General Workplace Inspection

• American Medical Response Safety and Risk Management

  Media

• Operation:

• Station:

• Location
  Address

• Conducted on

  Date

• Prepared by

• Personnel

1.0 - General

• 1.1 - Has the last inspection been reviewed?

  Yes

  No

  N/A

• 1.2 - Are there no outstanding actions?

  Yes

  No

  N/A

• 1.3 - Were alterations/renovations made since last inspection?

  Yes

  No

  N/A

• 1.4 - Is building construction acceptable for height and occupancy?

  Yes

  No

  N/A

• 1.5 - Is it a high rise?

  Yes

  No

  N/A

• 1.6 - Is it windowless?

  Yes

  No

  N/A

• 1.7 - Is it underground?

  Yes

  No

  N/A

• 1.8 - Telephone in good working condition?

  Yes

  No

  N/A

• 1.9 - HR and Safety posters posted?

  Yes

  No

  N/A

• 1.10 - Stair treads have a reasonable slip-resistant construction with nosing made similar?

  Yes

  No

  N/A

• 1.11 - Standard railings are on the open sides of all exposed stairways and stairwells?

  Yes

  No

  N/A

• 1.12 - Handrails are on at least one side of a closed stairway?

  Yes

  No

  N/A

• 1.13 - Flights of stairs with four or more risers are equipped with standard handrails?

  Yes

  No

  N/A

• Comments:

2.0 - Fire Prevention

• 2.1 - Is a manual alarm system in the system?

  Yes

  No

  N/A

• 2.2 - Is a fire detection system in place?

  Yes

  No

  N/A

• 2.2b - Smoke Detectors?

  Yes

  No

  N/A

• 2.2c - Heat Detectors?

  Yes

  No

  N/A

• 2.2d - Carbon Dioxide Detectors?

  Yes

  No

  N/A

• Location of closest hydrant:

• 2.3 -Evacuation plan displayed and understood by all employees?

  Yes

  No

  N/A

• 2.4 - Evacuation procedures discussed regularly? (3 to 4 times a year)

  Yes

  No

  N/A

• 2.4b - Date of last evacuation drill:

• 2.5- Portable fire extinguishers are mounted and located so that they are readily accessible to employees without subjecting the employee to possible injury?

  Yes

  No

  N/A

• 2.6 - Extinguishers recently serviced? (Check 6 monthly punch mark on tabs.)

  Yes

  No

  N/A

• 2.6b - Fire Extinguishers checked monthly?

  Yes

  No

  N/A

• 2.7 - Extinguishers clear of obstructions?

  Yes

  No

  N/A

• 2.8 - Extinguisher no more than 1200 mm max height & base not lower that 100 mm?

  Yes

  No

  N/A

• 2.9 - Indicator signs 2.1 m above floor level?

  Yes

  No

  N/A

• 2.10 - Adequate direction notices for fire exits?

  Yes

  No

  N/A

• 2.9 - Exit doors easily opened from inside?

  Yes

  No

  N/A

• 2.11 - Exits clear of obstructions?

  Yes

  No

  N/A

• 2.12 - Fire alarm system functioning correctly?

  Yes

  No

  N/A

• 2.13 - Smoke detectors installed in every sleeping area, adjoining hallway, and near kitchen area?

  Yes

  No

  N/A

• 2.13b - 30 feet away from additional detectors in large openings.

  Yes

  No

  N/A

• 2.13c - Smoke detectors tested and documented every month?

  Yes

  No

  N/A

• 2.14 - Smoke Detectors as close to center of ceiling as possible?

  Yes

  No

  N/A

• 2.15 - Smoke Detectors at top of stairways?

  Yes

  No

  N/A

• 2.16 - Smoke Detectors at least 3 feet from ceiling fans?

  Yes

  No

  N/A

• 2.17 - Carbon Dioxide Detector centrally located outside each sleeping area?

  Yes

  No

  N/A

• 2.18 - Carbon Dioxide Detectors at least 6 inches from exterior walls?

  Yes

  No

  N/A

• 2.18b - 3 feet from air supply or return vents?

  Yes

  No

  N/A

• 2.19 - Smoke / CO2 Detectors & Fire Extinguishers checked each month

  Yes

  No

  N/A

• 2.20 - Does the building have an audible fire alarm?

  Yes

  No

  N/A

• 2.21 - Does the building have a visual alarm system?

  Yes

  No

  N/A

• 2.22 - Is there automatic fire department notification?

  Yes

  No

  N/A

• 2.23 - Are there sprinklers throughout?

  Yes

  No

  N/A

• 2.23b - Partial sprinklers?

  Yes

  No

  N/A

• Where:

• 2.24 - Is there a water flow alarm?

  Yes

  No

  N/A

• 2.24b - Are the valves supervised?

  Yes

  No

  N/A

• 2.24c - Type of supervision:

  Electrical

  Locks

  Seal

  N/A

• 2.25 - All solvents, degreasers, or chemicals that are labeled as flammable/combustible are stored in a clearly labeled flammable materials cabinet when not in use?

  Yes

  No

  N/A

• 2.26 - All used solvent or oil soiled shop rags are properly contained in an approved flammable materials waste container?

  Yes

  No

  N/A

• 2.27 - Chemicals with different hazard classifications are stored separately?

  Yes

  No

  N/A

• Comments:

3.0 - General Lighting

• 3.1 - Good natural lighting?

  Yes

  No

  N/A

• 3.2 - Reflected light from walls & ceilings not causing glare to employees?

  Yes

  No

  N/A

• 3.3 - Light fittings clean and in good condition?

  Yes

  No

  N/A

• 3.4 - Emergency exit lighting operable?

  Yes

  No

  N/A

• 3.5 - Parking and outside area has appropriate lighting?

  Yes

  No

  N/A

• 3.6 - Light fittings clean and in good condition?

  Yes

  No

  N/A

• 3.7 - Power Failure lighting available?

  Yes

  No

  N/A

• 3.7b - Is emergency lighting per code?

  Yes

  No

  N/A

• 3.7c - Is it tested monthly?

  Yes

  No

  N/A

• Comments:

4.0 - Building Safety

• 4.1 - Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 4.2 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 4.3 - Walkways adequately and clearly marked?

  Yes

  No

  N/A

• 4.4 - Intersections kept clear of boxes etc?

  Yes

  No

  N/A

• 4.5 - Stair and risers kept clear?

  Yes

  No

  N/A

• 4.6 - Are liquid spills removed quickly?

  Yes

  No

  N/A

• 4.7 - Are railings in good condition?

  Yes

  No

  N/A

• 4.8 - Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• 4.9 - Are footpaths in good condition?

  Yes

  No

  N/A

• 4.10 - Furniture in sound condition?

  Yes

  No

  N/A

• 4.11 - Loading area clean and tidy?

  Yes

  No

  N/A

• 4.12 - Carpet or tile in good condition?

  Yes

  No

  N/A

• 4.13 - Safety rails in bathroom in good condition?

  Yes

  No

  N/A

• 4.14 - Trip hazards identified and reduced?

  Yes

  No

  N/A

• 4.15 - Stairs and raisers clear?

  Yes

  No

  N/A

• 4.16 - Water Heater 18 inches from ground with 18 inch clearance?

  Yes

  No

  N/A

• 4.17 - Doors self closing and locking?

  Yes

  No

  N/A

• 4.18 - Are walls in good condition?

  Yes

  No

  N/A

• 4.19 - Are ceilings in good condition?

  Yes

  No

  N/A

• 4.20 - Are windows and window coverings in good condition?

  Yes

  No

  N/A

• 4.21 - Plumbing in good condition?

  Yes

  No

  N/A

• 4.22 - Mold presence free

  Yes

  No

  N/A

• 4.23 - Stoves, Hot Plates, have good ventilation?

  Yes

  No

  N/A

• 4.24 - Washer and Dryers in good working condition?

  Yes

  No

  N/A

• 4.25 - Sink / Counter tops in good condition?

  Yes

  No

  N/A

• 4.26 - Soap Dispenser(s) at every sink?

  Yes

  No

  N/A

• 4.28 - Paper Towel dispenser in kitchen and bathrooms?

  Yes

  No

  N/A

• Comments:

5.0 - Exits, Doors

• 5.1 - Exits per code?

  Yes

  No

  N/A

• 5.2 - Number of exits:

  1

  2

  3

  4

  5 +

• 5.3 - Egress capacity adequate?

  Yes

  No

  N/A

• 5.4 - Exit enclosures free of storage?

  Yes

  No

  N/A

• 5.5 - Do 100% of exits discharge directly outside?

  Yes

  No

  N/A

• 5.7 - What is the fire rating of exit stair enclosure?

  1 Hour

  2 Hour

  N/A

• 5.8 - What is the fire rating of exit stair doors?

  1 Hour

  1.5 Hour

  N/A

• 5.8b - Are they self-closing?

  Yes

  No

  N/A

• 5.8c - Latching?

  Yes

  No

  N/A

• 5.9 - Are doors blocked?

  Yes

  No

  N/A

• 5.10 - Are doors locked?

  Yes

  No

  N/A

• 5.11 - Doors < 15-lb force required to release latch?

  Yes

  No

  N/A

• 5.12 - Do doors swing in direction of travel per code?

  Yes

  No

  N/A

• 5.13 - Doors have panic hardware per code?

  Yes

  No

  N/A

• Comments:

6.0 - Rubbish Removal

• 6.1 - Bins located at suitable points around site?

  Yes

  No

  N/A

• 6.2 - Bins emptied regularly?

  Yes

  No

  N/A

• 6.3 - Oily rags and combustible refuse in covered metal containers?

  Yes

  No

  N/A

• 6.4 - Bio waste stored appropriately?

  Yes

  No

  N/A

• Comments:

7.0 - Storage Design and Use

• 7.1 - Materials stored in racks and bins wherever possible?

  Yes

  No

  N/A

• 7.2 - Storage designed to minimise lifting problems?

  Yes

  No

  N/A

• 7.3 - Floors around racking clear of rubbish?

  Yes

  No

  N/A

• 7.4 - General condition of racks and pallets?

  Yes

  No

  N/A

• 7.5 - Materials stacked to give an 18 inch vertical and horizontal plan from roof?

  Yes

  No

  N/A

• 7.6 - Oxygen stored in racks with "Oxygen" indicator on outside of building?

  Yes

  No

  N/A

• 7.7 - Storage of items designed for proper ergonomics?

  Yes

  No

  N/A

• 7.8 - Food items stored with heavy items at lower levels?

  Yes

  No

  N/A

• 7.9 - Food stored to prevent infestation?

  Yes

  No

  N/A

• 7.10 - Pots and pans stored in good condition?

  Yes

  No

  N/A

• Comments:

8.0 - Machines / Welding, Cutting, and Brazing

• 8.1 - Are they kept clean?

  Yes

  No

  N/A

• 8.2 - Are the floors around the machines kept clean?

  Yes

  No

  N/A

• 8.3 - Guards in good condition?

  Yes

  No

  N/A

• 8.4 - Starting and stopping devices within easy reach of operator?

  Yes

  No

  N/A

• 8.5 - Waste/off cuts removed and stored safely?

  Yes

  No

  N/A

• 8.6 - Drip pans on floor to prevent spillage?

  Yes

  No

  N/A

• 8.7 - Adequate work space?

  Yes

  No

  N/A

• 8.8 - Is lighting adequate?

  Yes

  No

  N/A

• 8.9 - Noise levels controlled?

  Yes

  No

  N/A

• 8.10 - No bending or stooping required?

  Yes

  No

  N/A

• 8.11 - Duck-boards in good repair?

  Yes

  No

  N/A

• 8.12 - Operators trained/inducted into the operation of the machines?

  Yes

  No

  N/A

• 8.13 - Is the training recorded?

  Yes

  No

  N/A

• 8.14 - Do operators comply with the training?

  Yes

  No

  N/A

• 8.15 - Are lockout procedures implemented and followed?

  Yes

  No

  N/A

• 8.16 - Are gas bottles secured?

  Yes

  No

  N/A

• 8.17 - No damage to hand tools?

  Yes

  No

  N/A

• 8.18 - No damage to power tools?

  Yes

  No

  N/A

• 8.19 - Work height correct for the type of work and employee?

  Yes

  No

  N/A

• 8.20 - No sharp edges?

  Yes

  No

  N/A

• 8.21 - Tools not in use kept in place?

  Yes

  No

  N/A

• 8.22 - Guards shall be affixed to machines where possible and secured elsewhere if for any reason attachment to the machine is not possible

  Yes

  No

  N/A

• 8.23 - Exposure of blades- When the periphery of the blades of a fan is less than 7 feet above the floor or working level, the blades shall be guarded. The guard shall have no larger than 1/2 inch.

  Yes

  No

  N/A

• 8.24 - Machines designed for a fixed location shall be securely anchored to prevent walking or moving.

  Yes

  No

  N/A

• 8.25 - Abrasive wheels shall be used only on machines provided with safety guards. The safety guard shall cover the spindle end, nut and flange protection.

  Yes

  No

  N/A

• 8.26 - Work rests shall be of rigid construction and designed to be adjustable to compensate for wheel wear and shell be kept adjusted with a maximum opening of 1/8 inch to prevent the work from being jammed between wheel and rest.

  Yes

  No

  N/A

• 8.27 - Compressed gas cylinders shall be legibly marked with either the chemical or trade name of the gas. Such marking shall be by means of stenciling, stamping, or labeling, and shall not be readily removed.

  Yes

  No

  N/A

• 8.28 - Acetylene cylinders stored valve end up.

  Yes

  No

  N/A

• 8.29 - Cylinders kept away from radiators and other sources of heat?

  Yes

  No

  N/A

• 8.30 - Empty cylinders stored with valves closed?

  Yes

  No

  N/A

• 8.31 - Compressed gas cylinders stored in accordance with AMR Compressed Gas Policy?

  Yes

  No

  N/A

• 8.32 - Air compressors fixed to ground?

  Yes

  No

  N/A

• 8.32b - Air compressor certificate under glass?

  Yes

  No

  N/A

• Comments:

9.0 - Electrical Safety

• 9.1 - Safety switches installed?

  Yes

  No

  N/A

• 9.2 - Safety switches tested every 6 months and tests recorded?

  Yes

  No

  N/A

• 9.3 - No double adapters in use?

  Yes

  No

  N/A

• 9.4 - Portable equipment tested and tagged?

  Yes

  No

  N/A

• 9.5 - No broken plugs, sockets or switches?

  Yes

  No

  N/A

• 9.6 - No power leads across walkways?

  Yes

  No

  N/A

• 9.7 - No frayed or damaged leads?

  Yes

  No

  N/A

• 9.8 - No strained leads?

  Yes

  No

  N/A

• 9.9 - Portable power tools in good condition?

  Yes

  No

  N/A

• 9.10 - Where required are emergency shut-down procedures in place?

  Yes

  No

  N/A

• 9.11 - GFCI Electrical sockets in damp areas?

  Yes

  No

  N/A

• 9.12 - Flexible cords and cables (extension cords) only used as a temporary wiring in accordance with 29 CFR 1910.305 (g)(1) or state equivalent?

  Yes

  No

  N/A

• 9.13 - Portable space heaters have automatic shut-off feature.

  Yes

  No

  N/A

• 9.14 - Portable space heaters plugged into permanent wiring?

  Yes

  No

  N/A

• 9.15 - Flammable/Combustible chemicals stored at least 30 feet from all electrical panels and sub- transformers?

  Yes

  No

  N/A

• 9.16 - Width of working space in front of the electrical service panels are the width of the equipment or 30 inches, whichever is greater?

  Yes

  No

  N/A

• 9.17 - Working space of the electrical service panels permits a 90 degree opening of the equipment door or hinged panels?

  Yes

  No

  N/A

• Comments:

10.0 - Chemical Safety / Hazardous Materials

• 10.1 - Hazardous Substance Register complete and available?

  Yes

  No

  N/A

• 10.2 - Material Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• 10.3 - Risk assessments completed for hazardous substances?

  Yes

  No

  N/A

• 10.4 - All containers labelled correctly?

  Yes

  No

  N/A

• 10.5 - Unused substances disposed of?

  Yes

  No

  N/A

• 10.6 - Do special storage conditions apply?

  Yes

  No

  N/A

• 10.7 - If applicable are special storage conditions followed?

  Yes

  No

  N/A

• 10.8 - Workers trained in the use of hazardous substances?

  Yes

  No

  N/A

• 10.9 - If required is PPE available?

  Yes

  No

  N/A

• 10.10 - Is adequate ventilation provided?

  Yes

  No

  N/A

• 10.11 - Are eye washes and showers easily accessed?

  Yes

  No

  N/A

• 10.12 - Transfilling stations, or Cascade systems have been dismantled?

  Yes

  No

  N/A

• 10.13 - Compressed gas storage are protected from being struck and secured from falling.

  Yes

  No

  N/A

• 10.14 - Compressed gases are stored at least 30 feet from heat sources?

  Yes

  No

  N/A

• 10.15 - Compressed gas storage areas have appropriate signage in accordance with AMR National Compressed Gas Policy and Protection Policy?

  Yes

  No

  N/A

• 10.16 - Safety caps in place on all tanks that are designed to accept safety caps while in storage?

  Yes

  No

  N/A

• 10.17 - Appropriate washers used on portable oxygen tanks?

  Yes

  No

  N/A

• Unauthorized PPE equipment are not found at the operation?

  Yes

  No

  N/A

• Comments:

11.0 Ladders

• 11.1 - Are all ladders Industrial strength? (Non Household rated, check label.)

  Yes

  No

  N/A

• 11.2 - Are ladders in good condition?

  Yes

  No

  N/A

• 11.3 - If used for electrical work are they non conductive? (Wood or fibre glass.)

  Yes

  No

  N/A

• 11.4 - Used according to instructions?

  Yes

  No

  N/A

• 11.5 - For extension ladders are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

• Comments:

12.0 - First Aid Facilities

• 12.1 - Are cabinets and contents clean and orderly?

  Yes

  No

  N/A

• 12.2 - Are contents regularly checked?

  Yes

  No

  N/A

• 12.3 - No contents past their expiry date?

  Yes

  No

  N/A

• 12.4 - Cabinets clearly labelled?

  Yes

  No

  N/A

• 12.5 - Is there easy access to cabinets?

  Yes

  No

  N/A

• 12.6 - Employees aware of location of first aid cabinet?

  Yes

  No

  N/A

• 12.7 - Are first aid officers accessible?

  Yes

  No

  N/A

• 12.8 - Are emergency numbers displayed?

  Yes

  No

  N/A

• Comments:

13.0 - Office Hazards

• 13.1 - Condition of filing cabinets?

  Yes

  No

  N/A

• 13.2 - Condition of chairs? (Five star bases.)

  Yes

  No

  N/A

• 13.3 - Desks in good condition? (No damage.)

  Yes

  No

  N/A

• 13.4 - Screen Based Equipment positioned to reduce glare from windows etc?

  Yes

  No

  N/A

• 13.5 - Photocopiers positioned to avoid fumes?

  Yes

  No

  N/A

• 13.6 - Tasks designed to prevent Occupational Overuse Syndrome? (Breaks included.)

  Yes

  No

  N/A

• 13.7 - Air conditioning systems regularly maintained?

  Yes

  Unknown

  N/A

• 13.8 - Stable non-slip floor coverings in good condition?

  Yes

  No

  N/A

• 13.9 - Tall / Heavy items earthquake secured?

  Yes

  No

  N/A

• 13.10 - Work stations set up for proper ergonomics?

  Yes

  No

  N/A

• Comments:

14.0 - Egress

• 14.1 - Routes free of flammable furnishings or decorations?

  Yes

  No

  N/A

• 14.2 - Routes arranged so that travel is not through high hazard area?

  Yes

  No

  N/A

• 14.3 - Routes free of obstruction?

  Yes

  No

  N/A

• 14.4 - Safeguards (exit lighting, sprinklers,fire doors, alarm systems, etc) are in proper working order?

  Yes

  No

  N/A

• 14.5 - Route adequately lighted so that an employee with normal vision can see along exit route?

  Yes

  No

  N/A

• 14.6 - Exit are clearly visible and marked by a sign reading "Exit"?

  Yes

  No

  N/A

• 14.7 - Are exit route doors free of decorations or signs that obscure visibility of the exit route door?

  Yes

  No

  N/A

• 14.8 - Signs posted along the exit access indicating the direction of travel to the nearest exit, and exit discharge with line of sight to an exit clearly visible at all times?

  Yes

  No

  N/A

• 14.9 - Each doorway or passage along an exit route that can be mistaken for an exit marked "Not an Exit" or similar designation , or identified by a sign indicating actual use?

  Yes

  No

  N/A

• 14.10 - Exit signs illuminated by a reliable light source and distinctive in color?

  Yes

  No

  N/A

• 14.11 - Each exit sign have the word "Exit" in plainly legible letters not less than 6 inches high, with the principle strokes of the letter in "Exit" not less than 3/4 of an inch wide?

  Yes

  No

  N/A

• 14.12 - Established procedures for sounding emergency alarms in the workplace?

  Yes

  No

  N/A

• 14.13 - Tests of reliability and adequacy of non-supervised employee alarm system is made every 2 months?

  Yes

  No

  N/A

• 14.14 - Effective alarm system in accordance with National AMR Emergency Action Policy?

  Yes

  No

  N/A

• 14.15 - Procedures for reporting fires or other emergencies are in place?

  Yes

  No

  N/A

• 14.16 - Procedures for emergency evacuation, including type of evacuation and exit route assignments are in place?

  Yes

  No

  N/A

• 14.17 - Procedures to account for all employees after evacuation are in place?

  Yes

  No

  N/A

• 14.18 - Practices and documents evacuation drills at least annually?

  Yes

  No

  N/A

• Comments:

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign