Maintenance 5S Checklist

• Inspected by

• Location
  Address

GENERAL INFORMATION

• Use these score criteria for your inspection:
  
  3 - There is an ability to maintain it.
  2 - This is being complied with more systematically.
  1 - It is done but not systematically.
  0 - Not at all.
  N/A - Not Applicable

SORT OUT - SEIRI

• Is the floor area free of unwanted items?

  3

  2

  1

  0

  N/A

• Are tops and insides of all cupboards, shelves, tables, etc. free of unwanted items?

  3

  2

  1

  0

  N/A

• Are items stored according to frequency of use?

  3

  2

  1

  0

  N/A

• Are walls free of old posters, calendars, pictures , notices etc.?

  3

  2

  1

  0

  N/A

• Is there a general clutter free appearance?

  3

  2

  1

  0

  N/A

SET IN ORDER - SEITON

• Are direction indications available to all facilities from the entrance onwards?

  Yes

  No

  N/A

• Do all items of equipment have identification labels?

  Compliant

  Non-Compliant

  N/A

• Is the PSI Machine reading correctly

  Compliant

  Non-Compliant

  N/A

• Are specific areas demarcated for garbage/rejects/waste, etc.?

  3

  2

  1

  0

  N/A

• Are switches, fan regulators, controls, etc. labeled?

  3

  2

  1

  0

  N/A

• Are all cables, wires, pipes etc. neat and straight?

  3

  2

  1

  0

  N/A

• Sanitation boards are complete ( brooms, dustpans and squeegees in good condition)

  Compliant

  Non-Compliant

  N/A

• Cabinets are neat and organized

  3

  2

  1

  0

  N/A

SHINE - SEISO

• Are cleaning schedules available and displayed?

  Compliant

  Non-Compliant

  N/A

• Floors are clean and free of debris and pooling water

  Safe

  At Risk

  N/A

• Computers and printers are clean in good working condition

  Good

  Fair

  Poor

  N/A

• Sink area is clean

  Compliant

  Non-Compliant

  N/A

STANDARDIZE - SEIKETSU

• Is a daily checklist used to standardize 5s procedures?

  Yes

  No

  N/A

• Are standard check lists used to regularly inspect 5S?

  Yes

  No

  N/A

• Fire extinguishers and electrical panels are clearly marked and unobstructed

  Compliant

  Non-Compliant

  N/A

• Employee walking areas are unobstructed

  Compliant

  Non-Compliant

  N/A

SUSTAIN - SHITSUKE

• Do employees show positive interest in 5S activities?

  3

  2

  1

  0

  N/A

• Are trainings and other programs implemented to sustain workplace organization?

  Good

  Fair

  Poor

  N/A

COMPLETION

• If you scored 75% or higher click Passed/ If lower click the failed button

• Overall Rating

  Passed

  Failed

• Full Name and Signature of the Inspector

  Sign