Title Page

  • Prepared by

  • Conducted on

Main area / GF Office

Floors / Doors / Ceiling / Walls

  • Is the floor in good condition?

  • Walkways clear and easily accessible?

  • Trip hazards?

  • Slip hazards?

  • Entries/Exits free from obstructions?

  • Doors and locks in working order and secure?

  • Any damage or leaks from ceiling?

  • Any damage to walls?

  • Suspended or protruding hazards?

Lighting / Electrical

  • All areas have sufficient lighting?

  • Any lights not working?

  • All electrical equipment tested and tagged, and within date?

  • any damage to plugs, sockets and switches and power points?

  • Any water pooling near power points, electrical cables or equipment?

  • Any damage to electrical leads?

  • Electrical Distribution Board clearly labelled (in GF office)?

Ventilation

  • Air conditioning system working properly?

  • Any leaks from air conditioning system?

  • Dust / dirt accumulated in air vents?

  • Damage to ducting and vents?

  • Is the area adequately ventilated?

Equipment

  • Equipment appropriately stored?

  • Equipment in good condition?

  • All appliances in good condition and working properly?

  • Drinking fountain in good condition and working?

  • Any leaks from drinking fountain?

Storage

  • Commonly used items stored appropriately to reduce repetitive reaching to low levels, above the shoulders or out from the body?

  • storage of items at ground level or above shoulder level is avoided?

  • Storage areas are neat and tidy and items are easily accessible?

  • Shelving is of a sound and sturdy condition?

  • Items in storage areas are secure and no risk of falling?

Emergency Procedures / First Aid

  • Fire extinguishers are available, kept in allocated location and unobstructed?

  • Correct and clear signage is displayed identifying where fire extinguishers are located?

  • fire extinguishers have been checked within the last 6 months?

  • Staff have had training in centre evacuation procedures within the last 12 months?

  • First Aid kit available and clearly labelled?

  • First Aid kit appropriately stocked, including blue Band-Aids?

HSO Sign off

  • Add 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.