LA BREAD | Periodic Safety Walk

• Inspection Title

• Conducted on

  Date

• Prepared by

• Location
  Address

Machine Safety

• Machine is positioned correctly?

  Yes

  No

  N/A

• Anchored to the floor?

  Yes

  No

  N/A

• Walls or fencing around machine are positioned correctly?

  Yes

  No

  N/A

• All machine guards in place? (Do the guards allow for the operator's hands, arms, or other body parts to make contact with hazardous machine parts?)

  Yes

  No

  N/A

• Are the guards effective? (Is there evidence that the guards have been tampered with or bypassed to make them ineffective?)

  Yes

  No

  N/A

• Are the guards firmly secured and not easily removed?

  Yes

  No

  N/A

• Is the machinery and work station clean and free of oils, greases and debris?

  Yes

  No

  N/A

• E-Stops working correctly?

  Yes

  No

  N/A

• Lockout / Tag out procedures and/or placards posted on the machine?

  Yes

  No

  N/A

Operator Controls

• Are starting / stopping controls within easy reach of the operator?

  Yes

  No

  N/A

• Are controls labeled to identify their function?

  Yes

  No

  N/A

• Are emergency stop controls easily accessible and clearly identified?

  Yes

  No

  N/A

• Is the machine wired so that it must be manually restarted if power is interrupted and then reapplied?

  Yes

  No

  N/A

General Safeguarding Requirements

• Can the machine be locked out at each power source?

  Yes

  No

  N/A

• Are the guards installed so that they do not create hazards such as shear or pinch points or sharp edges?

  Yes

  No

  N/A

• Are employees trained on all applicable safety procedures relating to machine operation?

  Yes

  No

  N/A

• Is all machinery and equipment kept clean and properly maintained?

  Yes

  No

  N/A

• Are previsions made to prevent machines from automatically starting when power is restored after a power failure or shut down?

  Yes

  No

  N/A

Personal Protective Equipment. (PPE)

• PPE sign posted?

  Yes

  No

  N/A

• Eye protection worn when required?

  Yes

  No

  N/A

• Face shield / Weld mask being used when required?

  Yes

  No

  N/A

• Appropriate gloves / hand protection being used when required?

  Yes

  No

  N/A

• Work boots worn by all employees (no gym shoes, sandals, bare feet)?

  Yes

  No

  N/A

• Is clothing worn in line with company dress code?

  Yes

  No

  N/A

Electrical Safety

• Electrical panels appropriately covered or our employees protected from coming within 6' of a live exposed panel?

  Yes

  No

  N/A

• Lock out / tag out procedures in place and being implemented if required?

  Yes

  No

  N/A

• Are all energized electrical components protected to reduce employee exposures (closed panels, no missing knockouts, etc.)?

  Yes

  No

  N/A

Housekeeping

• Clear access/egress to work location?

  Yes

  No

  N/A

• Are slip, trip & fall hazards in reasonable condition to minimize risk of injury?

  Yes

  No

  N/A

• Proper material storage?

  Yes

  No

  N/A

• Adequate lighting?

  Yes

  No

  N/A

• Are all personal belongings properly stored?

  Yes

  No

  N/A

Fire Safety

• Fire extinguishers present within 75 ft. Of machine operation and charged?

  Yes

  No

  N/A

• Fire extinguisher inspection tags up to date?

  Yes

  No

  N/A

• Is anything blocking an entrance way, fire extinguisher, or pathway?

  No

  Yes

  N/A

Aisle-ways

• Do aisles have adequate lighting?

  Yes

  No

  N/A

• Are aisles clear of debris, materials & equipment?

  Yes

  No

  N/A

• Is sufficient clearance provided around machines to allow for safe operation and material handling?

  Yes

  No

  N/A

Tool Safety

• Are tools and cords in safe condition for use?

  Yes

  No

  N/A

• Are all tool and machine guards in place and working appropriately?

  Yes

  No

  N/A

Back Injury or Lifting Related Hazards

• Are employees using safe lifting procedures?

  Yes

  No

  N/A

• Are material handling devices being used appropriately?

  Yes

  No

  N/A

Other Employee Safety Issues

• Any other employee safety issues that are not noted above (unsafe acts, unsafe behavior, violating co. rules, Etc.)

  Safe

  At Risk

  N/A

Other Safety Issues

• Any other job site safety issues that are not noted above?

  No

  Yes

  N/A

• Safety Inspection Completed by John Cooley, Environmental Health and Safety Specialist for Sejong Alabama, LLC.

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