Title Page

  • Site conducted

  • Conducted on

  • Inspected By

  • Accompanied By

  • Location
  • Inspection Code:
    Y - Meets Standard
    N - Does Not Meet Standard
    N/A – Not Applicable
    N/R – Not Reviewed-

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  • Smoke Detectors

  • Heat Sensors

  • Pull Stations

  • Strobes

  • Fire Extinguishers

  • Emergency Lights

  • Exit Lights

  • Carbon Monoxide Detectors (if applicable)

  • Electrical Outlets

  • Electrical Panels Labeled/No missing

  • Breakers/Blocked

  • Lighting

  • Facility Exits

  • Facility Exit Plan Posted

  • SDS Binder Accessible/Index Current

  • Chemicals Stored and Labeled Properly

  • Broken Glass

  • Proper Use of Extension Cords/Surge

  • Protectors

  • Trip Hazards

  • Walls – Ceilings – Floors

  • Doors/Door Closers/Hardware

ENVIRONMENTAL SAFETY

  • Facility Cleanliness

  • Trash Containers

  • Cleaning Supplies / Storage

  • HVAC Vents

  • Floor Coverings

  • Outside Area – cleanliness - safe

  • Daily Sanitizing Log

Sign Off

  • Name and Signature

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.