Title Page

  • Site conducted

  • Conducted on

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General Facilities

  • Is the temperature and airflow in the area adequate?

  • Are photocopiers/printers located away from personal workstations?

  • Are there any sources of excessive noise? Are noise levels at or below acceptable levels for the work being done?

  • Are all light bulbs and tubes working and are all lightning covers adequately clean?

  • Are there adequate numbers of waste and recycling receptacles and are they well positioned?

  • Are light items stored in higher locations and heavier items stores in lower locations?

  • Is the general conditions of walls, floors, floor coverings and ceilings good?

  • Are ventilation ducts kept clean and unobstructed?

  • Are areas around photocopiers and other equipment well ventilated?

  • Is general indoor air quality acceptable for the majority of occupants (e.g Temperature, humidity, air flow, etc.?

Infection Control

  • Are there sufficient hand-hygiene dispensers in your area (e.g. work area, outside and inside patient’s room, corridors etc.)?

  • Are the hand-hygiene dispensers regularly filled?

Work stations / office furniture

  • Is the area tidy and well kept?

  • Are items safely stored so they are not at risk of falling off or causing injury?

  • Is furniture in good repair?

  • Furniture not blocking doorways?

  • Are filing cabinets/desk drawers closed when not in use?

Floors, Aisles, Stairs and Landings

  • Floors, Aisles, Stairs and Landings

  • Aisles clear and unobstructed?

  • Are stairs in good condition (no worn or broken treads)?

  • Are handrails in good condition?

  • Are landings clear of obstructions?

  • Are stairs and passageways well lit?

Emergency Exits, Procedures and Equipment

  • Are emergency numbers and procedures clearly displayed

  • Are appropriate fire extinguishers visible and easy to access?

  • Have fire extinguishers been inspected/tagged within the last 6 months?

  • Are fire extinguishers free from obstruction?

  • Are emergency exit stairs adequately lit?

  • Are exit signs in place and illuminated?

  • Are exit doors marked and clearly visible?

  • Can exit doors be opened from inside?

  • Are exit corridors clear of obstructions (including outside of the building)?

First Aid

  • Are the locations of first aid kits labelled, easily visible, easily accessible, and known to staff?

  • Are First Aid kits items available inside the box?


  • Are electrical items tested, tagged and in date?

  • Are all power outlets and switches in good condition (not broken) and tagged out if faulty?

  • Are extension leads / power boards used as designed (Ensure no temporary or makeshift leads/power boards, double adaptors, piggyback plugs, overloading)?

  • Are electrical items free from damage and unlikely to be exposed to water?

  • Are electrical appliances in a safe working area?

  • Are leads/cords kept clear of walkways and tucked away tidily under desks?

Manual Handling ( Please ask risk management for manual handling brochure)

  • Are frequently used items within easy access between knee and shoulder?

  • Are heavy items stored at waist height?

  • Are step ladders or stools used to access items stored on high shelves?

  • Are trolleys available and used to transport items?

  • Are repetitive actions minimized and rest breaks taken?

  • Is a risk assessment made when patient, furniture or offices must be moved and are the risks from manual handling? controlled as far as possible?


  • Is there adequate lighting for the work being carried out?

  • Is glare and reflection controlled to acceptable levels?

  • Is the area’s lighting steady (no flickering light)


  • Is the workstation set up correctly?

  • Is space under the desk clear to allow leg room and symmetrical posture to access workspace on the desk?

  • Is working in an awkward or constrained posture, fixed position or standing position avoided where possible?

  • Are repetitive movements avoided where possible?

  • Are computer monitors positioned properly (e.g to avoid glare, at the correct height, distance and angle, etc.)?

  • Are equipment controls well designed and properly positioned

  • Are items that are frequently used easily accessible

  • If reaching up is necessary, is a step stool or similar device provided?

  • Is there sufficient space for the work to be done?

  • Are workstations adjustable to suit the size and height of the worker (e.g via adjustable monitor, adjustable chairs, work surface heights, etc.)?

  • Have aids been provided for computer workstations (e.g foot rests, document holders, mouse bridges, etc.)?


  • Is fridge clean and operational?

  • Is microwave position at suitable height, clean and operational?

  • Is oven/stove clean and operational?

  • Is equipment secured?

  • Is the area free from pests or evidence thereof?

  • Is there adequate provision of soap, dishcloths and towels (if a sink is present)?


  • Are toilets and washing facilities kept clean and hygienic, including doors, walls and counter tops?

  • Is there adequate provision of soap, hand drying facilities and toilet paper?

  • Are waste bins clean, emptied regularly and well positioned?

  • Are electric hand dryers maintained in good working order?

  • Is lighting adequate?

  • Is the floor/area free from water?

  • Are Doors and their locks working?

  • Female/Male signs are clear?

Hazardous Materials/Chemicals (e.g. Cleaning and Printing)

  • Are flammable, explosive, toxic and asphyxiant gases stored outside?

  • Are current (i.e less than 3 years old) Material Safety Data Sheets (MSDS) maintained for all substances used)?

  • Are staff provided with the appropriate PPE for the hazardous substances being used?

  • Are all hazardous storage cupboard and each containers labelled?

  • Are chemical/biological spills kits readily accessible?

  • Is all other required emergency equipment readily accessible in or very near the work area?

  • Are current chemical inventories maintained for each work area?

  • Are quantities of hazardous substances (e.g. flammable or combustible materials, very toxic materials, etc.) maintained at a minimum to avoid excessive storage of such items within the work area?

  • Are hazardous wastes (e.g., chemical and biological agents, sharps, radioactive substances, broken glass, etc.) labelled, handled/packaged and disposed appropriately as per KFMC policy and procedure?

Personal Protective Equipment (PPE)

  • Is personal protective equipment (e.g, gloves, respirators, hearing protection, safety glasses, lab coats, hard hats, etc.) provided where necessary?

  • Is PPE worn where necessary?

  • Is there adequate storage available for all PPE?

  • Is PPE maintained in good condition?

Equipment and Machinery

  • Have risk assessments been performed on all machinery?

  • Is all machinery and equipment in good operating condition?

  • Have all staff been properly trained in the correct operation of machinery and equipment?

  • Are there inspection and maintenance tags for all machinery and equipment?

  • Are hazardous and/or restricted areas clearly designated?

  • Is lighting adequate for the work being performed?

Compressed Gas or Air

  • Are cylinders stored in well-ventilated areas and are they properly segregated?

  • Are cylinders adequately secured (e.g. individually chained, capped when not in use, etc.)?

  • Are empty cylinders stored separately from full cylinders and are they adequately signed?

  • Are all apparatus and line attached to cylinders appropriate for the gas and pressure present?

  • Are empty and full cylinders properly transported (e.g., secured to a cylinder dolly with the cap in place)?

  • Are air receivers and compressors installed with pressure gauges and relief valves?

  • Are relief valves on air receivers and compressors tested regularly?


  • Name and Signature

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.