Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1.0 - Previous inspection

  • 1.1 - Has the last inspection been reviewed?

  • 1.2 - Are there no outstanding actions?

2.0 - Fire Prevention

  • 2.1 - Door wedged or propped open, none found?

  • 2.2 - Fire doors are not blocked by carts, equipment, or materials?

  • 2.3 - Extinguishers is not missing damaged, or discharged?

  • 2.4 - Extinguishers has current inspection documentation?

  • 2.5 - Extinguishers clear of obstructions?

  • 2.6 - Sprinkler Heads/Smoke Detectors are clean & intact?

  • 2.7 - Indicator Lights are not obstructed?

  • 2.8 - Fire Exit signs are illuminating and working properly?

  • 2.9 - Fire Doors close and latch properly?

  • 2.10 - Storage is less than 18" from ceiling?

  • 2.11 - Doors to Soiled/Clean/Hazardous Materials Rooms closed locked?

  • 2.12 - Emergency Exit Corridors / Doors are clear?

  • 2.13 - All wheeled equipment in corridor is "attended"?

  • 2.14 - Flammables, stored appropriately?

  • 2.15 - Penetrations to Walls / Ceilings / Floors, not present?

  • 2.16 - No unauthorized space heaters present?

  • 2.17 - No unauthorized heat producing equipment present (Toasters, etc)

  • 2.18 -Trash containers are no more than 32-gallons in capacity.

  • 2.19 - Fire extinguisher appropriate for the area?

3.0 - Electrical Safety

  • 3.1 - Electrical outlets are not damaged or loose?

  • 3.2 - Critical equipment is plugged into Red Outlet?

  • 3.3 - All extension cords are equipped with a ground prong?

  • 3.4 - All switches, receptacles and computer boxes have covers or plates?

  • 3.5 - Electrical panels are accessible - 36" clearance around panels.

4.0 - General Safety

  • 4.1 - Handrails are attached firmly to the walls?

  • 4.3 - Storage is at least 6" from the floor. No boxes on the floor?

  • 4.4 - Floors - tiles, carpet in good repair - no trip hazards?

  • 4.5 - Storage Rooms clean and orderly?

  • 4.6 - No items are being stored under the sinks?

  • 4.7 - Step ladders available to reach high places are in good shape?

  • 4.8 - No electrical cords, telephone and computer wires in area that might entangle feet?

  • 4.9- Desk, chairs, furniture in safe condition?

5.0 - Hazardous Marerial

  • 5.1 - Staff are able to obtain a MSDS?

  • 5.2 - Secondary container are labeled properly?

  • 5.3 - Hazardous materials properly stored?

6.0 - Security Management

  • 6.1 - Employee personal items are secured out of sight?

  • 6.2 - Employee I.D. Badges visible and worn properly?

  • 6.3 - Doors with security hardware operate properly?

7.0 - Utilities Management

  • 7.1 - All lights are operational, no lights out?

  • 7.2 - Ceiling tiles, none discolored,/wet/damaged?

  • 7.3 - HVAC System - Air temperature within condor table range?

  • 7.4 - Plumbing, faucets,, toilets operational (no leaks)?

  • 7.5 - Ice machine clean and maintenance on schedule?

  • 7.6 - lights in nearest stairwell operational?

8.0 - Other

  • 8.1- Hair restraint is worn

  • 8.2 - All surfaces and floors are clean

  • 8.3 - All pieces of equipment are clean to sight and touch - equipment on serving line, storage shelves, cabinets........

  • 8.4 - Refrigerators / freezers are clean.

  • 8.5 - Can openers are clean

  • 8.6 - Garbage cans are clean

  • 8.7 - No evidence of pests is present

Comments

  • Additional Comments

  • Surveyor's Signature

  • Please print a copy of this inspection and send a copy to the Safety Officer when all deficiencies have been corrected! Attach any work orders and/or purchase request.

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.