Title Page

  • Conducted on

  • Prepared by

  • Site
  • Which section of the site?

Floors

  • can water be walked onto smooth floors (e.g foyers) on rainy days?

  • are there any hard, smooth floors in wet or oily areas?

  • are there any leaks of fluids onto the floor from processes or machines?

  • are there any surface transitions not easily noticed ( any ridge that is as high as a sole of a shoe/footwear or higher)?

  • is the floor slippery when wet?

  • is there poor drainage causing pooling of fluids?

  • are any anti-slip paint, coating profiles or tapes worn smooth or damaged?

  • are there any isolated low steps (commonly at doorways)?

  • are there any trip hazards due to equipment and other objects left on the floor?

  • are there any raised carpet edges or holes worn in carpets

  • are there any tiles becoming unstuck or curling at the edges?

  • are there any holes or unevenness in the floor surface?

  • is there a build up of moss or other vegetation (weeds) on pathways?

  • is anything protruding into walkways e.g. tree branches?

  • are all mats, carpet, linoleum secured and not lifting up.

  • are there potholes in footpaths or walkways?

Stairs, Ladders and Ramps

  • is the lighting insufficient for ramps, ladders or steps to be seen clearly?

  • is the lighting for ramps, ladders or steps creating glare?

  • do any steps have too small a rise or tread or an excessive step edge (nosing)?

  • are any step edges (nosing) slippery or hard to see?

  • is anti-slip edging in place?

  • are the steps uneven or are there excessive variations in step dimensions?

  • are handrails inadequate on stairs?

  • are ramps too steep or too slippery?

  • are ladders compliant hand have the appropriate back guard?

  • are any persons observed using stairs or ladders using 3 points of contact?

  • are ladders in good condition (i.e. not damaged, rusted or corroded )?

Lighting

  • is there insufficient lighting in passageways, at flooring transitions, ramps or stairs?

  • does the lighting throw distracting shadows or produce excessive glare?

Housekeeping

  • is there a build-up of polish on floors?

  • is there spills of product etc. on floors or walkways?

  • do workers have to walk on floors wet from washing?

  • are wet floor signs not available or not used correctly?

  • do you need to provide information/training/advice to contractors regarding cleaning procedures?

  • are paper, rubbish, dirt, or spills left on the floor?

  • are aisles poorly marked?

  • are aisles cluttered?

  • are there any trip hazards due to equipment and other movable objects left lying on the ground?

  • do spills ( wet or dry) occur regularly during work processes?

  • is the cleaning method appropriated for the floor surface?

  • is emergency equipment partially blocked?

Tasks

  • do workers have to walk or work on greasy, oily or wet floors that are not adequately slip resistant?

  • do loads that are carried or pushed interfere with vision?

  • are the loads to be carried excessive or likely to upset a person's balance?

  • do heavy trolleys or other equipment have to be pushed up ramps?

  • are workers hurried due to time constraints?

  • do workers required training in the procedures for dealing with slips and trips hazards?

  • are workers following 3 points of contact when using ladders or stairs?

  • are workers using 3 points of contact when entering or exiting plant/equipment?

  • is the ground where equipment operators/truck drivers expected to alight from their equipment stable and even?

Footwear

  • do the workers' safety shoes lack grip?

  • do workers require slip resistant footwear?

  • are the tread patters on footwear clogged with dirt?

  • are boot cleaning stations provided in areas where mud could accumulate on safety footwear?

  • 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.