Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Chemicals

  • Inventory of hazardous chemicals is current ( within one year)

  • SDS/ MSDS readily available for each hazardous material on inventory

  • Chemicals stored properly ( insecticides, Detergents / sanitizers, caustics/ acids/ polishes)

  • All containers properly identified and labeled with hazard warnings

  • Proper personal protective equipment used when handling chemicals ( see SDS/ MSDS)

  • Working eye wash station available with continuous 15-minute flow

  • Copy of chemical hazards communication plan

Storage Areas

  • Aisles and floor clean

  • Shelves and racks are of adequate strength and secured

  • compressed gas cylinders stored in upright position, are individually chained and those not in use have protective caps in place.

  • Employees frequently receive training on correct lifting techniques

  • Heavy items stored on shelves between knee and shoulder height

  • No goods over 30 lbs. stored at more than five feet above floor

  • Goods have been removed from cartons prior to being placed on shelves

  • Cartons cross- stacked to avoid tipping or tumbling

  • Step Ladder in good condition and of sufficient height to reach tip of storage without standing on the top tow steps.

  • Floors and walk-ins are clean, dry , and not slippery

  • Flammables properly stored ; sterno, charcoal lighter fluid , butane , etc. ( No more than 24 containers of butane in one location)

  • Sharp edges are identified and eliminated

  • Bump hazards are eliminated

  • Falling object hazards are eliminated

  • Emergency releases in walk-in refrigerators and freezers in proper working order

Exits

  • Exit route unobstructed

  • Exits clearly marked with illuminated signs

  • Emergency lighting provided for all occupied areas and tested

  • Emergency evacuation plans posted

  • All doors in exit path kept closed

  • Lighting is adequate

  • handrails provided on all stairs

  • Adequate number of exits provided

  • Exit doors are operable in the path of exit travel without the use of a key or any special knowledge

Electrical

  • All electrical cords are in good condition

  • Extension cords are not used in place of permanently installed or fixed wiring

  • Cover plates, switches, outlets, etc. are in good condition

  • Equipment grounded or double insulated

  • A Lockout/ Tag out procedure is in place and staff are trained regarding these procedures. See 406 for additional information

  • Ground plugs on equipment in good condition

  • Motors are clean and properly lubricated

  • Emergency shutdown switches installed and easily accessible

  • Switches and circuit breakers are clearly marked to indicate equipment/ areas controlled

  • Control panes have a minimum 36" of unobstructed workspace in front and are closed

Fire prevention

  • Portable fire extinguishers properly mounted, accessible and serviced annually.

  • Monthly visual inspections of portable fire extinguishers near cooking are 40 BC rated

  • Are employees familiar with location of portable extinguishers, manual controls on extinguishing systems and fire alarms

  • Automatic fire protection system inspected and serviced by a qualified persons semi-annually

  • Minimum of 18" clearance under sprinkler heads

  • Fire doors in proper operational condition and unobstructed

  • Do employees know how to report a fire

  • Decorations are flameproof or non-combustible

  • All fire alarms unobstructed

  • Hoods, filters, and ducts clean and free of grease accumulation. A cleaning schedule has been established

  • Emergency phone numbers posted at several locations ( i.e. kitchen and office)

Kitchen Work

  • Lighting adequate, fixtures shielded

  • Machines are suitable anchored to prevent creeping or tipping

  • Employees know location and operation of gas/ electric emergency cutoffs

  • No steam leaks on production equipment

  • Floors and Equipment clean and free of food/ grease build-up

  • Area is free of cut, bump, and trip hazards

  • 35" safety cones used with floor hazards

  • Floor mats properly placed

  • Swinging doors have see through panels and are easy to open ; overhead mirrors at doors with blindspots

  • Slicer left unplugged and set at zero when not in use or during cleaning; cut resistant gloves on both hands available for use when cleaning blade

  • Persons under 18 years old prohibited from operating slicers and food processors

  • Can opener blades clean and in good repair

  • Clean-as-you- go policy is enforced

  • Knives stored properly in rack

  • Meat, fish and other grinders: Worm- type power driven grinders guarded to fingers can't contact worm and pushers used to increase safety

  • No broken springs on lowerators; plates not stacked over 18" on counter

  • Pan handles or potholders used to lift hot pots; no greasy rags stored under counter

  • Employee locker rooms clean

  • Compactors are equipped with adequate guards and safety switches

Monthly Safety Inspection Guide

  • Guards for equipment in good condition and in place

  • Eye, face, and hand personal protection equipment is available, maintained and used

  • No sharp corners projecting on machines

  • Employees wear clean outer garments and closed-heel , closed-toe and slip resistant footwear

  • Employees do not wear loose or dangling jewelry

Dish Area

  • Floor mats, non-slip material, or strips properly placed and in good condition

  • Dish Machine final rinse above 180 degrees or approved chemical disinfectant used

  • Protective cover over disposal opening; no water leaks from hoses, valves , or dish machine

  • Ventilation in area is adequate

  • Dishes stacked properly in carts and tables

  • Mops and pails clean and available to clean up spills

  • Broken glass is swept up promptly and placed in special, clearly marked containers

  • No standing water where people stand

  • Emergency shut-off accessible

Dining Area

  • Broken, torn, wobbly or unsteady tables or chairs are quickly repaired

  • Carpet and runners in good condition; stair treads and nosing have non-slip material and are secure

  • Wet mopping is avoided during rush hours

  • Sufficient 35" safety cones are available and used at every public entrance where floors are wet

  • Explanation for questions answered no

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.