JHSC Monthly Workplace Inspection

• Inspection No.

• Conducted on

  Date

• Personnel present at time of Inspection

Inspection Information

• Facility Inspected

  Select Leamington Kingsville Wellington Crossfield Langley Langley Tunnels Ruby Creek Abby 4SK

  • Leamington
  • Kingsville
  • Wellington
  • Crossfield
  • Langley
  • Langley Tunnels
  • Ruby Creek
  • Abby
  • 4SK

• Departments Inspected

  Select Packing Shipping and Distribution Office Casing Barn Basement Conveyor Boiler Rooms Wharf Tunnels Harvest North Harvest South Crew/Cultivation/Prep

  • Packing
  • Shipping and Distribution
  • Office
  • Casing Barn
  • Basement Conveyor
  • Boiler Rooms
  • Wharf
  • Tunnels
  • Harvest North
  • Harvest South
  • Crew/Cultivation/Prep

1.0 Previous inspections

• Has the previous workplace inspection sheet been reviewed?

  Yes

  No

  N/A

• Are there any outstanding/not completed items on previous inspection?

  No

  Yes

• Are there any repeat items?

  Yes

  No
Tap to enter information

• List item(s)

2.0 Electrical

• Is the area around electrical panels clear of debris and obstructions? (3 ft in front of the panel and on each side)

  Yes

  No

  N/A
Tap to enter information

• There must be a 3 foot area clear around electrical panels

• Is all electrical equipment in good condition? (no frayed or damaged cords, broken outlets?)

  Yes

  No

  N/A

• Are extension cords used only for temporary power needs and water proofed?

  Yes

  No

  N/A

• Lockout Stations are properly stocked

  Yes

  No

  N/A

• How many locks are needed to restock?

3.0 General Lighting

• Is the area well lit?

  Safe

  At Risk

  N/A

• Lighting is not flickering

  Safe

  At Risk

  N/A

• Are there any dark areas?

  No

  Yes

• Are any lights burnt out?

  No

  Yes

• Please indicate how many and the location where the lights are burn out

4.0 Housekeeping

• Is the floor clear of loose material, pallets, debris, tools, etc?

  Yes

  No

  N/A

• Are the floors clear of anything slippery, oily or wet?

  Yes

  No

  N/A

• Doors and emergency exits are accessible, (not blocked) and functional

  Yes

  No

  N/A

5.0 Stairways, Hallways & Aisles

• Are stairwells clear and unblocked?

  Yes

  No

  N/A
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• Take photo

  Media

• Are the stairs in good repair?

  Safe

  At Risk

  N/A

• Are the stairways well lighted?

  Yes

  No

  N/A

• Are the handrails, handholds in place?

  Yes

  No

  N/A

• Are mirrors installed at blind corners?

  Yes

  No

  N/A

6.0 Materials Handling & Storage

• Are storage areas free from tripping hazards?

  Yes

  No

  N/A
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• Take picture of area

  Media

• Do materials interfere with walkways?

  No

  Yes

• Are materials stored neatly and safety piled?

  Yes

  No

  N/A

• Are there stepladders or stools to get to materials on higher shelves

  Yes

  No

  N/A

• Are storage shelves overloaded?

  No

  Yes

• Are heavy and large objects stored on lower shelves?

  Yes

  No

  N/A

7.0 WHMIS

• Are there WHMIS materials used in the area?

  Yes

  No

  N/A
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• Is there a current MSDS (less than 3 years old) for the product(s) available?

  Yes

  No

  N/A
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• Advise Department Supervisor to update MSDS inventory

• Are there secondary containers used?

  Yes

  No

  N/A
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• Picture of Secondary container

  Media

• Are there Workplace Labels used?

  Yes

  No

  N/A
Tap to enter information

• Are the labels available and up to date?

  Yes

  No

  N/A

• Is there an eyewash station or eyewash bottle near by and free of obstruction?

  Yes

  No

  N/A
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• Is there a tap or sink near by?

  Yes

  No

  N/A

• Picture of eye wash bottle/station

  Media

8.0 Equipement

• Are elevating / lifting devices used only within capacity?

  Yes

  No

  N/A
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• Are capacities posted on the equipment?

  Yes

  No

  N/A
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• Advise Department Supervisor

• Are lifting devices inspected yearly and the inspection listed on the device?

  Yes

  No

  N/A
Tap to enter information

• Are the pre-use inspections completed?

  Yes

  No

  N/A
Tap to enter information

• Yearly inspection records must be keep showing; date of inspection, lifting capacity of the device

• Take picture of the inspection sticker

  Media

• Do operators have their current lift ticket on their person?

  Yes

  No

  N/A
Tap to enter information

• Operators must have proof of training in order to operate equipment

• Are chain hoists, ropes and slings marked for load capacity?

  Yes

  No

  N/A

9.0 Warehouse & Shipping

• Are dock platforms, bumpers, stairs and steps in good condition?

  Yes

  No

  N/A

• Is there signage for drivers to chock their tires?

  Yes

  No

  N/A

• Is racking in good condition (no visable damage, missing braces?)

  Yes

  No

  N/A

• Does the racking have a load capacity sticker?

  Yes

  No

  N/A

• Take picture of load capacity sticker on racking

  Media

• Are there lockout devices and trailer stands available to associates to use?

  Yes

  No

  N/A

• Are trucks locked out or have a trailer stand in place?

  Yes

  No

  N/A

10.0 Safety Environment Items

• Associates who stand for longer than 1 hr at a time have ergonomic mats <br>

  Yes

  No

  N/A

• The area has adequate ventilation/airflow

  Good

  Fair

  Poor

  N/A

11.0 PPE

• PPE is provided to associates

  Yes

  No

  N/A

• PPE is inspected by supervisors on an ongoing basis

  Yes

  No

  N/A

• PPE stations are properly stocked with the correct equipment

  Yes

  No

  N/A

• Associates arrive to work with PPE in good condition

  Yes

  No

  N/A

12.0 First Aid

• First Aid Stations are indicated with a sign

  Yes

  No

  N/A

• AED Units are indicated with a sign

  Yes

  No

  N/A

• AED Battery reading is, "OK"

  Yes

  No

  N/A

• First Aid Stations are accessible and in a visable location

  Yes

  No

  N/A

• First Aid Holder List is up to date and posted beside the station

  Yes

  No

  N/A

13.0 Security

• Exterior doors are only accessible with a key card/fob

  Yes

  No

  N/A

• Evacuation Points and shelter areas are identified with a sign

  Yes

  No

  N/A

• Lighting is adequate in parking areas and out door walking areas

  Yes

  No

  N/A

• Alarm system functioning (if applicable)

  Yes

  No

  N/A

• Parking Lot lines are painted and applicable signage is present

  Yes

  No

  N/A

14.0 Labels and Safety Items

• Safety labels and warnings are clearly visible and in good condition

  Yes

  No

  N/A

• Equipment and Emergency stations are properly labeled with warning, caution and hazard signs

  Yes

  No

  N/A

• Seasonal controls (salt, sunglasses, high-vis clothing) are in use

  Yes

  No

  N/A

• LOTO SOP's posted at or near machines

  Yes

  No

  N/A

• What SOPs are missing?

15.0 Safety Notice Boards

• JHSC photos and contact information present?

  Yes

  No

  N/A

• Emergency Contact Numbers posted?

  Yes

  No

  N/A

• Worker Rights Information posted?

  Yes

  No

  N/A

• Health and Safety Company policy posted and applicable standards (workplace violence, etc.)

  Yes

  No

  N/A

• Mental Health Awareness posting present?

  Yes

  No

  N/A

• Hazardous Substance information present?

  Yes

  No

  N/A

• In the event of an incident - steps to take poster present?

  Yes

  No

  N/A

• List of first aiders present?

  Yes

  No

  N/A

• Copy of OHSA present?

  Yes

  No

  N/A

• Employment standards poster present?

  Yes

  No

  N/A

• Disability and claims information present?

  Yes

  No

  N/A

16.0 Noise

• Is it hard to hear in the area?

  Yes

  No

  N/A

• Do associate wear ear protection where required?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Where do you go in the event of an emergency (fire, tornado, violence)?

• Where is the first aid station located?

• What do you do if you are involved in an incident (injury, property damage, near miss) in the workplace?

• Is PPE readily available for you to complete your job tasks?

  Yes

  No

  N/A

• Do you feel you are properly trained to conduct your work duties?

  Yes

  No

  N/A

• Why do you feel you have not adequately been trained?

• Do you have any suggestions for making your working environment safer?

  Yes

  No

  N/A

• Comments

• Surveyed Associates Name and Signature

  Sign

• Hazards observed during inspection
  Class A - Condition or practice with potential for a Critical Injury or Death Class B - Condition or Process with potential for serious injury or property damage Class C - conditions or practices with potential for minor injury or property damage
  

Hazard observed

• What is the hazard Observed?

• Hazard Class

  Class A Hazard

  Class B Hazard

  Class C Hazard

• Additional Comments

• Signature of Inspecting Committee Member

  Sign

• Signature of Inspecting Supervisor or Manager of the Department

  Sign

• Only complete this page if you have been designated to inspect the first aid room. If you have not been selected to inspect the first aid room, please continue to the next page.

• 1 Dressing Scissors (2)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 2 Dressing Forceps (Tweezers) (2)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 3 Safety Pins (24)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 4 Cotton-Tipped Applicators (Q-tips)(50)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 5 Antiseptic Wipes(24)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 6 Adhesive dressings individually wrapped (bandaids)(60)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 7 2" Sterile Gauze Pads (48)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 8 3" Sterile Gauze Pads (48)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 9 1" Gauze Bandages (12)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 10 2" Gauze Bandages (8)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 11 4" Gauze Bandages (4)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 12 Absorbent Cotton - Cotton Balls (25)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 13 Triangular Bandages (12)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 14 Splints of assorted sizes

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 15 Splint padding (2)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 16 Hot and cold running water

  Yes

  No

  N/A

• 17 Stainless steel washbasins (3)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 18 Cabinet for storing the dressings (1)

  Yes

  No

  N/A

• 19 Garbage receptacle with lid (1)

  Yes

  No

  N/A

• 20 Couch or bed to lie on (1)

  Yes

  No

  N/A

• 21 Stretcher (1)

  Yes

  No

  N/A

• 22 Blankets (2)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 23 CPR Mask (1)

  Yes

  No

  N/A

• 24 Non-Latex Gloves - Size Small (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 25 Non-Latex Gloves - Size Medium (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 26 Non-Latex Gloves - Size Large (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 27 Valid Standard St. John Ambulance Manual

  Yes

  No

  N/A

• 28 Burn Gel (10)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 29 Splinter Remover (5)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 30 After Bite (10)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 31 Ice Packs (10)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Safety Pins (24)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Adhesive Dressings - Sterile (24)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• 3" Sterile Gauze Pads (12)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Rolls of 2" Gauze Bandages (4)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Rolls of 4" Gauze Bandages (4)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Triangular Bandages (6)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Roll Up Splint

  Yes

  No

  N/A

• Splint Padding (2)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Sterile Surgical Pads for Pressure Dressings (4)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• CPR Mask (1)

  Yes

  No

  N/A

• Roll of Adhesive Medical Tape (1)

  Yes

  No

  N/A

• Antiseptic Wipes (24)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Non-Latex Gloves - Size Small (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Non-Latex Gloves - Size Medium (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Non-Latex Gloves - Size Large (2 pairs)

  Yes

  No

  N/A

• How many items are needed to re-stock the station?

• Valid FIRST AID/CPR Manual

  Yes

  No

  N/A

• First Aid Reg 1101

  Yes

  No

  N/A

• Ice Pack (1)

  Yes

  No

  N/A

• Burn Gel (1)

  Yes

  No

  N/A

• Comments:

• JHSC Rep Name and Signature

  Sign

• Supervisor or Manager Name and Signature

  Sign