Information

  • Audit Title

  • Conducted on

  • Prepared by

Emergency Evacuation & Emergency Exits

  • Are all exits and paths to/from exits free of obstructions?

  • Are exits clearly marked?

  • Do emergency lights work?

  • Are doors that could be mistaken for a way of exit marked “Not an Exit” or with the name of the room?

  • Can all exits be opened from the inside without a key?

  • Do all emergency alarms work?

Electrical

  • Are extension cords only for temporary use?

  • Are power cords free of splices, taps, and damaged insulation?

  • Is the area free of electrical Daisy Chains

  • Do all extension cords have ground pins in place?

  • Are live electrical parts on tools, equipment, building wiring, and electrical panels enclosed to prevent contact?

  • Do circuits become overloaded? <br>If so, list why below.

  • Are breaker boxes clear and can they be accessed when needed?

  • Are machines that have moisture (e.g.: refrigerators, air conditioners) or used outdoors or in industrial settings grounded?

  • Do electrical cords and equipment used at wet locations have waterproof covers or seals to keep moisture out?

housekeeping

  • Are toilets and washing facilities clean and stocked with supplies (soap, towels, and toilet paper)?

  • Are scrap materials stored safely to prevent tripping, fire or pest hazards?

  • Are spills cleaned up promptly?

  • Is there effective drainage for wet areas?

  • If you have nonpotable or not-fit-for-drinking water outlets, are they marked as such?

walking Surfaces/Stairways

  • Are aisles and passageways kept clear of tripping hazards (cords, pipes, hoses etc.) and at least 28” wide?

  • Is the floor free of holes, projections, or depressions that could cause trips, or let material fall on workers below?

  • Are covers on holes or large openings in floors secure and capable of supporting the maximum load safely?

  • Are floors still able to hold the intended load safely?

  • Select "Yes" if Employees ARE NOT expected to work from heights? If they are, select No, and list fall protection provided.

  • Is there at least 7’ of head room in all aisles and on all stairs?

  • Are guardrails in place on the open sides of all walking surfaces 4’ or more above an adjacent surface?

  • Are guardrails 36” – 42” high and capable of withstanding 200 LB of force in any direction against the top rail?

  • Are toeboards to catch debris installed on guardrails where people may work or walk on the surface below?

  • Are stair tread surfaces non-slip, not excessively worn, and free of stored materials?

  • Are walkways protected from or clearly visible to vehicle or forklift traffic?

  • Are guardrails installed on stairways with four or more risers?

Lighting

  • Is there sufficient lighting in work areas?

  • Are temporary lights protected from accidental breakage?

  • Are parking areas equipped with sufficient security lighting?

Chemical

  • Do all chemical boxes, bottles, bags, tanks, etc. have a label that has the chemical name and appropriate hazard warning?

  • MSDS has been read and understood for all chemicals that are used

Personal Protective Equipment (PPE)

  • Combination door locks under your area of responsibility are working correctly

  • Select Yes if there ARE NO Jobs for which you feel a hazard assessment should be conducted. (i.e. for new Machines, tools, processes, Jobs)<br> If No is selected is please list Jobs for which you feel a hazard assessment should be conducted.

  • Does the furnished PPE fit?

  • Is the PPE in good condition?

  • Is the PPE appropriate for the job?

  • Do employees wear the PPE when required?

  • Are safety glasses worn where there is a potential for flying particles or objects?

  • Are goggles or face shield worn where there is a danger of corrosive material splash?

  • Is safety-toed footwear worn where there is a potential for heavy objects to roll or fall on the feet?

  • Is a hard hat worn where there is a potential for being struck by a falling or flying object?

  • Are ear plugs or ear muffs available and used in areas where it is necessary to raise your voice to be heard by a co-worker?

  • Are gloves, aprons, or shields worn when there is a danger of cuts or chemical contact?

Ladders

  • Are ladders in good condition with tight joints between steps and rails, no missing parts, or damage?

  • Are defective ladders removed from service?

  • Are rungs and steps free of grease and oil?

  • Do employees have both hands free when they are climbing up the ladder?

  • Do employees use a longer ladder rather than use the top step of a stepladder?

  • Do employees use a single or extension ladder rather than lean stepladder against a wall to climb?

  • Are ladders raised at least 3’ above an upper level if the employee will climb onto that level?

  • Are ladders used at a 4 to 1 angle?

  • Are employees using non-metallic ladders when working around electrical equipment?

Storage

  • Are materials stored in a way that does not create a hazard (protected from slipping or collapse)?

  • Are storage areas kept free of tripping and fire hazards?

  • Are shelves capable of holding the intended load?

  • Do employees have a safe way to stock and unstock the shelves?

  • Select Yes if Employees DO NOT have to get on the shelves to get stock. <br>If they do, select No and list fall protection they are using.

  • Are storage racks tightly assembled and free of sagging from overload or damage by vehicle traffic?

  • Are hand trucks, carts, or hoists available and used for routine lifting or carrying tasks?

Safe Machine and Tool Operation

  • Select Yes if there are no New Machines or Tools in area. <br>Select No if there are New Machines or Tools in the area and list them.

  • Are Employees trained in the safe use of all machines?

  • Do employees have the required PPE to use while operating of all machines?

  • Are moving parts of machines such as belts, pulleys, gears, cutters guarded to prevent accidental contact?

  • Are all the safeguards adjusted properly before use?

  • Select Yes if there ARE NO electrical hazards.<br>If No, list Hazards.

  • Is the area around all machines clear of any tripping or slipping hazards?

  • Is there sufficient clearance around all machines for safe operations, material handling, and service?

  • Is the power shut-off within easy reach of the operator’s work station for all machines?

  • Employees ARE NOT wearing loose clothing or jewelry that could get caught in the machinery?

  • All work practices have been observed and are safe.

  • Do employees get help when they need it?

  • Are employees who may be around machines kept safe?

  • Do any machines that require lockout/Tagout procedures have one and are employees trained in their use?

  • is Maintenance perfomed on Machines and records of maintenance kept?

Sprinkler Systems

  • Is there a minimum 18” clearance below sprinkler heads?

Elevator Checks to be done Quarterly

  • Phase One
    1. Outside panel on first floor, use key on red key ring
    2. Turn key off
    3. Door opens and elevator stays on 1st floor
    4. Turn key on
    Phase Two
    1. Turn outer key to ON position
    2. Turn in-car key to ON position
    3. Press and hold door close button
    4. Got to 2nd floor
    5. Press and hold door open position
    6. Turn key to hold. Car stays on 2nd floor with door open
    7. Turn key off
    8. Car returns to 1st floor
    9. Turn outer key OFF
    Or quick test
    1. Outer key to ON
    2. Inside key to ON
    3. Outer key to OFF
    4. Inside key to OFF

Eye Wash and Shower

  • Plumbed Eye wash and Shower Tested twice weekly, until dirty water issue is resolved. Joe will Test on Friday's Chris earlier in the week.

  • Plumbed Eye Wash Station Test:
    1. Remove protective caps and run water for approximately 1 minute.
    2. Confirm access to stations is unobstructed.
    3. When test is completed, sign initials and date on inspection card attached to each unit.
    4. Report any trouble with stations to the SHAPP/Facility Chair.
    Emergency shower test:
    1. Access emergency shower test bucket and funnel from Clean Room Service Aisle.
    2. Confirm access to stations is unobstructed.
    3. Assemble test unit and position to catch water.
    4. Run water by using pull chains and also foot peddles to begin water flow.
    5. When test is completed, sign initials and date on inspection card attached to each unit.
    6. Discard all test water in sink outside clean room main entry (outside Cage Area).
    7. Return test equipment to Clean Room Service Aisle.
    8. Report any trouble with showers to the SHAPP/Facility Chair.

EMERGENCY LIGHT INSPECTION TEST

  • Checked. Testing stick located in Shipping/Receiving.

ILLUMINATED EXIT SIGN INSPECTION & TESTING:

  • Viewed all signs to confirm if all bulbs are illuminated.

  • First Floor:
    • Mt Stewart
    • ARTD Lab Door to AMS
    • Outside Shop
    • ARTD Lab Hall by S&R
    • Outside CMM Room
    • South Emergency Exit Hallway near South stairs
    Second Floor:
    • Reception
    • North stairs
    • South stairs
    • Outside Dining Room
    • Inside Dining Room
    • AMS South
    • AMS main entry
    • Inside Mt. Denali

EXTERNAL BUILDING, LOT, AND PERIMETER INSPECTION:

  • Parking lots: North, East, South, West (clear of debris, new cracks)

  • Irrigation water run-off: SW , NW (no excessive pooling of water found?)

  • Building exterior: North, East, South, West (visual inspection) No Issues found?

  • Landscaping: North, East, South, West (no damaged or dead items)

  • Transformer Access Room (no unauthorized items, etc present)

  • Fire Alarm Control (electrical/phone) Room (lights out, clear of debris). All ok?

  • Air Compressor Room (lights are not out and clear of debris)

  • Dumpster Area (clear of debris)

  • All intercoms working

  • Locks maintained in good working order?

Other

  • Please list anything that should be added to this checklist.

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.