Title Page

  • Conducted on

  • Prepared by

Housekeeping

  • There are no broken or unused equipment / machinery in the work area.

  • Aisles, stairs, and floors clean and are free from obstacles.

  • Take a picture of area.

  • Garbage is being properly contained and disposed of.

  • No spills or leaks in the work area.

  • Workstations / table(s) are clean.

  • Equipment and tools are clean.

Material Handling

  • Inventory or WIP, is being piled or stacked within safe limits

  • Item(s) are being properly stored in their designated areas

  • Work material(s) are being handled safely and properly

  • There is a good use of lifting equipment

Machinery

  • Guarding to power transmission equipment is in place (eg. CNC saw guard).

  • Pinch points are guarded.

  • Emergency safeguards are in operation (eg. Emergency stop buttons, CNC laser eye).

  • Guards or deflective devices provided for chips/sparks from rotating equipment

  • Machinery is clean and appears to be in good running condition

  • Load capacities are identified and clearly marked on hoisting/lifting equipment

  • Hoisting/lifting chains and slings are properly maintained and in good condition

  • Only those personnel trained, are operating the machinery

Hand Tools

  • Tools are in good working condition

  • Guards and safety fixtures are safe and operational

  • Tools are being stored in their proper location or in a safe manner

  • Tools are being used for their intended uses

Ergonomics

  • Workers do not make unnatural or awkward motions, or strain themselves.

  • There is significant lighting in the area of the worker to be in

  • The room temperature is adequate for the worker to do his/her duty

Personal Protective Equipment (PPE)

  • Safety footwear is being worn when required

  • Eye protection is being worn

  • Hearing protection is being worn

  • Gloves are being worn when required

  • Respirators are being worn when required

  • Machine operators has long hair contained (e.g.. Hair net, hat, tied back, etc..)

Clothing

  • No signs of loose clothing in area of moving machinery parts

  • Proper clothing is being worn

Fire Protection

  • Combustible containment storage is in good working condition

  • Combustibles (rags, towels, excess flammable chemicals, etc..) are stored safely

  • Emergency exits are marked and are free from obstruction(s)

  • Fire extinguishers clear from obstruction

  • Sprinkler heads have at least 18" clearance

  • Fire extinguishers are being inspected, recorded & up to date

  • Drums or tanks are properly bonded or grounded

  • Compressed gas cyinders stored securely upright and away from heat sources

  • Emergency evacuation plans are posted

Health Hazards

  • Work area(s) are free from excessive dust, gasses and fumes? Adequate ventilation

  • Washrooms in the area are being kept clean eg. Floors are dry/clean, soap, paper towel, toilet paper

  • Controlled products being used are properly labeled (e.g. supplier & work labels)

  • Controlled products waste is being properly contained

First Aid

  • Safety report forms available

  • First Aid equipment, and supplies inventories are being monitored (checklist on first aid box)

  • First Aid response team members names, and photos are posted in your work area

  • First Aid room (If applicable) is clean and organized

  • Eye wash equipment is clean, free from obstruction & inspection tags are up to date

Forklift Vehicles

  • Forklift vehicles (if applicable) & all other lift(s) inspections logs are up to date

Safe Work Procedures

  • All employees (if applicable) are trained in safe work procedures (confirm with supervisor)

  • All employees (if applicable) have access to safe work procedures (confirm with supervisor)

Safe Walk Area's

  • Walk ways, aisle ways and stair ways are clear

  • Stair treads are free from damage and wear

  • Stair ways are marked and free of garbage, snow and ice

Electrical Panels

  • There are clear access to all electrical panels from all sides

  • There are no signs of loose or damage cable(s) lines running to and from the panel box

  • Floor taping around the electrical panels is good condition

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.