Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
General: electrical, water, fire etc.
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Evidence of trip hazards - poor/worn/damaged flooring.
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Evidence of damaged electrics - sockets, equipment, frayed wiring, exposed wires.
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Inadequate lighting?
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Evidence of poorly stored equipment? e.g. outside chairs, equipment on shelves, baby changing table, high chairs.
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Blenders and food processors working? Interlock working?
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Any damaged equipment/tables/chairs?
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Step ladders/foot stools - any missing or damaged anti-slip feet, cranked rungs or stiles (sides), missing or weakened rungs, missing tie rods, cracked or damaged welds, missing or loose screws or rivets?
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Fire fighting equipment in good working order?
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Fire exits clear, and doors working?
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Hot tap water temperature at -50 degrees C or above?
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Cold tap water temperature at 20 degrees C or below?
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Is the tap nozzle free from lime scale build up?
First Aid
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First aid box fully equipped?
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Eye goggles in correct positions and in working order?
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Hand cream available?
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Eye wash available?
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Number of accidents since last monthly check?
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Action taken as a result of the accident?
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Date of completed action?
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Were any accidents RIDDOR reportable?
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Details of any contact from the council
Staff Training
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Any new staff?
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Name
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Job role
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Details of training required
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Date completed
Last months monthly check
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Were all of last months actions completed?
