Safety in Motion General Premises Inspection - C-Store

• Document No.

• Client / Site

• Conducted on

  Date
• Location
  Address

• Personnel

Housekeeping

• Items stored properly (lights,boxes,cleaning,supplies)?<br>

  Yes

  No

  N/A

• Is office area clean?

  Yes

  No

  N/A

• Are work stations clean?

  Yes

  No

  N/A

Exit Lights & Exterior Lights

• Light covers inspected?

  Yes

  No

  N/A

• Are lights working properly?

  Yes

  No

  N/A

Walking/Working Surfaces

• Are lights visible and unobstructed?

  Yes

  No

  N/A

• Are all floor openings covered?

  Yes

  No

  N/A

• Is floor free from slip hazards?

  Yes

  No

  N/A

• Is there adequate lighting for the workspace?

  Yes

  No

  N/A

• Are lighting covers more than 7' from the floor?

  Yes

  No

  N/A

• Are edges smooth around tables and sinks?

  Yes

  No

  N/A

• Mop buckets inspected?

  Yes

  No

  N/A

• Is the floor dry around ice machines?

  Yes

  No

  N/A

• Are wet floor signs displayed while cleaning?

  Yes

  No

  N/A

Equipment Guarding

• Are guards in working condition?

  Yes

  No

  N/A

• Equipment maintained not broken?

  Yes

  No

  N/A

Fire Protection

• Is the exit path clear of blockage?

  Yes

  No

  N/A

• Are team members trained on evacuation procedures?

  Yes

  No

  N/A

• Is the smoke detector in operating condition (light blinking)?

  Yes

  No

  N/A

• Is the evacuation plan displayed?

  Yes

  No

  N/A

• Is there 18" clearance from ceiling sprinklers to storage?

  Yes

  No

  N/A

• Are all portable fire extinguishers current (check that gauge is in the green and the card is good for one year from the date punched)?

  Yes

  No

  N/A

Extension Cords

• Are extension cords being used for temporary power only (not more than 8 hours)?

  Yes

  No

  N/A

• Are all extension cords in use equipped with a ground plug?

  Yes

  No

  N/A

• Are all extension cords in use in good condition-no breaks in cover?

  Yes

  No

  N/A

Electrical Safety

• Are wall outlets/switches in good condition (not loose or broken)?

  Yes

  No

  N/A

• Are all warmers grounded and cords are in good condition?

  Yes

  No

  N/A

• Are there covers on all outlets/switches?

  Yes

  No

  N/A

• Are there grounds on all cords with three wires?

  Yes

  No

  N/A

• Are Appliances cords inspected?<br>

  Yes

  No

  N/A

• Is there 3ft of clearance around electrical panels?

  Yes

  No

  N/A

Safety Data Sheet Book

• Is the SDS book accessible to all team members?

  Yes

  No

  N/A

• Are the Safety Data Sheets current?

  Yes

  No

  N/A

Ladders

• Right ladder for Job?

  Yes

  No

  N/A

• Are ladders Inspected?

  Yes

  No

  N/A

Hand Tools - Knives, etc

• Are hand tools maintained in good condition and stored properly?

  Yes

  No

  N/A

• Safety knives used?<br>

  Yes

  No

  N/A

Chemicals and Portable Containers

• Are all containers labeled (water, alcohol, acetone, etc)?

  Yes

  No

  N/A

• Are portable containers labeled with warning?

  Yes

  No

  N/A

• Are chemical containers labeled with warning?

  Yes

  No

  N/A

Calendars and Lesson plans.

• Lesson Plans being used properly?<br>

  Yes

  No

  N/A

• Calendars being used?<br>

  Yes

  No

  N/A

Proper Lifting?

• Proper lifting observed?

  Yes

  No

  N/A

(PPE) Personal Protective Equipment)

• Personal Protective Equipment is available and worn to protect?

  Yes

  No

  N/A

• " Feet and body ": Proper footwear and appropriate clothing?

  Yes

  No

  N/A

• Personnel protective equipment in good condition?

  Yes

  No

  N/A

Walk-In Coolers

• Can all walk-in and freezer doors be opened from the inside (even if locked)?

  Yes

  No

  N/A

• Are all lights on?

  Yes

  No

  N/A

• Are walking surfaces dry?

  Yes

  No

  N/A

• Are racks in good condition?

  Yes

  No

  N/A

• Are all fans covered?

  Yes

  No

  N/A

• Merchandise is accessible with only 6 pack over shoulder height?

  Yes

  No

  N/A

Building Safety

• Intersection kept clear of boxes and trash?

  Yes

  No

  N/A

• Are exit doors clear not block or lock?

  Yes

  No

  N/A

• Out side Maintained clean and no obstructions?

  Yes

  No

  N/A

Posted Warning Signs

• Are no smoking signs posted in no smoking areas?

  Yes

  No

  N/A

Compressed Gas Cylinders

• Are cylinders chained or in a rack (CO2)?

  Yes

  No

  N/A

First Aid Kit

• Properly stocked?

  Yes

  No

  N/A

• Expiration dates validated?

  Yes

  No

  N/A

• Blood Borne Pathogen Kit available?

  Yes

  No

  N/A