Hom Furniture

• Location Name:

• Conducted By:

  Select Alanna Soukkala, CSP, OHST David Rumsey, CSP, CRM John Bestman, CSP Lindsey Hanson, CSP, CHST Mike Music, CSP, CRM Scott Rief, GSP, OHST

  • Alanna Soukkala, CSP, OHST
  • David Rumsey, CSP, CRM
  • John Bestman, CSP
  • Lindsey Hanson, CSP, CHST
  • Mike Music, CSP, CRM
  • Scott Rief, GSP, OHST

• Conducted on

  Date
• Location
  Address

• Onsite Personnel that participated in the walkthrough inspection:

• Does the property have employees that have to access the roof?

  Yes

  No

  N/A

• Are measures in place to ensure that only authorized personnel have access to the roof? (Doors Locked, Keycard, Signs Posted etc.)

  Safe

  At Risk

  N/A

• Are there any fall hazards that exist on the roof? How close do maintenance personnel need to get to an unprotected edge? If closer than 15 feet then additional fall protection needs to be used.

  Safe

  At Risk

  N/A

• Does anyone drive for business purposes?

  Safe

  At Risk

  N/A

• Motor Vehicle Record Check for all Drivers, Annual followup?

  Safe

  At Risk

  N/A

• Minimum Age 21 for all Drivers

  Safe

  At Risk

  N/A

• Maximum 14 Hour Days (DOT 11 Hours Driving)

  Safe

  At Risk

  N/A

• Are they performing a Road Test, a Ride Along? Are limiting Cell Phone Use when driving?

  Safe

  At Risk

  N/A

• Driver Training?

  Safe

  At Risk

  N/A

• Does the Location have a cookie/beverage area:

  Yes

  No

  N/A

• Are the outlets in this area equipped with Ground Fault Circuit Interrupter (GFCI) Outlets?

  Safe

  At Risk

  N/A

• Is there a fire extinguisher in the area?

  Safe

  At Risk

  N/A

• Proper Storage of Food?

  Safe

  At Risk

  N/A

• Regular Cleaning of Kitchen Equipment?

  Safe

  At Risk

  N/A

• Is the location responsible for snow & ice management?

  Yes

  No

  N/A

• Snow Log to Document Shoveling / Sanding / Salting

  Safe

  At Risk

  N/A

• Using Broadcast Spreader to apply Sand & Salt relating to snow/ice removal?

  Safe

  At Risk

  N/A

• Are snow cleats used by employees to improve traction?

  Safe

  At Risk

  N/A

• Do the warehouse & break rooms have adequately stocked first aid kits?

  Safe

  At Risk

  N/A

Hazardous Chemicals

• Are all hazardous chemical labeled properly? Including identifier and hazard warning information? Including secondary containers?

  Safe

  At Risk

  N/A

• How are the Safety Data Sheets Maintained onsite? Do employees know where to locate them?

  Safe

  At Risk

  N/A

• Are all hazardous chemicals stored properly?

  Safe

  At Risk

  N/A

• Is the eyewash station inspected as needed regularly?

  Safe

  At Risk

  N/A

Slips Trips Falls

• All employees required to wear Anti-Slip Shoes?

  Safe

  At Risk

  N/A

• Controls in place to control spills? Mops, Wet Floor Signs, Exhaust Fans, etc.

  Safe

  At Risk

  N/A

• Areas of concern with low coefficient of friction? Entrances, loading dock, customer pickup.

  Safe

  At Risk

  N/A

• Does the property maintain clear walkways & hallways?

  Safe

  At Risk

  N/A

• 1/4 inch of elevation change can create a trip. Areas in need of repair? Thresholds, Potholes, Carpet Fraying, Damaged Tile?

  Safe

  At Risk

  N/A

• Cameras Facing Exterior / Parking Lot?

  Safe

  At Risk

  N/A

• Paint on Curbs (Bright Color with Slip Resistant Paint)?

  Safe

  At Risk

  N/A

Electrical Hazards

• is 3 feet of clearance maintained for electrical panels including in storage rooms?

  Safe

  At Risk

  N/A

• Extension cords (temporary use only), ground pin intact? cords are in good condition? Not ran through major walkways?

  Safe

  At Risk

  N/A

• Is the powered recliner section connected properly? No Daisy Chaining? Cords are not in walk ways?

  Safe

  At Risk

  N/A

Manual Material Handling

• Where are heavy items stored or located? Heaviest items on middle shelves?

  Safe

  At Risk

  N/A

• Are material handling carts used for moving heavy objects?

  Safe

  At Risk

  N/A

• Team Lifts for Heavy or Awkward Objects?

  Safe

  At Risk

  N/A

• Are employees tipping items on and off carts to reduce forces involved in lifting heavy objects?

  Safe

  At Risk

  N/A

• Lifting Training?

  Safe

  At Risk

  N/A

• Are employees practicing push not pull techniques?

  Safe

  At Risk

  N/A