Information
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Facility Number
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Facility Manager Name
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Conducted on
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Audit Prepared by
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Location
General
Overall Store Items
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Is the warehouse floor free of obvious debris or liquid that potentially might cause a slip/trip hazard?
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Is the warehouse free of obvious electrical hazards?
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Are operators of PIE slowing down and sounding horns at intersections?
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Are proper lifting techniques being employed? Observe a few employees while they are working. Examples include minimizing twisting, lifting while bending at the knee, not the back, team lifting of heavy or awkward items, etc.
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Are first aid kits maintained and stocked with the minimum required items?
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Is the employee bulletin board up to date and contain pertinent safety related information?
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Is the HazCom/SDS binder and the I2P2/Emergency action plan binder both located in the lunch room and made easily accessible?
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Are chemicals kept in properly labeled bottles?
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Are associates wearing and maintaining their protective footwear while working in the warehouse?
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Is the correct PPE being used for different job tasks? If no, please note area, PPE, and task.
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Is the eyewash station being inspected on a regular basis,maintained properly, and free of obstructions?
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In the battery handling room, is the battery handler properly trained and using the proper PPE for the job task?
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Are exits and fire exits unblocked, maintaining a minimum of 28 inches of clearance?<br>
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Do fire exit work properly, open freely, and alarm sounds when opened?<br>
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Are fire extinguishers being checked on a monthly basis?
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Do the storage racks appear to be in good repair including uprights and cross bars? Make note of exact location and photograph suspected deficiencies.
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Are pallets stored properly in the racks as to not cause them or product to fall?
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Does machinery have the required equipment safeguards in place and are the guards being used properly?
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Are there any areas that employees access and work regularly that may present a fall hazard and are not properly safeguarded?
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Are staircases free of slip/trip hazards? If no, please note location and take photo of condition.
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Are ladders in proper working order?
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Do compressor room, HVAC room, and other areas that are designated as "Authorized Personnel Only" appear to be free of obvious hazards?
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Does the compressor room have copies of the SDS for refrigeration related chemicals?
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Is the HVAC room free of obvious electrical hazards including, but not limited to electrical panels, missing or improper labeling, frayed wires, missing ground plugs, broken light switches, etc.? Check mart cart plugs and cords.
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Are there any additional electrical concerns? If yes please list.
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Are there any safety related concerns present that are not listed in the audit? If yes, explain.
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Are there any additional safety concerns with this department?
Employee Interview #1
Interview #1 - Non-management Employee
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Name of interviewed employee
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Job Title
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Do you have any concerns in regards to safety that you feel we need to address? If yes, please describe in detail.
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Have you spoken to a manager about these concerns?
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Were these concerns that you raised addressed by your manager?
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Have you received any of the following training? Select yes if training was received and employee has good knowledge? Select no if employee does not display good working knowledge. Select N/A if the training type does not apply.
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Has the employee received the chemical training, including receiving a copy of the chemical training booklet?<br>
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Can the employee explain what a Safety Data Sheet (SDS) is?
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Using the pictogram cards, can the employee identify a few pictograms successfully?<br>
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If there were an emergency situation involving another employee, can the employee provide some explanation as to how they would properly assist in handling the situation?
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Can the employee explain the location of and how to use the eyewash station?<br>
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Has the employee been trained on the various types of lifting techniques?
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Emergency Evacuation training? What is the designated area that you need to report to, using the quickest way out, and more importantly why do you need to report there?
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Compactor/bailer use? Employee should know about age restriction of 18 years or older, close door prior to turning on the compactor, and never to climb in the compactor/bailer.
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Powered Industrial Equipment trained?
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Have employee describe the training that they received and how long the session was. Does the employee appear competent to use the equipment? Some items they should be able to discuss are stability triangle and weight capacity.
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Has the employee received any other safety related training? If yes, please list additional training. Additional training can include Utility Knife Training, Step Stool Use, other department specific training, etc.
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Does the employee seem knowledgeable in regards to his/her training?<br>
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Have the employee demonstrate how they inspect the powered industrial equipment at the beginning of their shift. Are they covering all of the items on the checklist and seem proficient with checking the vehicle?<br>
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If there was a small amount of blood spilled on the floor, would you clean it up?
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What would you do? Note answer. Answer should be inform a manager.
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Inform the employee that they are not authorized to clean up blood and that they must inform a manager if they encounter a blood spill or any other accident.
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Employee Interview #2
Interview #2 - Non-management Employee
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Name of interviewed employee
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Job Title
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Do you have any concerns in regards to safety that you feel we need to address? If yes, please describe in detail.
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Have you spoken to a manager about these concerns?
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Were these concerns that you raised addressed by your manager?
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Have you received any of the following training? Select yes if training was received and employee has good knowledge? Select no if employee does not display good working knowledge. Select N/A if the training type does not apply.
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Has the employee received the chemical training, including receiving a copy of the chemical training booklet?<br>
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Can the employee explain what a Safety Data Sheet (SDS) is?
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Using the pictogram cards, can the employee identify a few pictograms successfully?<br>
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If there were an emergency situation involving another employee, can the employee provide some explanation as to how they would properly assist in handling the situation?
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Can the employee explain the location of and how to use the eyewash station?<br>
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Has the employee been trained on the various types of lifting techniques?
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Emergency Evacuation training? What is the designated area that you need to report to, using the quickest way out, and more importantly why do you need to report there?
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Compactor/bailer use? Employee should know about age restriction of 18 years or older, close door prior to turning on the compactor, and never to climb in the compactor/bailer.
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Powered Industrial Equipment trained?
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Have employee describe the training that they received and how long the session was. Does the employee appear competent to use the equipment? Some items they should be able to discuss are stability triangle and weight capacity.
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Has the employee received any other safety related training? If yes, please list additional training. Additional training can include Utility Knife Training, Step Stool Use, other department specific training, etc.
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Does the employee seem knowledgeable in regards to his/her training?<br>
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Have the employee demonstrate how they inspect the powered industrial equipment at the beginning of their shift. Are they covering all of the items on the checklist and seem proficient with checking the vehicle?<br>
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If there was a small amount of blood spilled on the floor, would you clean it up?
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What would you do? Note answer. Answer should be inform a manager.
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Inform the employee that they are not authorized to clean up blood and that they must inform a manager if they encounter a blood spill or any other accident.
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Employee interview #3
Interview #3 - Non-management Employee
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Name of interviewed employee
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Job Title
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Do you have any concerns in regards to safety that you feel we need to address? If yes, please describe in detail.
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Have you spoken to a manager about these concerns?
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Were these concerns that you raised addressed by your manager?
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Have you received any of the following training? Select yes if training was received and employee has good knowledge? Select no if employee does not display good working knowledge. Select N/A if the training type does not apply.
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Has the employee received the chemical training, including receiving a copy of the chemical training booklet?<br>
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Can the employee explain what a Safety Data Sheet (SDS) is?
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Using the pictogram cards, can the employee identify a few pictograms successfully?<br>
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If there were an emergency situation involving another employee, can the employee provide some explanation as to how they would properly assist in handling the situation?
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Can the employee explain the location of and how to use the eyewash station?<br>
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Has the employee been trained on the various types of lifting techniques?
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Emergency Evacuation training? What is the designated area that you need to report to, using the quickest way out, and more importantly why do you need to report there?
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Compactor/bailer use? Employee should know about age restriction of 18 years or older, close door prior to turning on the compactor, and never to climb in the compactor/bailer.
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Powered Industrial Equipment trained?
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Have employee describe the training that they received and how long the session was. Does the employee appear competent to use the equipment? Some items they should be able to discuss are stability triangle and weight capacity.
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Has the employee received any other safety related training? If yes, please list additional training. Additional training can include Utility Knife Training, Step Stool Use, other department specific training, etc.
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Does the employee seem knowledgeable in regards to his/her training?<br>
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Have the employee demonstrate how they inspect the powered industrial equipment at the beginning of their shift. Are they covering all of the items on the checklist and seem proficient with checking the vehicle?<br>
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If there was a small amount of blood spilled on the floor, would you clean it up?
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What would you do? Note answer. Answer should be inform a manager.
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Inform the employee that they are not authorized to clean up blood and that they must inform a manager if they encounter a blood spill or any other accident.
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Safety File Review
Safety Files and Training Documentation
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Review the OSHA 300 logs for injuries this year and last year. Are the managers accurately recording the injuries on the log?<br>
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How many injuries are recorded on the OSHA 300 log?
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Review the injury investigation file. Is the manager conducting adequate injury investigations and providing corrective actions?
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Review the Safety Employee Warning Notice file. How many warning notices for safety violations have been issued for this year?
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Are quarterly safety committee meetings accomplished and productive? Review last committee meeting and attempt to speak with an individual that attended the meeting.
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Is the Blood Borne Pathogen Authorized user list up to date with the most current managers listed?
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Is there a copy of the Blood Borne Pathogen knowledge test on file for each authorized manager? If no, list missing names or other discrepancies.<br>
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Interview a Blood Borne Pathogen trained manager. Can the manager describe how to properly clean up a blood spill?<br>
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Review the chemical training files. Spot check and verify that the revised chemical training had been completed for active associates. Pay close attention to porters and maintenance shop workers. Is the training up to date?
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Review the Lock Out Tag Out authorized user list. Is there a copy of the knowledge test on file for each authorized associate? If no, list missing names or other discrepancies. The information for the LOTO authorized user list may be in the repair shop as they are the only ones trained for LOTO.
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Has the Lock Out Tag Out annual review been conducted for all authorized employees?<br>
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Review the training documentation for the powered industrial trucks. Are the file in good order, including an authorized user list?
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Spot check the powered industrial training documentation for several users. Are the documents completely filled out, including the having the required signatures, initials, and valid dates of training?
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Does the facility have a retraining program for operators that have failed to properly operate PIE, including near miss incidents?
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Are the Vehicle Inspection Reports being conducted and turned in daily? Review with manager.
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Are SDS (Safety Data Sheets, formerly known as MSDS) on file for all chemicals used in the facility? If no, make note of any deficiencies.<br>
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Are the SDS located in a binder and tabbed in order to make it easier to quickly find a section?
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Are there any additional concerns with the file or record keeping system?
Wrap Up
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During this audit were any items discovered that require corrective action?
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Please enter any additional information or concerns regarding this audit.
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Signature of Person in Charge.