Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1.0 Previous Inspections

  • 1.1 - Has the previous inspection been reviewed?

  • 1.2 Have all the previous outstanding faults and issues been resolved?

2.0 Building and Internal Structures

  • 2.1 Floor Surfaces even and uncluttered?

  • 2.2 Entry and Walkways kept clear?

  • 2.3 Walkways adequately size and clearly marked

  • 2.4 Intersections kept clear of obstructions (boxes,trolleys and equipment)?

  • 2.5 Stairs and risers kept clear and in good repair?

  • 2.6 Railings are solid, stable and in good repair?

  • 2.7 Are fall preventative measures in place and in good repair (eg hand rails in toilets)?

  • 2.8 Liquid spills are removed quickly?

  • 2.9 Walls are clean and in good repair?

  • 2.10 Windows are clean and free of cracks?

  • 2.11 Ceilings are clean and panels in good repair?

  • 2.12 Back entrances and loading areas clean, tidy and free of obstructions?

3.0 Accessory Equipment

  • 3.1 Approved accessories are used?

  • 3.2 Accessories are clean and in good condition?

4.0 Chemicals and Dangerous Goods

  • 4.1 Hazardous Substances Register is up to date and available?

  • 4.2 Safety Data Sheets (SDS) available for all chemicals?

  • 4.3 Risk assessments completed for hazardous substances?

  • 4.4 All containers are labelled correctly?

  • 4.5 Unused substances are disposed of at the end of the day or at expiry?

  • 4.6 Staff have been instructed in the use of all chemicals?

  • 4.7 Is the correct Personal Protective Equipment (PPE) available and in good working condition?

  • 4.8 Are eye washes and showers easily accessed for spills?

5.0 Documentation

  • 5.1 Daily checklists have been completed and signed by supervisors?

  • 5.2 Monthly checklists completed and submitted to manager for review?

  • 5.3 Incident and Corrective Action forms have been reviewed for any unresolved issues?

  • 5.4 Staff are aware of reporting mechanisms for incidents, injuries and hazards?

6.0 Electrical Safety

  • 6.1 Are Safety Switches installed to all areas?

  • 6.2 Where fitted Safety Switches are tested every 6 months and recorded?

  • 6.3 Leads, power boards and appliances not protected by Safety Switches are tested and tagged at appropriate intervals?

  • 6.4 Portable equipment is tested and tagged annually?

  • 6.5 No broken plugs, sockets or switches, no frayed or damaged cords and no strained leads?

  • 6.6 No leads across walkways or in areas where that can be run over or caught by equipment of staff?

  • 6.7 Where required are emergency shutdown procedures in place?

  • 6.8 Air conditioning systems are maintained regularly?

7.0 Fire Prevention and Emergency Procedures

  • 7.1 Evacuation procedures are displayed appropriately for staff, patients and visitors?

  • 7.2 Staff are trained in evacuation procedures at regular intervals?

  • 7.3 Fire extinguishers are located correctly and are clearly marked for type of fired to be used for?

  • 7.4 Extinguishers are checked regularly and serviced?

  • 7.5 Extinguishers are kept clear of obstructions?

  • 7.6 Extinguishers are correctly affixed to walls and labelled for easy identification?

  • 7.7 Adequate direction notices are in place for fire exits?

  • 7.8 Exit doors open easily from the inside?

  • 7.9 Exits and exit doors are clear of obstructions?

  • 7.10 Fire alarm system is checked for correct functioning (By building owner)?

8.0 First Aid Facilities

  • 8.1 Are cabinets and contents clean and orderly?

  • 8.2 Contents are checked regularly for expired items and to restock after use?

  • 8.3 Cabinets are clearly labelled?

  • 8.4 There is easy access to the cabinet?

  • 8.5 Staff are aware of location and contents of first aid cabinets?

  • 8.6 Emergency numbers are clearly displayed in each area of the branch?

9.0 General Lighting

  • 9.1 Good natural / artificial lighting?

  • 9.2 Reflected light from walls, ceilings not causing glare for staff?

  • 9.3 Light fittings clean and in good condition?

  • 9.4 Emergency exit lighting is operable?

10.0 Kitchen and Staff room Facilities

  • 10.0 Facilities are kept clean by regular cleaning?

  • 10.2 Facilities are clear of rubbish and obstructions?

  • 10.3 Sanitary disposal units are replaced at regular intervals?

  • 10.4 Employees are aware of responsibly to maintain cleanliness of facilities?

11.0 Ladders and Tools

  • 11.1 Ladders are less than 2 metres in height?

  • 11.2 Ladders are in good condition and used according to instructions?

  • 17.3 If used for electrical work are made of on conductive material?

  • 17.4 In MRI ladders are made of non-ferrous material?

  • 17.5 Tools are in good working order and stored appropriately?

12.0 Medical Imaging Equipment

  • 12.1 Equipment and controls are kept clear?

  • 12.2 The floors around the equipment are kept clear?

  • 12.3 Is the appropriate shielding in place and in good condition?

  • 12.4 The emergency stop button is functional and easy to locate?

  • 12.5 There is adequate work space around the equipment?

  • 12.6 There is adequate lighting around the equipment and the controls?

  • 12.7 Noise levels are controlled in the MRI environment?

  • 12.8 The noise protection is clean and easily accessible to the MRI scan room?

  • 12.9 Equipment is ergonomic ally designed to be adjusted to individual workers?

  • 12.10 Radiation Compliance stickers are up to date?

  • 12.11 Staff are aware of lockout procedures and how to implement them in cases of breakdowns?

13.0 Office Equipment and Furniture?

  • 13.1 Office and waiting room furniture are in good condition?

  • 13.2 Office and waiting room chairs are in good , condition?

  • 13.3 Workstations are ergonomically adjustable for different workers?

  • 13.4 Monitors and other screens are positioned to reduce glare from lighting?

  • 13.5 Photocopiers and facsimile equipment are positioned to avoid fumes near staff?

  • 13.6 Tasks are designed to prevent Occupational<br> Overuse Syndrome?

  • 13.7 Stable non-slip floor coverings are in good condition?

14.0 Off site Facilities

  • 14.1 Work area provides comparable equipment and furniture to what is used at a SCR office?

  • 14.2 Work area is able to be accessed by an unobstructed entry?

  • 14.3 Electrical appliances are protected by a Safety Switch or are tested and tagged appropriately?

15.0 Rubbish Disposal

  • 15.1 Rubbish bins are positioned at suitable points around the site?

  • 15.2 Regular emptying of bins occurs ?

  • 15.3 Staff are aware of their responsibility to ensure rubbish collection from their area is performed?

16.0 Storage Facilities

  • 16.1 Shelving,cupboards and other furniture are functional and in good repaire?

  • 16.2 Storage area is clear of obstructions and rubbish?

  • 16.3 Supplies are stored neatly to provide ease of access?

  • 16.4 Storage is planned to reduce manual tasks by being close to the area of use?

  • 16.5 Cylinders are stored with wall attachments to prevent falls?

17.0 Vehicle Checks

  • 17.1 Scheduled maintenance performed?

  • 17.2 Condition of brakes and lights reported at each service?

  • 17.3 Condition of tyres reported at each service?

  • 17.4 First aid kit supplied and checked every year or after use?

18.0 Work Areas and Benches

  • 18.1 Clear of rubbish?

  • 18.2 Accessory equipment not in use, stored correctly?

  • 5.3 Work bench height correct for type of work and staff able adjust to height?

  • 5.4 No sharp edges or pointy corners?

19.0 Sign Off

  • On site Representative

  • Inspector

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.