Title Page
Client Information
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Company Name
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Primary Company Contact
Audit Information
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Audit performed at
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Audit performed on
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Auditor Contact Information
Positive Observations & Additional Notes
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Positive Observations
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Additional Notes
Inspection Items
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Type of Inspection
Written Programs
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Client has a written safety manual.
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Safety manual addresses training requirements/competent persons.
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Safety manual addresses emergency planning/egress.
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Policies are current & reviewed periodically.
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Safety manual addresses all relevant hazards that employees are exposed to.
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Safety manual addresses Powered Industrial Trucks (PIT)
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Safety manual addresses slips, trips, and falls
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Safety manual addresses PPE & respirators
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Safety manual addresses noise & environmental hazards
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Safety manual addresses HAZCOM
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Safety manual addresses the control of hazardous energy (LOTO)
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Safety manual addresses electrical work
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Safety manual addresses hand & power tools
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Safety manual addresses hot work
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Safety manual addresses commercial driving
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Safety manual addresses incident reporting/investigation
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Safety manual addresses fire prevention/protection
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Safety manual addresses machine guarding
General Recordkeeping
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Safety inspections/evaluations are documented
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PPE hazard assessments are documented IAW 1910.132(d)(2)
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Training records are maintained for a sufficient period
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Incident reports & investigations are documented
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Employees receive a safety orientation that is documented
OSHA Forms 300, 300A, 301
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OSHA Form 300 (Log of Work-Related Injuries and Illnesses) is maintained and filled out accurately
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Previous OSHA Form 300s are maintained for five (5) years minimum
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OSHA Form 301 (Injury and Illness Incident Report) is filled out whenever there is a work-related injury/illness
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OSHA Form 301 is maintained for five (5) years (starting count after year of incident)
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OSHA Form 300A (Summary of Work-Related Injuries and Illnesses) is accurately maintained
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OSHA Form 300A is available for employees to review
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OSHA Form 300A for the previous year is posted between February 1st and April 30th (Must be in a frequented area)
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Previous OSHA Form 300As are maintained for five (5) years.
Safety Committee
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Client has an established safety committee
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Client's safety committee is certified
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Safety committee represents the accident and illness concerns of all employees
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Safety committee meets monthly
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Safety committee has appropriate representation (at least half of members represent employee interests)
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Safety committee reviews workplace incidents
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Safety committee has established written procedures (bylaws, etc.)
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Safety committee conducts periodic inspections in order to discover hazards
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Safety committee tracks membership and attendance
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Safety committee develops a written agenda for meetings
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Safety committee makes decisions by majority vote
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Safety committee maintains accurate meeting minutes and makes them available to employees
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Minutes include inspection reports
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Minutes include reports on specific hazards and corrective actions taken
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Minutes include reports on workplace injuries and illnesses
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Minutes include management responses to committee reports
Emergency Action Plan (EAP)
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Client has an EAP that covers all reasonably anticipated workplace emergencies
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EAP includes procedures for reporting an emergency
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EAP includes procedures for evacuation, including exit routes and exit route assignments
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EAP includes procedures to account for employees after an emergency
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EAP includes procedures to be followed by employees who remain to operate critical plant operations before they evacuate
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EAP includes procedures to be followed by employees performing rescue or medical duties
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EAP includes the name or job title of every employee who may be contacted by employees who need more information about the plan or an explanation of their duties under the plan
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Employees are trained on the EAP (See 1910.38(f) for specific requirements)
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An alarm system with distinctive signals is maintained
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EAP is available for employees to review
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Client has 11 or more employees
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EAP is kept in writing
Exit Routes
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Exits are marked with an exit sign and illuminated by a reliable light source
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Exits are kept clear of obstructions
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Exits routes do not pose a hazard (presence of flammable materials, fall hazards, etc.)
Medical Services & First Aid
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Employees are trained and assigned to administer first aid
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A nearby infirmary, clinic, or hospital is used for the treatment of all injured employees
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Employees are informed of where to receive medical treatment
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First aid kits/facilities are available to employees and contents are unexpired
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AEDs are available to employees
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Employees are exposed to corrosive chemicals
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Eye wash stations are provided within the work area
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Body wash stations are provided within the work area
Bloodborne Pathogens
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Employees face an occupational exposure to bloodborne pathogens
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PPE is available for Bloodborne Pathogen/PIM spill cleanup
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Waste receptacles are available and identified
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Training is given to First Responders annually and documented
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Vaccinations are offered to first responders and recorded
Personal Protective Equipment
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A PPE workplace hazard assessment been completed and accurately maintained.
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Employees have been trained in the use, maintenance, and limitations of personal protective equipment.
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Personal protective equipment is maintained in a sanitary condition and ready for use.
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Appropriate eye/face protection is worn when required.
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Appropriate foot protection is worn when required.
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Appropriate hand protection is worn when required.
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Appropriate respiratory protection is worn when required.
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Appropriate hearing protection is worn when required.
Respiratory Protection
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An Industrial Hygiene study has been performed for hazardous areas in order to to determine exposures.
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Employees are required to use respirators.
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Employees are properly fitted with appropriate respirators.
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Monthly checks are conducted on respirators used for emergency purposes.
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Respirators are properly stored.
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Annual pulmonary function tests are conducted for users of respirators.
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Annual training is conducted for the type of respirators being used.
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Employees voluntarily using respirators have received Appendix D.
Hearing Conservation
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Information indicates that employees exposure to noise may equal or exceed an 8-hour time-weighted average of 85 decibels.
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Client has established a hearing conservation & monitoring program.
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Employees have a variety types of hearing protection to choose from.
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Areas of high noise levels (85dba) are posted for required hearing protection.
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Employees receive annual training on noise exposure, effects, precautions, and use of hearing protection.
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Baseline and annual audiograms are conducted.
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Standard threshold shifts (STS) are documented and retested.
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Records are kept for each employee and their results.
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Employees are notified of audiogram results.
Fire Protection Equipment
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Fire extinguishers are serviced annually and inspected monthly.
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Fire extinguisher training is provided to employees who may be required to use an extinguisher on an annual basis.
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Fire extinguishers are easily accessible and not obstructed.
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Sprinkler heads are unobstructed.
Flammable and Combustible Materials
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Proper storage practices to minimize the risk of fire including spontaneous combustion are in place.
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Smoking is prohibited indoors and in areas where a risk of fire is present.
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Compressed gas cylinders are secured in place.
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Oxygen cylinders are stored away from items such as oil, grease, acetylene, and other fuel gas cylinders (20 feet or 5 feet non-combustible partition).
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Flammable liquids and cylinders are stored away from radiators, other sources of heat, and exits.
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Oxygen/acetylene equipment are equipped with flashback arresters.
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Oxygen/acetylene equipment lines are bled off and tanks closed when not in use.
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Hot work areas are identified throughout the location and hot work permits are utilized.
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Bulk drums of flammable liquids are grounded and bonded to containers during dispensing.
Energy Control Procedures
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Energy control procedures are in place for the servicing and/or maintenance of machines and equipment.
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Employees have been appropriately trained on lockout/tagout procedures.
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Audits are performed annually to ensure lockout/tagout is being conducted as required.
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Employees were observed correctly following established energy control procedures.
Machine Guarding
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Nip points, shear points, couplers, point of operation, gears, and chains are guarded.
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All corners and edges of guards are smooth and do not present a hazard in itself.
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Guards are secured to equipment.
Hand Tools and Equipment
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Tools and equipment used by employees in the workplace are in good condition.
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Guards are utilized on tools
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Appropriate handles are used on files and similar tools.
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Non-double insulated tools are grounded.
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Compressed air used for cleaning is limited to 30 psi and/or equipped with a safety nozzle.
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Equipment is anchored in place and made secure.
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Grinder work rests are adjusted to within 1/8-inch of the wheel and the tongue guard within ¼-inch.
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Push sticks or blocks are provided at the work place in the several sizes and types suitable for the work to be done.
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Cleanliness around woodworking machinery is maintained in order to ensure that guards properly function and that fire hazards are minimized.
HAZCOM
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Employees are trained on the potential hazards involving various chemicals stored or used in the workplace.
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All containers are labeled as to their contents.
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Safety Data Sheets (SDS) are readily available for each hazardous substance used.
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A list of hazardous substances used in the workplace is maintained.
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Standard operating procedures for chemical spill cleanup have been established and are followed.
Electrical
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Live parts of electric equipment are guarded against accidental contact
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Electrical equipment / cords are in good condition.
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Electrical appliances and equipment are grounded.
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Disconnecting switches and circuit breakers are labeled to indicate their use.
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Power/disconnect panels have >36 inches of clearance.
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Relevant NFPA 70E requirements are met.
Material Handling/Powered Industrial Trucks
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Stored materials are stable and secure.
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Forklifts are operated in a safe manner (appropriate speed, seatbelt worn, etc.).
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Forklifts are maintained in a safe operating condition and safety devices are functional.
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Daily forklift inspections are conducted and documented prior to use.
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Forklift operators have received initial training and refresher training every 3 years.
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Propane tanks are in good condition and stored properly.
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Electric forklift charging areas have acid neutralizers, immediately available fire protection, and adequate ventilation.
Slips, Trips, and Falls
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Employees are trained on the nature of fall hazards in the work area, how to recognize them, and the procedures to be followed to minimize those hazards.
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Walking surfaces are maintained in a clean and, so far as possible, a dry condition. Where wet processes are used, drainage is maintained and false floors, platforms, mats, or other dry standing places are provided.
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Aisles and passageways are identified and kept clear.
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Holes in the floor, grates, sidewalk, or other walking surface are covered or otherwise made safe.
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Rugs and floor coverings are in good condition and do not pose a tripping hazard.
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Stairs have uniform riser heights, tread depths, are equipped with handrails, and are clear of obstructions/tripping hazards.
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Employees are protected against all other fall hazards.<br>
Ladders
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Employees are trained in the safe usage of ladders and abide by all safe work requirements
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Ladders are maintained in good condition.
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Non-slip safety feet are provided on each ladder and rungs provide good footing.
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Ladders are visually inspected prior to use.
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Periodic inspections of ladders are documented.
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Portable ladders are secured when stored to prevent tipping/falling.
Exit Routes
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Exits are marked with an exit sign and illuminated by a reliable light source.
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Exits are kept clear of obstructions.
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Exits routes do not pose a hazard (presence of flammable materials, fall hazards, etc.).
Medical Services and First Aid
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First aid kits/facilities are available to employees and contents are unexpired.
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AEDs are available to employees and charged/unexpired.
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Employees are exposed to corrosive chemicals
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Eye wash stations are provided within the work area
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Body wash stations are provided within the work area
Bloodborne Pathogens
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Employees face an occupational exposure to bloodborne pathogens
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PPE is available for Bloodborne Pathogen/PIM spill cleanup
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Waste receptacles are available and identified
General Work Environment
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Work areas are adequately illuminated.
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Toilets/washing facilities are clean and sanitary.
Personal Protective Equipment
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Personal protective equipment is maintained in a sanitary condition and ready for use.
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Appropriate eye/face protection is worn when required.
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Appropriate foot protection is worn when required.
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Appropriate hand protection is worn when required.
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Appropriate respiratory protection is worn when required.
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Appropriate hearing protection is worn when required.
Respiratory Protection
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Employees are required to use respirators.
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Employees are properly fitted with appropriate respirators.
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Monthly checks are conducted on respirators used for emergency purposes.
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Respirators are properly stored and in good condition.
Fire Protection Equipment
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Fire extinguishers are serviced annually and inspected monthly.
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Fire extinguishers are easily accessible and not obstructed.
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Sprinkler heads are unobstructed.
Flammable and Combustible Materials
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Proper storage practices to minimize the risk of fire including spontaneous combustion are in place.
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Smoking is prohibited indoors and in areas where a risk of fire is present.
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Flammable liquids and cylinders are stored away from radiators, other sources of heat, and exits.
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Bulk drums of flammable liquids are grounded and bonded to containers during dispensing.
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Combustible dust is minimized.
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Compressed gas cylinders are secured in place.
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Oxygen cylinders are stored away from items such as oil, grease, acetylene, and other fuel gas cylinders (20 feet or 5 feet non-combustible partition).
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Oxygen/acetylene equipment is equipped with flashback arresters.
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Oxygen/acetylene equipment lines are bled off and tanks closed when not in use.
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Hot work areas are identified throughout the location and hot work permits are utilized.
Energy Control Procedures
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Employees were observed correctly following established energy control procedures.
Machine Guarding
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Nip points, shear points, couplers, point of operation, gears, and chains are guarded.
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All corners and edges of guards are smooth and do not present a hazard in itself.
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Guards are secured to equipment.
Hand Tools and Equipment
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Tools and equipment used by employees in the workplace are in good condition.
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Guards are utilized on tools.
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Appropriate handles are used on files and similar tools.
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Non-double insulated tools are grounded.
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Compressed air used for cleaning is limited to 30 psi and/or equipped with a safety nozzle.
-
Equipment is anchored in place and made secure.
-
Grinder work rests are adjusted to within 1/8-inch of the wheel and the tongue guard within ¼-inch.
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Push sticks or blocks are provided at the work place in the several sizes and types suitable for the work to be done.
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Cleanliness around machinery is maintained.
HAZCOM
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All containers are labeled as to their contents.
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Safety Data Sheets (SDS) are readily available for each hazardous substance used.
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A list of hazardous substances used in the workplace is accurately maintained.
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Standard operating procedures for chemical spill cleanup have been established and are followed.
Electrical
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Live parts of electric equipment are guarded against accidental contact.
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Electrical equipment / cords are in good condition.
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Electrical appliances and equipment are grounded.
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Disconnecting switches and circuit breakers are labeled to indicate their use.
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Power/disconnect panels have >36 inches of clearance.
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Applicable NFPA 70E requirements are met.
Material Handling / Powered Industrial Trucks (PITs)
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Stored materials are stable and secure.
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PITs are operated in a safe manner (appropriate speed, seatbelt worn, etc.).
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PITs are maintained in a safe operating condition and safety devices are functional.
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Daily PIT inspections are conducted and documented prior to use.
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Electric forklift charging areas have acid neutralizers, immediately available fire protection, and adequate ventilation.
Slips, Trips, and Falls
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Walking surfaces are maintained in a clean and, so far as possible, dry condition. Where wet processes are used, drainage is maintained and false floors, platforms, mats, or other dry standing places are provided.
-
Aisles and passageways are identified and kept clear.
-
Holes in the floor, grates, sidewalk, or other walking surface are covered or otherwise made safe.
-
Rugs and floor coverings are in good condition and do not pose a tripping hazard.
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Stairs have uniform riser heights, tread depths, are equipped with handrails, and are clear of obstructions/tripping hazards.
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Employees are protected against all other fall hazards.<br>
Ladders
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Ladders are in good condition.
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Ladders are visually inspected prior to use.
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Ladders are secured when stored to prevent tipping/falling.
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Employees were observed using ladders safely.
