cardboard are separated for recycling?

9.0 - Storage Design and Use

  • Materials stored in rack and bins wherever possible?

  • Items stored with heaviest items near the bottom of shelving?

  • Storage designed to minimize lifting?

  • Load limits posted on all floors above ground level?

10.0 - Work Area

  • Desks are good condition?

  • Computer equipment (screens, keyboard) are positioned to reduce fatigue syndrome?

11.0 - Material Handling Equipment

  • Daily or shift inspections are conducted for the Forklift?

  • Hand trucks, carts and Pallet jacks in good condition?

12.0 - No at risk behavior observed

  • Observation 12.1

  • Observation 12.2

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.