Information
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Hazards are rated as:
Class A (a condition or practice likely to cause permanent disability, loss of life, extensive damage or negative environment impact) must be corrected immediately
Class B (a condition or practice likely to cause temporary disability or disruption to property or environmental damage) must be corrected within 14 days
Class C (a condition likely to cause minor injury or damage) must be corrected within 14 days
Class D (housekeeping issues) must be corrected within 30 days
Hallways Entrances and Stairways
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Clear and unblocked
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Stairwells well lit?
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Handrails and handholds in place?
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Is emergency lighting availible?
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Comments:
Reception Area
Floors
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Loose material or debris?
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Floors slippery or wet?
Lighting
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Are the areas well lit?
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Are bulbs missing?
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Are there areas that are dark?
Equipment
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Furniture and equipment is safe?
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Worn or badly designed chairs?
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Sharp edges on cabinets or desks?
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Poor ergonomics? (height if chair, keyboard elevation, etc.)
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Crowding?
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Extension cords overused?
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Electrical cords etc creating tripping hazard?
Material Storage
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Are materials neatly and safely piled?
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Are large and heavy objects stored on lower shelves?
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Are passageways and work areas clear of o obstructions?
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Are desk and file drawers kept closed when not in use?
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Are there any tripping hazards?
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Are paper and waste properly disposed of?
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Are office accessories in a secure area?
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Are materials stacked on desks or cabinets?
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Are file cabinet drawers overloaded?
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Are file cabinets loaded with the heaviest items in the bottom drawers? l
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Is the first aid kit clearly marked and accessible?
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Comments
Offices/Workstations
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Is there loose material worn carpeting or debris?
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Are the floors slippery, oily or wet?
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Are Areas well lit?
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extension cords use extensively?
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Electrical cords tripping hazard?
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Materials safely and neatly piled?
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Large and heavy objects stored on lower shelves?
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Passageways clear of obstructions?
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Drawers closed when not inn use?
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Is the furniture safe? (no sharp edges, chairs in good condition, ergonomics, etc.)
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Office accessories secure?
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File cabinets overloaded?
Copier Stations
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Is there loos material, worn carpeting or debris?
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Are the floors slippery, oily or wet?
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Is the area well lit?
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Is the copier functioning correctly?
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Are extension cords used extensively?
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Are electrical cords creating tripping hazards?
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Are materials neatly and safely piled?
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Are large and heavy items stored on the lower shelves?
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Are passageways clear of obstructions?
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Are drawer and cabinets closed when not in use?
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Are there any tripping hazards?
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Are materials stacked on desks or counters?
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Are counters clean and safe?
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Are there any controlled substances (WHMIS)?
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If yes: are they properly labelled?
Washrooms
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Is there loose material, debris or worn flooring?<br>
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Are the floors slippery, oily or wet?
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Is the area well lit?
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Are supplies adequate? (toilet paper, soap, etc)
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Are there any controlled products (WHMIS)
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If yes: are the products properly labelled?
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Comments
Electrical Closet and Janitorial Closet
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Is there loose material worn flooring or debris?
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Are the floors slippery wet or oily?
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Are materials neatly and safely piled?
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Are large and heavy objects stored on lower shelves?
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Are passageways or work areas clear of obstructions?
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Is the key available in case of emergency?
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Are there any controlled substances (WHMIS etc.)
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Are they properly labelled?
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Are storage shelves overloaded?
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Comments
Emergency Equipment
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Is all fire control equipment inspected and certified?
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Is emergency lighting in place and regularly tested?
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Are first aiders available in the area?
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Are first aid kits available and stocked?
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Comments
Lunch Room
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Are food prep areas clean?
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Is the safety board area neat and prominently marked?
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Is the general notice board current?
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Is noise protection availible?
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Are there 'NO SMOKING' signs posted?
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Is the lunch room well lit and adequately ventilated?
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Is there a clear exit/access?
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Is the lunchroom free of hazards? (worn frayed cables, poorly maintained appliances or overloaded plug ins or power packs)
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Are there any cords that employees could trip over?
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Is there loose material, worn flooring or debris?
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Is the floor slippery, wet or oily?
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Are the waste disposal facilities emptied and contents removed for disposal?
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Are there any controlled substances (WHMIS), etc)
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If yes, are they properly labelled?
Multi Purpose Rooms - Meeting Rooms
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Is there loose material worn flooring or debris?
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Are the floors slippery, wet or oily?
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Is the area well lit?
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Are bulbs missing?
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Is necessary equipment in working order?
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Are extension cords over used?
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Do cords create a tripping hazard?
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Are materials neatly and safely piled?
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Are storage shelves overloaded or beyond their rated capacity?
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Are large or heavy objects stored on the bottom shelves?
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Are passageways and work areas free of obstructions?<br>
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Are materials stacked on counters or desks?
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Are drawers and cupboards closed when not in use?
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Are office accessories in a secure place?
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Are file cabinet drawers overloaded?
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Are there any controlled substances? (WHMIS etc.)
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If yes; are they properly labelled?
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Comments
Air Handling System
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Is the temperature consistent?
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Is the temperature at a comfortable level? (between 19 and 22 degrees Celsius)
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Is the system free of contamination? (dust, fumes, etc)
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Comments
Other
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Comments