• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Walking/Working Surfaces and Fall Protection

  • Proper labels in place and legible?<br> -Portable ladders and stairways require labeling indicating weight limits.

  • Floors and work platforms free of excessive debris and clutter?<br> -Excessive oil, trash, manufacturing byproducts, etc. in the work are?<br> -No items stored on stairs?

  • Handrails secure and free of excessive defects?<br> -Heavily damaged handrails that require replacement? Loose? Broken welds? Bent handrails and/or toe boards?<br> -Handrails do not contain excessive oil/grease?

  • Handrails installed where a fall from a height of four feet or greater exists?

  • Fall protection equipment available for working at heights greater than 4 feet from the working surface below it where fall prevention is not available?

  • Harnesses, lanyards, SRL, and lifelines maintained in good condition and inspected properly?<br> -Inspection labels present and legible?<br> -Webbing free of frayed, cut or broken fibers?<br> -Quick connect buckles working properly?


  • Are all tools in good working condition?<br> -Held together with tape?<br> -Excessive noise/vibration?<br> -Requires excessive manual manipulation?

  • All existing guarding in place?<br> -Guards laying on the floor?<br> -Bolts/Screws missing from fixed guarding?<br> -Guards shifted causing open point of operation?

  • Existing guarding sufficient in preventing access to the point of operation?<br> -Gaps in guarding too large?<br> -Use of chains as barrier guarding?<br> -Interlocked/Presence sensing devices not working properly?<br> -No guard installed where it should exist?

  • Machinery working properly and not causing regular manual manipulation?<br> -Frequent breakdowns causing manual work?<br> -Machinery producing excessive noise/vibration due to disrepair?

  • Machinery design/layout inherently hazardous?<br> -Congestion created in design?<br> -Equipment no longer safest design for the process?<br> -Can a hazardous piece of equipment be eliminated from the process/work area?

Emergency Response/Fire Protection

  • Fire extinguishers inspected monthly and unblocked?

  • Employees aware of emergency procedures and where assembly areas are? (Interview >=2 employees)

  • Eyewash/Safety Shower stations inspected and unblocked?

  • Spill kits are available where needed and are equipped/inspected as required?

  • Sufficient emergency equipment installed in the area?<br> -Fire extinguishers, eyewash, safety shower, spill kits, alarm pull stations, etc.

  • Fire suppression systems not blocked/damaged?

Mobile Equipment

  • Equipment inspected per inspection frequency requirements?

  • Operators using horns and warning devices where required?

  • No passengers on equipment designed for operators only?

Hazardous Energy Control (Lockout/Tagout)

  • Employees expected to conduct lockout trained and equipped properly?<br> -Employees understand their role and requirements?<br> -Employees have locks available if needed?

  • Employees locked out during a change over and/or other tasks that require lockout?<br> -All employees who are working on the equipment have their own lock affixed to the proper energy source(s)?<br> -Lockout was verified, stored energy was dissipated and equipment will not operate?

  • Energy control procedures exist for all equipment in the area and employees know where to find them?

  • Lockout exceptions have been adequately evaluated and determined safe?<br> -Do regular tool/machine adjustments introduce hazards with unacceptable risk?<br> -Other exceptions?

General Safety and Housekeeping

  • Trash, debris, and equipment not left laying around?

  • Equipment free of excessive dust, oil and/or soot?

  • Floor surfaces covered in oil/dust covering the painted surface?

  • General tripping hazards due to housekeeping, equipment layout, and/or workstation design?

Signature and Finalization

  • I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.

  • Select date

  • General Comments

  • Overall Safety Score

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