Hazard Rating Matrix

  • For the following questions please indicate the hazard rating where applicable:

    hazard matrix.jpg

Inspected areas & Those that were not accessed

  • Identify areas that were inspected and those that were unable to gain access to during the inspection.
    Either list the areas in the space below or insert close-up photos of the building key plan.

  • Areas that were inspected & those which could not be accessed:

  • Add media

Housekeeping

  • 1. Are materials and supplies stored properly on shelves, i.e. heavier material stored on lower shelves?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 2. Are bookcases and filing cabinets higher than 6 ft. secured to the wall?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 3. Are racks and shelving properly installed and in good condition?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 4. Are trolleys or dollies available to move heavy items?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 5. Are carpets, tiles or other flooring in good condition and free of tripping hazards?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 6. Are all aisles, stairwells, areas of refuge and doorways clear of materials and equipment?
    • Corridors that lead to an exit must be kept clear, in good repair and a minimum width of 1.1 meters must be maintained at all times.
    • Combustible materials are not allowed to be accumulated in any part of the exit corridors and doorways

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 7. If space heaters are used, will they shut off when tipped over?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 8. Are office procedures and equipment posing potential hazards identified, and have safe work procedures been developed to mitigate the hazards?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

General Safety

  • 9. Have employees received a safety orientation from their supervisor?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 10. Are personnel aware of hazard and reporting procedures?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 11. Are personnel aware of who the safety committee members are in their area?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

Emergency Preparedness

  • 12. Are campus emergency numbers posted by the phone?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 13. Are procedures in place for personnel working alone in evenings, or weekends?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 14. Do personnel know how to access First Aid?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

Fire Safety

  • 15. Are personnel familiar with the emergency evacuation plan, including egress routes, pull stations, extinguisher locations and assembly points?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 16. Do sprinkler heads have a minimum clearance of 18 inches?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 17. Has the fire extinguisher been inspected within the last year?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 18. Is the Fire extinguisher accessible?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 19. Are pull stations clearly visible?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 20. Are emergency exit signs functional (i.e., not burnt out)?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

Hazardous Products

  • 21. Are hazardous products in use? If yes, identify location & types of materials.

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 22. Do personnel working with hazardous products have WHMIS training?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 23. Is SDS information filed and accessible for all chemicals in use?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 24. Are the SDSs up-to-date or online link utilized?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 25. Are gloves, safety glasses and other appropriate personal protective equipment available to workers?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 26. Are emergency showers and eyewash stations available and unobstructed?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 27. Have the safety showers and eyewash stations been inspected and tested within the last year? Check the tags attached to each.

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

Electrical Safety

  • 28. Do all appliances have 3-pronged plugs for grounding?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 29. Are all wires and plugs in good condition?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 30. Are cables secured to prevent tripping hazards?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 31. Are power bars and extension cords used appropriately:
    • It is ok to plug one power bar directly into a wall outlet or through a single extension cord into an outlet. It is not ok to plug one power bar into another power bar.
    • Extension cords should not be plugged into power bars or into other extension cords.
    • Extension cords should not be excessively loaded.
    • 12 outlet power bars should not be used.

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • 32. Are all panels and covers in place on electrical equipment?

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

Tools, Machinery and Equipment

  • 33. Are tools, machinery or equipment used? If yes, please confirm with the department that inspections of the area are being performed.

Other

  • 34. Are building materials in good condition?
    • Look for any visible signs of water staining or water damage (i.e., bubbling paint, water damaged drywall, rotting wood).
    • Ask area occupants or staff if there has been any recent water ingress reported/identified.

  • Room
  • Department:

  • Room Number:

  • Hazard Rating:

  • Photo:

  • Recommended Date of Completion:

  • Additional Items or Comments

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