• How would you rate the general 5S condition of the plant?

  • How would you rate the general condition of the pedestrian walkways? Are pedestrian walkways clearly identified?

  • How did you rate the compliance of employees and/or visitors adhering to the designated rules?

  • What did you see?

  • How did you feel about your interaction with vehicles and fork lift trucks whilst in the manufacturing or distribution areas?

  • If you felt at risk, briefly comment

Personal Protective Equipment

  • Were the site PPE rules clearly defined to you before entering the workplace?

  • How would you rate employee compliance to wearing required PPE?

  • Note Deviation(s)

Machinery Safety

  • When viewing production equipment, in general, how did you rate the condition of guarding or safety devices? Did any appear to be missing or not functional? Ask an operator if any safety devices are not functional.

  • Add Photograph

  • Do the employees appear to be working safely in and around machinery? Observe 1 machine operation.

  • Add photograph

Continuous Improvement

  • Are Safety A4 Communications available in the workplace and evidence they have been communicated to employees?

  • Take Photograph

  • Ask any operator if they are aware of the latest A4 Safety communication. Check if the content is known.


  • Any other comments or questions to be raised, or feedback from the employees?

  • Provide a short description

  • Full Name and Signature of the leadership team member

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