Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

HC Washroom (including areas for storage of clean equipment)

  • Have cleaning schedules been completed properly?

  • Is the washroom tidy and orderly? (chemicals locked in cages, equipment stored off the floor, hoses not trailing, bins emptied, PPE and blue bags stored properly, no foreign object risks)

  • In the washroom is equipment in containers of chemical solutions fully submerged?

  • In the washroom are the containers of chemical solution properly tagged?

  • In the washroom are the containers of chemical solution being changed to the correct frequency? (check tag - at least daily)

  • In the washroom is clean equipment tagged correctly?

  • In the washroom is clean equipment properly covered?

  • In the washroom is clean equipment properly clean?

  • Is clean equipment stored outside the washroom properly covered? (including caps on valve outlets, pipe ends)

  • Is clean equipment stored outside the washroom tagged correctly?

  • Is the clean equipment stored outside the washroom properly clean?

  • Is equipment outside the washroom in containers of chemical solutions fully submerged?

  • Outside the washroom have the containers of chemical solution been changed to the correct frequency? (check tag - max 48 hours)

  • Is the clean equipment stored outside the washroom adequately separated from dirty equipment/containers in use?

  • Is clean equipment stored by the detinning entrance and by Line 1 properly covered? (including caps on valve outlets, pipe ends)

  • Is clean equipment stored by the detinning entrance and by Line 1 tagged correctly?

  • Is the clean equipment stored by the detinning entrance and by Line 1 properly clean?

  • Is the clean equipment stored by the detinning entrance and by Line 1 adequately separated from dirty equipment/containers in use?

  • Is equipment on the racking outside the production office properly covered?

  • Is equipment outside the production office in containers of chemical solutions fully submerged?

  • Outside the production office have the containers of chemical solution for the blades been changed to the correct frequency? (check tag - 7 days max)

Boot-wash

  • Is the area clean, tidy and orderly? (chemical locked in cages, cleaning equipment stored off the floor, floor under boot-wash unit clean, containers for manual boot washing available)

  • Is there sufficient sanitiser available at the entrance?

  • Has the boot-wash check form been completed properly?

Entrance sinks

  • Is there sufficient soap and hand towels available at the wash hand basins?

  • Is the entrance clean, tidy and orderly?

Continued

LR Washroom (including areas for storage of clean equipment)

  • Have cleaning schedules been completed properly?

  • Is the washroom tidy and orderly? (chemicals locked in cages, equipment stored off the floor, hoses not trailing, bins emptied, PPE and blue bags stored properly, no foreign object risks)

  • Is clean equipment stored outside the washroom properly covered? (including caps on valve outlets, pipe ends)

  • Is clean equipment stored outside the washroom tagged correctly?

  • Is the clean equipment stored outside the washroom properly clean?

  • Is the clean storage area outside the washroom tidy and orderly?

  • Are coloured containers, lids and scoops stored properly? (Separation of colours, clean racking and clean storage boxes)

Entrance sinks

  • Is there sufficient soap and hand towels available at the wash hand basins?

  • Is the entrance clean, tidy and orderly?

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.