Flint Genesee Job Corps Center – Safety Officer Weekly/Monthly Inspection Form

• Site conducted

  Select

• Building

  Select Building A Building B Building C Building D Building E Building F Building G Building H

  • Building A
  • Building B
  • Building C
  • Building D
  • Building E
  • Building F
  • Building G
  • Building H

• Date

  Date

• Frequency

  Weekly

  Monthly

• Inspector

• Location
  Address

• Select YES if Safe. Note HAZARD IDENTIFIED/COMMENTS & WORK ORDERS SUBMITTED

• GENERAL CLEANLINESS & PRACTICES<br>No evidence of smoking, no evidence of vermin or pests, food properly stored, clean, trash free desks, drawers, cabinets and trash cans.

  Yes

  No

  N/A

• WALKING SURFACES<br>Slippery, tears, holes, railings, trip hazards.

  Yes

  No

  N/A

• WALLS<br>Holes, paint and protruding objects.

  Yes

  No

  N/A

• WINDOWS<br>Cracks, locks, hinges, shades, screws, dust/dirt/cobweb free, clean sills.

  Yes

  No

  N/A

• ELECTRICAL<br>Boxes, switches, plugs, conduits, armor, receptacles, polarity, GFCI, exit signs, emergency lights, fans, covers, guards, insulation, hand dryers, lighting.

  Yes

  No

  N/A

• PLUMBING<br>Pipes, faucets, drains, traps, toilets, urinals and showers.

  Yes

  No

  N/A

• CEILINGS<br>Plaster, paint, condition, tiles, clean vents/lights.

  Yes

  No

  N/A

• DOORS<br>Hinges, locks, frames, panic bar, hardware.

  Yes

  No

  N/A

• FIRE PROTECTION<br>Portable fire extinguishers, fire alarms systems and emergency lighting operational.

  Yes

  No

  N/A

• CLEANING SUPPLIES/SDS<br>Properly stored and labeled, current and accessible SDS.

  Yes

  No

  N/A

• FIRST AID EQUIPMENT<br>First aid boxes full and visible.

  Yes

  No

  N/A

• Work Orders:

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• Inspected by

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