Information

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Is the emergency/lockdown information posted?

  • Is the fire exit/alternate exit information posted?<br>

  • Is the emergency exit information available?<br>(Red binder, class lists, etc.)

  • Is there a current latex-free blood kit available at the entry?<br>(Gloves, plastic bags, paper towels)

  • If non-compliant, what is missing?

  • Are black out materials available for all exterior lines of sight?<br>(Are the blinds functional?)

  • Is there a functioning phone in the room?

  • Does the phone have emergency contact numbers available?

  • Are ceiling tiles/wall coverings in good repair?<br>(Without damage, mould, or water marks)

  • Is lighting adequate and in good repair?<br>(Are there bulbs or covers missing)

  • Are heat detectors present and functional?

  • Is there an occupancy sensor and is it functional?<br>(Red light will come on)

  • Are overhead screens, curtains/blinds, and media equipment secured?

  • Are bookshelves and large filing cabinets secured to a wall?

  • Are heavy/bulky items stored on lower shelves?<br>(Boxes of paper, etc.)

  • Is equipment stored in such a way to prevent trips/cuts/personal injury?

  • Are safeguards provided for hazardous equipment?<br>(ie: paper cutters)

  • Is a CSA approved stepladder available to reach high areas?

  • Are walls and doors free of fire bridges?

  • Are heater intakes and radiators free of obstruction?

  • Are insulated pipes wraps and/or 9" floor tiles present?

  • If yes, is there and sign of damage or potential for friable material?

  • Are floor tiles and rugs clean and in good repair?

  • Is there any evidence of punctures or damage to walls, ceiling materials, or floors?

  • Are the windows and/or screens in good repair?<br>(Record any missing screens)

  • Are there any apparent issues involving electrical devices?

  • Are there excessive wires/power bars that could create a safety issue?

  • Are electrical outlets in good repair?

  • Is there a minimum of 1 meter of clearance in front of electrical panels?

  • Are all breakers/fuses properly labelled?

  • Are there any chemicals, including cleaning agents/sanitizers, present? (Include pictures of chemicals)

  • Add media

  • Are all chemicals, including cleaning agents/sanitizers, properly labelled?<br>

  • Are there any housekeeping issues in this room?

  • Use this area to record any additional issues/comments.

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.