Title Page

  • Audit Title

  • Site

  • Conducted on

  • Prepared by

  • Personnel

Part 1: Observation

  • Is the work area floor free of debris and slippery conditions?

  • Is access to emergency exits, fire extinguishers, and other emergency equipment unobstructed?

  • Is all equipmemt in safe working condition and being used properly?

  • Are proper safeguards in place on machinery and equipment?

  • Are operators exposed to dangerous energy (electricity, compressed air, chemicals, stored energy, heat, etc.) during production or maintenance?

  • Are all employees wearing the required PPE?

  • Are all flexible cords and cables free of cracks, cuts, frays, and knots?

  • Were there any other hazards identified in your inspection?

Part 2: Coaching

  • Did you observe any unsafe behavior?

  • If so, what improvement actions were discussed?

  • Did you observe any safe behaviors?

  • How was this positive behavior acknowledged and what feedback was given to the employee?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.