Title Page
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Conducted on
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Prepared by
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Shift
Inspection Items
GENERAL INSPECTION / HOUSEKEEPING
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Aisle/walkways are clear and unobstructed?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Floors are clean and free of obstructions or tripping hazards?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Lights and light fixtures are working and in good order with proper illumination?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Garbage & Recycling bins (number and location adequate)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Proper material storage (leaning panels)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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All chemical bottles are clearly labelled as per WHMIS (GHS) - product identifier, hazard symbols, etc.?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Racking and shelving in good condition, secured from tipping and in good location? (not obstructing aisles or limiting worker movement)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
ELECTRICAL POWER SYSTEMS - ESA CHECKS
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High voltage and control panels closed and secured
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Control panel identified and accessible (1M clearance)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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General condition of wiring (extension cords, fans, etc.)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Electrical equipment protected from the elements
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Are there any extension cords replacing permanent wiring?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Emergency exit signs are in good working order and illuminated ?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Is there any equipment showing exposed wiring (computers, machines, fans, etc.)
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- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
FIRE PROTECTION
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Fire extinguishers and hoses are properly identified and secured on bracket?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Fire extinguishers are accessible (not blocked) and inspected monthly (check tags)?
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if missing, indicate specific area/location and extinguisher number
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Spill kits are accessible - ensure emergency contact numbers , ID sign and inventory list posted, verified?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
SAFETY BULLETIN BOARD (CAFETERIA HALLWAY)
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Health & Safety Policy posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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JHSC Membership list posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Emergency Evacuation Plan posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Occupational Health & Safety Act posted (hanging from H & S drop box)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Form 82-In Case of Injury At Work Poster in posted?
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What is the hazard class rating?
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JHSEC meeting minutes posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Safety Rules are posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
FIRST AID ROOM
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Located as prescribed by legislation
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Names of qualified first-aid providers are posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Instructions for accident reporting sticker (Form 82)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Names and phone numbers of emergency facilities visible & posted?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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First aid log book, taxi chit and first aider onboarding present
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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WSIB packages are full (outside First Aid Room)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Bins in first aid cabinets are full (red dot indicates on order)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
WASTE DISPOSAL
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Recyclables are being disposed of properly?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Adequate # of recycling and waste bins
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Waste bins being emptied regularly?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
STACKING AND STORAGE
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Boxes stored properly (18" from deflector shield o sprinkler head)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Filing cabinets not top heavy or left open when not in use
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
ADDITONAL ITEMS NOTED/CHECKED:
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Indicate any other issue not previously mentioned
JOB OBSERVATION / PERFORMANCE NOTES: (at least one)
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EMPLOYEE INTERVIEW / WORKER CONCERNS:
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Indicate name of employee interviewed
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Does the employee know what to do in an evacuation?
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Inform employee of nearest evacuation and meeting points. Notify Supervisor.
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Does the employee know hazards of their job? Please indicate
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Inform employee of specific job related hazards. Notify Supervisor
JHSEC Inspector Signature
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JHSEC Member
