Title Page

  • Company/ Facility Name

  • Site

  • Conducted on

  • Prepared by

  • Location

Training/ Environment/ Work Process/ Fire Emergency Procedures/ Means of Exit/ Warehouse and Shipping/ Loading/Unloading Racks/ Lighting/ Machine Guards/ Electrical

  • Instructions:
    1. Answer "Yes", "No", "N/A" for the questions below.
    2. Add photos and notes by clicking on the paperclip icon.
    3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF, Word, Excel or Web Link.


  • Is training provided for each person newly assigned to a job?

  • Does initial training include a thorough review of hazards and accidents associated with the job?

  • Is adequate instruction in the use of personal protective equipment provided?

  • Is training for the use of emergency equipment provided?

  • Are workers knowledgeable in the "Right to Refuse" procedures?


  • Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?

  • Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?

  • Are work surfaces and grip surfaces safe when wet?

  • Do workers know the symptoms of heat cramps/heatstroke, or frost bite/hypothermia?

Work Process

  • Are repetitive motion tasks properly paced and kept to a minimum?

  • Are the material safety data sheets placed in locations accessible to all employees?

  • Are hazards signalled by signs and tags?

  • Have all trucks, forklifts and other equipment been inspected and maintained?

  • Are lockout or tagout procedures in place and followed?

  • Is ventilation equipment working effectively?

Fire Emergency Procedures

  • Is there a clear fire response plan posted for each work area?

  • Do all workers know the plan?

  • Are drills held regularly?

  • Are fire extinguishers chosen for the type of fire most likely in that area?

  • Are there enough extinguishers present to do the job?

  • Are extinguisher locations conspicuously marked?

  • Are extinguishers properly mounted and easily accessible?

  • Are all extinguishers fully charged and operable?

Warehouse and Shipping

  • Are dock platforms, bumpers, stairs and steps in good condition?

  • Are light fixtures in good condition?

  • Are all work areas clean and free of debris?

  • Are stored materials properly stacked and spaced?

  • Are tools kept in their proper place?

  • Are there metal containers for oily rags and for rubbish?

  • Are floors free of oil spillage or leakage?

  • Is absorbent available for immediate clean-up of spills and leaks?

  • Are all flammable and combustible products stored appropriately? For example: Are Class I (one) flammable products (as per NFPA or your local fire code) stored in Class I approved buildings or outside the warehouse?


  • Is the level of light adequate for safe and comfortable performance of work?

  • Does lighting produce glare on work surfaces, monitors, screens and keyboards?

  • Is emergency lighting adequate and regularly tested?

Machine Guards

  • Are all dangerous machine parts adequately guarded?

  • Do machine guards meet standards?

  • Are lockout procedures followed when performing maintenance with guards removed?


  • Are all machines properly grounded?

  • Are portable hand tools grounded or double insulated?

  • Are junction boxes closed?

  • Are extension cords out of the aisles where they can be abused by heavy traffic?

  • Is permanent wiring used instead of extension cords?

  • Please proceed to the next section.

Tools and Machinery/ Confined Spaces/ Housekeeping/ Floor and Wall Openings/ Stairs, Ladders and Platforms/ Elevating Devices/ Sound Level/ Noise/ Temporary Work Structures/ Employee Facilities/ Medical and First Aid/ Personal Protective Equipment (PPE)/ Materials Handling and Storage

Tools and Machinery

  • Are manufacturers' manuals kept for all tools and machinery?

  • Do power tools conform to standards?

  • Are tools properly designed for use by employees?

  • Are defective tools tagged and removed from service as part of a regular maintenance program?

  • Are tools and machinery used so as to avoid electrical hazards?

  • Is proper training given in the safe use of tools and machinery?


  • Is the work area clean and orderly?

  • Are floors free from protruding nails, splinters, holes and loose boards?

  • Are aisles and passageways kept clear of obstructions?

  • Are permanent aisles and passageways clearly marked?

  • Are covers or guardrails in place around open pits, tanks and ditches?

Floor and Wall Openings

  • Are ladder-ways and door openings guarded by a railing?

  • Do temporary floor openings have standard railings or someone constantly on guard?

Stairs, Ladders and Platforms

  • Are stairs and handrails in good condition?

  • Are ladders free of defects?

  • Are ladders set up properly before use?

  • Are the elevated platforms properly secured and do they have handrails?

Elevating Devices

  • Are elevating devices used only within capacity?

  • Are capacities posted on equipment?

  • Are they regularly inspected, tested and maintained?

  • Are controls of the "dead man" type?

  • Are operators trained?

Sound Level/Noise

  • Are regular noise surveys conducted?

  • Is hearing protection available and used properly?

Employee Facilities

  • Are facilities kept clean and sanitary?

  • Are facilities in good repair?

  • Are cafeteria facilities provided away from toxic chemicals?

  • Are hand washing facilities available?

Medical and First Aid

  • Do all employees know how to get first aid assistance when needed?

  • Do the first-aiders know when and to which hospital or clinic an injured person should be taken?

  • Are there employees trained as first-aid practitioners on each shift worked?

  • Are first-aid kits provided as per jurisdiction’s first-aid regulations?

  • Are first-aid supplies replenished as they are used?

Personal Protective Equipment (PPE)

  • Is required equipment provided, maintained and used?

  • Does equipment meet requirements?

  • Is it reliable?

  • Is personal protection utilized only when it is not reasonably practicable to eliminate or control the hazardous substance or process?

  • Are the areas requiring PPE usage properly identified by warning signs?

Materials Handling and Storage

  • Is there safe clearance for all equipment through aisles and doors?

  • Is stored material stable and secure?

  • Are storage areas free from tipping hazards?

  • Are only trained operators allowed to operate forklifts?

  • Are dock boards (bridge plates) used when loading or unloading from dock to truck or dock to rail car?

  • Are specifications posted for maximum loads which are approved for shelving, floors and roofs?

  • Are racks and platforms loaded only within the limits of their capacity?

  • Are chain hoists, ropes and slings adequate for the loads and marked accordingly?

  • Are slings inspected daily before use?

  • Are all new, repaired, or reconditioned alloy steel chain slings proof-tested before use?

  • Are pallets and skids the correct type and inspected?

  • Do personnel use proper lifting techniques?

  • Is the size and condition of containers hazardous to workers?

  • Are elevators, hoists, conveyors, balers, etc., properly used with appropriate signals and directional warning signs?

  • Completed by:

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.