Monthly Workplace Inspection

• Site inspected

  Select

• Conducted on

  Date

• Inspected by Health & Safety Reps

• Accompanied by Manager/Guest

General Workplace

• Indicate Area

  Select

• Are floors and ceilings in good repair

  Safe

  At Risk

  N/A

• Are corridors and isles free from obstructions and STF hazards

  Yes

  No

  N/A

• Is general housekeeping of an acceptable standard

  Yes

  No

  N/A

• Is the furniture safe? no sharp edges, shelves are not overloaded

  Safe

  At Risk

  N/A

• Electrical safety. No appliances plugged into power bars, extension cords.

  Safe

  At Risk

  N/A

• Are hazardous substances properly stored and labelled?

  Safe

  At Risk

  N/A

• Is there any unused or broken equipment laying around

  Safe

  At Risk

  N/A

• Is equipment stored appropriately? uncluttered, easy reach

  Safe

  At Risk

  N/A

• Is emergency lighting in place and tested?

  Pass

  Fail

  N/A

• Is the First Aid Kit checked quarterly?

  Compliant

  Non-Compliant

  N/A

• Other items; general observations of safety.

• Any staff concerns to note

Fire and Emergency Provisions

• Are fire exits and doors free from obstruction and no visible damage

  Safe

  At Risk

  N/A

• Are fire doors kept closed

  Safe

  At Risk

  N/A

• Are fire extinguishers in place, free from obstruction and in date

  Safe

  At Risk

  N/A

Please sign and email the report to OHW Specialist

• Select date

  Date

• Signature

  Sign