Kinship Hornell Safety Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Previous Inspection

• Has the last inspection been reviewed?

  Yes

  No

  N/A

• Has outstanding findings been addressed?

  Yes

  No

  N/A

OSHA

• Is the required OSHA Job Safety and Health Protection Poster displayed in a prominent location where all employees are likely to see it?

  Yes

  No

  N/A

• Are emergency telephone numbers posted where they can be readily found in case of emergency?

  Yes

  No

  N/A

• Do employees know where to find Safety Data Sheets (SDS) at their location?

  Yes

  No

  N/A

• Is the Summary of Work-Related Injuries and Illnesses (OSHA Form 300A) posted during the months of February, March, and April?

  Yes

  No

  N/A

• Additional Findings:

PHI Safety

• Are passwords kept secure and not visible?

  Yes

  No

  N/A

• Are computer screens locked when unattended?

  Yes

  No

  N/A

• Is PHI secured at fax/printer?

  Yes

  No

  N/A

• Is PHI shredded and not put in the recycling bin?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

General Work Environment

• Are all worksites clean, sanitary and orderly?

  Yes

  No

  N/A

• Is furniture in good condition? (No damage)

  Yes

  No

  N/A

• Are office layouts designed for staff to be closest to the exit?

  Yes

  No

  N/A

• HVAC systems regularly maintained?

  Yes

  No

  N/A

• Stable non-slip floor coverings in good condition?

  Yes

  No

  N/A

• Are all portable ladders maintained in good condition?

  Yes

  No

  N/A

• Are employees prohibited from using ladders that are faulty?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

Fire Prevention

• Is there an Emergency Evacuation plan in place and understood by all employees?

  Yes

  No

  N/A

• Are Emergency Evacuation routes posted?

  Yes

  No

  N/A

• Extinguishers in place, clearly marked?

  Yes

  No

  N/A

• Extinguishers recently serviced?

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Yes

  No

  N/A

• Adequate direction notices for fire extinguishers?

  Yes

  No

  N/A

• Exit doors easily opened from inside?

  Yes

  No

  N/A

• Exits clear of obstructions?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

General Lighting

• Light fittings clean and in good condition?

  Yes

  No

  N/A

• Emergency exit lighting operable?

  Yes

  No

  N/A

• Are all work areas adequately illuminated?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

Building Safety

• Is panic button system regularly tested?

  Yes

  No

  N/A

• No structure damage visible?

  Yes

  No

  N/A

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Entry, walkways, and stairs kept clear?

  Yes

  No

  N/A

• Are ceiling tiles free of stains?

  Yes

  No

  N/A

• Are vents cleaned?

  Yes

  No

  N/A

• No plumbing issues are visible?

  Yes

  No

  N/A

• Are railings in good condition?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

Storage Design and Use

• Is proper storage practiced to minimize the risk of fire, including spontaneous combustion?

  Yes

  No

  N/A

• Materials stored on shelves wherever possible?

  Yes

  No

  N/A

• Storage designed to minimize lifting problems?

  Yes

  No

  N/A

• Floors around shelving clear of obstructions?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

Electrical Safety

• Is electrical panel clear from obstruction?

  Yes

  No

  N/A

• Are electrical enclosures such as switches, receptacles, junction boxes, etc., provided with tight-fitting covers or plates?

  Yes

  No

  N/A

• Are electrical appliances such as vacuum cleaners, coffee makers, etc. grounded?

  Yes

  No

  N/A

• Is IT room clean and free of dust?

  Yes

  No

  N/A

• Are electrical enclosures clean and free of dust?

  Yes

  No

  N/A

• No extension cords are in use?

  Yes

  No

  N/A

• No broken plugs, sockets or switches?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

Vehicle Safety

• Are vehicles used to transport clients/residents equipped with lamps, brakes, horns, mirrors, windshields, and turn signals, and are they in good repair?

  Yes

  No

  N/A

• Do vehicles have adequate tread on tires?

  Yes

  No

  N/A

• Is vehicle inspection, registration, and oil change up to date?

  Yes

  No

  N/A

• Is there a fire extinguisher available in the vehicle?

  Yes

  No

  N/A

• Is the vehicle repair log maintained?

  Yes

  No

  N/A

First Aid & Personal Protective Equipment

• Are employees aware of location of first aid kit?

  Yes

  No

  N/A

• Are contents clean and orderly?

  Yes

  No

  N/A

• No contents past their expiration date.

  Yes

  No

  N/A

• Is all PPE maintained in a sanitary condition and ready for use?

  Yes

  No

  N/A

• Is PPE appropriate and properly fitted?

  Yes

  No

  N/A

• Additional Findings:

• Risk:

  Low

  Medium

  High

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