Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Documentation

  • OSHA 300 Log is current.

  • Weekly safety training is complete and up-to-date.

Work Area Hazards

  • Walking - No slip or trip hazards.

  • Exits - Emergency exits are clearly marked, are not blocked, and have a clear path.

  • Fire Extinguishers - Equipment is marked, has been inspected, is hanging on the wall, and not blocked.

  • Emergency Lighting - Has been checked and is working.

  • Electrical Cords - There is no damaged insulation.

  • Electrical Cabinets - They are not blocked.

  • Machines Guards - Are in place during operation.

  • Eyewash Stations - Are not blocked and are ready to be used.

  • Chemicals - Are labeled and stored correctly when not in use.

  • Chemicals - Safety Data Sheets are available to employees.

  • There is no food or drink around chemicals.

Employee Behavior Safety

  • Employees were observed wearing the proper PPE.

  • Lockout Tagout equipment is accessible to employees.

  • At least one employee was asked if they knew the Evacuation Procedure and they did.

  • There were no unsafe behaviors observed.

  • What was done to correct the unsafe behavior?

  • Employees were observed lifting, bending, and moving in ergonomically safe ways.

  • Equipment operators were observed moving through the area in a safe way.

Additional Information

  • What could be done to improve safety in this area?

  • What positive safety items need to be highlighted?

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.