Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Instructions on the Rating

  • n/a: not applicable or not checked; no credit = no fulfilment, no conceptional approach to be identified; very poor = almost no fulfillment, multiple major deviations (>=2); poor = 1 major deviation and/or numerous other observations; fair = basically fulfillment, some non critical observations; good = only single or very few minor deviations; excellent = no single deviation

Housekeeping Rating Form

MACHINERY AND EQUIPMENT

  • a. must be clean and free of unnecessary materail or hangings

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  • b. must be free of unnecessary dripping of oil or grease

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  • c. must have proper guards provided in good condition incl. groundings and and locked electrical cabinets and proper IDs

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STOCK AND MATERIAL

  • a. must be properly piled and arranged

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  • b. must be loaded safely and orderly in pans, cars and trucks incl. closed buckets

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TOOLS & PPE

  • a. must be properly stored (orderly, according to the needs) (5S = excellent)

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  • b. must be free of oil and grease or other contamination when stored

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  • c. must be in safe working condition

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AISLES

  • a. must be provided to work positions, fire protection and first aid equipment

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  • b. must be safe and free of obstructions

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  • c. must be clearly marked

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FLOORS

  • a. must have surfaces safe and suitable to work

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  • b. must be clean, dry and free of refuse, unnecessary material, oil and grease

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  • c. must have an adequate number of receptacles provided for refuse (Waste bins) with proper ID and used accordingly

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BUIDLINGS

  • a. must have walls and windows that are reasonably clean for operations in that area and free of unnecessary hangings

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  • b. must have lighting systems that are maintained in a clean and efficient manner

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  • c. must have stairs that are clean, free of materials, well lit, provided with adequate hand rails and treads in good condition

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  • d. must have platforms that are clean, free of unnecessary material and well lit

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GROUNDS

  • a. must be in good order, free of refuse an unnecessary materials

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Signoff

  • Auditor

  • Co auditor

  • Area owner

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.