Title Page
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Client / Site
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Conducted on (Date and Time)
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Inspected by
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Location
GENERAL INFORMATION
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Area:
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Take a photo of the workspace.
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Use these score criteria for your inspection:
3 - There is an ability to maintain it.
2 - This is being complied with more systematically.
1 - It is done but not systematically.
0 - Not at all.
N/A - Not Applicable
SORT OUT - SEIRI
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Is the floor area free of unwanted items?
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Are tops and insides of all cupboards, shelves, tables, etc. free of unwanted items?
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Are items stored according to frequency of use?
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Are walls free of old posters, calendars, pictures , notices etc.?
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Is there a general clutter free appearance?
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Capture photo(s) of red tagged items.
SET IN ORDER - SEITON
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Are direction indications available to all facilities from the entrance onwards?
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Do all items of equipment have identification labels?
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Are all rooms, cubicles and similar areas clearly numbered or named?
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Are specific areas demarcated for garbage/rejects/waste, etc.?
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Are switches, fan regulators, controls, etc. labeled?
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Are all cables, wires, pipes etc. neat and straight?
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Is colour coding used effectively for easy identification?
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Is there a general appearance of orderliness?
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Is it easy to find any item/document without delay?
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Identify and allocate a place for all the materials needed for your work.
SHINE - SEISO
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Are cleaning schedules available and displayed?
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Are floors, walls, windows doors etc. maintained at a high level of cleanliness?
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Is use of adequate cleaning tools evident?
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Are machines, equipment, tools, furniture maintained at a high level of cleanliness and their maintenance schedules displayed?
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Is there a general appearance of cleanliness all round?
STANDARDIZE - SEIKETSU
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Is a daily checklist used to standardize 5s procedures?
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Are standard check lists used to regularly inspect 5S?
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Are labels, notices etc. standardized?
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Do isles/pathways have a standard size and colour?
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Are pipes, cables etc. color coded?
SUSTAIN - SHITSUKE
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Is there a system for how and when the 5S activities will be implemented?
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Does management provide support to 5S programme by recognition, resources and leadership?
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Have first 3S become a part of the daily work?
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Do employees show positive interest in 5S activities?
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Are 5S posters and 5S points of work reminders displayed?
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Are trainings and other programs implemented to sustain workplace organization?
COMPLETION
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Recommendation
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Overall Rating
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Full Name and Signature of the Inspector