Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location


  • Are floors free of water, ice, oil or other fluids?

  • Are floor surfaces even (eg no loose tiles or carpet that is torn or has ridges or holes)?

  • Are ramps designed to prevent slips and falls?


  • Are walkways and doorways clear of boxes, extension cords and litter?

  • Are spills cleaned up immediately?

  • Are the responsibilities for cleaning floors, clearing work areas and walkways clearly specified?


  • Are there any stairs on your premises?

  • Are stairways kept clear of boxes, extension cords and litter?

  • Is the tread on stairs adequate to minimise slipping?

  • Is the tread on each stair adequate?

  • Are hand-rails adequate?


  • Are work areas, walkways and stairs well lit?

  • Does the lighting enable workers to move between indoor and outdoor tasks safely?


  • Is the footwear worn by workers suitable for the workplace?

Final comments

  • Additional Comments - Is there anything else you would like us to know?

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.