• LSI

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Last audit reviewed?

  • Open action items from last audit?

  • Required OSHA poster displayed?

Recordkeeping (1904)

  • OSHA 300 up to date and correct?

  • Training records maintained and complete?

  • Portable Fire Extinguisher

  • Mechanical power presses

  • Blood Borne Pathogens

  • Hazard Communication (GHS)

  • Hearing Conservation

Housekeeping (1910.22)

  • Are all work sites clean, sanitary and orderly?

  • Are floors and aisle ways clutter free?

  • Are materials and equipment stored in such a way that they will not interfere with aisles?

  • Are aisles and passageways sufficiently illuminated?

  • Is access to stairways and emergency equipment maintained?

  • Are aisles marked and maintained in good condition?

  • Are spilled materials or liquids cleaned up immediately ?

  • Is metallic or conductive debris prevented from accumulating around electrical enclosures?

PPE (1910.132 - .138)

  • Is PPE provided?

  • Is PPE marked with appropriate ANSI or ASTM specifications?

  • Is PPE functional and in good repair?

  • Is PPE maintained in a sanitary and reliable condition?

  • Are all affected persons required to wear PPE as needed ?

  • Are employees trained on when, where and how to use PPE ?

  • Are hard hat areas designated and enforced?

  • Are hearing protection areas designated and enforced ?

  • Are eye and face protection areas designated and enforced?

  • Are foot protection areas designated and enforced?

Exit Routes (1910.36, .37)

  • Are all exit doors unlocked?

  • Are exit routes free of decorations or signs that obscure the visibility of the exit route door?

  • Are exits readily accessible at all times?

  • Are exits marked with an exit sign and illuminated by a reliable source?

  • Are exit routes adequately lighted?

  • Do exit discharges lead directly outside?

  • Are doors, along the exit route, which could be mistaken for exits, otherwise marked?

  • Are exit routes marked when not obvious ?

Portable Fire Suppression (1910.157)

  • Are fire extinguishers mounted in readily accessible locations ?

  • Are fire extinguishers the correct size and type ?

  • Are fire extinguishers distributed at the correct maximum distance?

  • A,C,D - 75'

  • B - 50'

  • Are fire extinguishers serviced annually and inspected monthly ?

  • Are fire extinguishers fully charged and in operable condition ?

  • Are employees trained annually in the use of fire extinguishers ?

Fixed Fire Suppression (1910.159)

  • Is the maintenance of the system assigned to a contractor ?

  • Are alarm and riser inspections conducted annually?

  • Are sprinkler heads protected by metal guards when exposed to physical damage?

  • Is there an 18" vertical clearance below sprinkler heads ?

Medical and First Aid (1910.151)

  • Are persons designated to provide first aid?

  • Have first aid responders received current training in first aid, CPR, AED and BBP?

  • Are first aid supplies adequate and avsilable?

  • Is a safety shower present when required?

  • Are eyewash stations present in required areas?

  • Are AED batteries and pads within their expiration dates?

Hazard Communication (1910.1200)

  • Are incoming containers checked to ensure they are properly labeled?

  • Are secondary containers marked with HMIS or GHS appropriate information?

  • Are MSDS/SDS maintained for each chemical in the workplace?

  • Are MSDS/SDS readily accessible to all employees?

  • Are employees trained on how to understand labels and MSDS/SDS?

Powered Industrial Trucks (1910.178)

  • Are only trained and licensed personnel permitted to operate PIT's ?

  • Are PIT'S inspected daily?

  • Are PIT'S found to be in need of repair, defective or unsafe taken out of service ?

  • Are PIT'S operated in a safe manner?

  • Are PIT operators evaluated at least every 3 years?

Electrical (1910.301)

  • Is all electrical equipment free from recognized hazards?

  • Are portable electric tools grounded or double insulated?

  • Is strain relief provided to prevent a pull from being transmitted directly to joints or terminals ?

  • Are cord, cable and raceway connections intact and secure?

  • Do flexible cords contain an equipment grounding conductor?

  • Is it prohibited to fasten flexible cords in a manner that could damage their outer jacket?

  • Is it prohibited to run flexible cords through doors, windows or wall openings?

  • Are unused openings in electrical enclosures closed with covers, plates or plugs?

  • Is a 36' clearance maintained around electrical enclosures?

  • Is "daisy chaining" surge protectors prohibited?

Plant; General

  • Are potential pinch points marked and guarded?

  • Are forklift LP tanks properly stored?

  • Are compressed gas cylinders properly stored?

  • Are welding curtains being used when necessary?

  • Are anti fatigue mats in use and in good condition?

  • Are open dock doors blocked to prevent falls?

LSI Specific

  • Are training records for new hires complete?

  • Safety Rules & Awareness signed?

  • Corporate Safety Policy signed?

  • New Hire Safety Orientation checklist complete and signed?

  • New Hire Walkthru checklist complete and signed?

  • Are regular inspections, drills and tests conducted?

  • Daily standard work completed?

  • Quarterly safety audits completed?

  • Evacuation / Fire Drills conducted ?

  • Regular Hoist / Crane inspections?

  • Regular chain and sling inspection?

  • Are corporate Safety programs in place and compliant?

  • Blood Borne Pathogens

  • Fire Prevention

  • Emergency Evacuation

  • Hazard Communication

  • Lock Out Tag Out

  • Hearing Conservation


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.