Conducted on
Date
Prepared by
Location
Address
SORT - Determine what is needed and remove the rest … do we need it? How often is it used?
Have all the unnecessary items (tools, machines, boxes, etc.) been removed from the department?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Does the inventory or in-production inventory include any parts that are not required?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are tools and equipment located in the most convenient location?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Do cupboards, storage cabinets and shelves only contain essential items?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Is the quarantine area properly managed? - (fully up to date?)
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
SET - A place for everything and everything in its place. . . . . No Searching!
Are shelves and other storage areas clearly defined with location indicators and all footprints clearly marked?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are shadow boards and other storage systems used where possible?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are walkways and work areas clearly defined and unobstructed?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are personal belongings (coats, bags, newspapers, etc.) stored in lockers provided?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Safety Equipment - Is all safety equipment in place and up to date?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
SHINE - Cleaning and looking for ways to keep it clean.
Floors - Are they kept clean, tidy and in good state of repair?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Machines & Tools - Are they free from dirt, visible leaks and spillages?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Bins - Are they properly maintained and emptied on a regular basis?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Is anyone responsible for routine inspection/maintenance?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Do operators regularly sweep up and clean down machines and tools without being told?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
STANDARDISE - Make standards obvious and maintained.
Is stock control established, obvious and in use?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Is everyone aware of their responsibilities and department flow with ease?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Is information to carry out daily work routine clear and in use?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are improvement ideas being generated and regularly acted on?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Are the standards for the first 3S's clear and up to date?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
STUSTAIN - Maintain high standards and constantly seek to improve.
Are checklists available and being used?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
5S Board - Is this up to date and regularly reviewed?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Have improvement suggestions from last month been acted upon?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Training - Is everyone adequately trained to carry out their job role?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
Education - Can everyone in the area explain the benefits of 5S?
No Compliance
Very Little Compliance
Some Compliance
Significant Compliance
Total Compliance
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Katherine Hawker
Formula ONE
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.
