Title Page

  • Site

  • Conducted on

  • Prepared by

  • Location
  • Site Contact



  • Is the workplace near appropriate facilities? (eg Dr Surgery, Food, Public Transport)

  • Is the means of access safe? (eg Adequate lighting, uneven surfaces)

  • Is this a multi level office building?

  • How many levels do Northcott occupy

  • Are facilities (bathroom, kitchen etc) shared with another business?

  • Are facilities maintained regularly?

  • Do all Staff on all shifts have access to the workplace ? (eg keys)

  • Is parking within 100m of workplace?

  • Is pest control part of the scheduled maintenance?

Policy and Procedures

  • WHS Policy and Injury Management Policy on display on notice board?

  • Is there a dedicated bulletin board for WHS?

  • Are the latest Safety Committee minutes on display?

  • If You Are Injured notice on display?

  • Have all staff completed the Northcott online induction?

  • Have all staff completed the onsite induction?

  • Inductions verified?

  • Is there a WHS office rep appointed?

Working Alone

  • Is there a working alone procedure in place?

  • Is the entrance into the office secure?

  • Are parking areas well lit, safe?

  • Are contact lists current and easily accessible?

  • Have staff expressed concern with working alone procedures?

Emergency Plan

  • Is there a written emergency plan?

  • Are there clear emergency procedures on display for all to see?

  • Are Staff, managers and supervisors instructed and trained in the procedures?

  • Have emergency warden been appointed? On display with photos?

  • Are emergency contact details relevant to the types of possible threats (e.g. fire, police, poison information centre) displayed at the workplace in an easily accessible location?

  • Are contact details updated regularly?

  • Is there a mechanism, such as a siren or bell alarm, for alerting everyone in the workplace of an emergency?

  • Is there a mechanism, such as flashing light alarm for those with a hearing loss?

  • Are procedures in place for assisting others if needed?

  • If there is a site plan and is it displayed in key locations throughout the workplace?

  • Are site plans relevant to the layout of the building?

  • Are site plans current? (within 5 years)?

  • Date plan last updated?

  • Does site plan show the location of fire protection equipment, smoke detectors, sprinklers, emergency exits and assembly points? List those missing.

  • Have neighbouring businesses been consulted in relation to emergency procedures?

  • Have you considered the risks from neighbouring businesses (e.g. fire from restaurant/takeaway food outlets)?

  • Are emergency practice runs (e.g. evacuation drills) regularly undertaken to assess the effectiveness of the emergency plan?

  • Are the results of drills recorded? Times, challenges etc

  • Do drills include customers, contractors and visitors?

Emergency Exits

  • All emergency exits clear of obstruction?

  • Are emergency signs in place? (Illuminated and above exits)

  • Is there unobstructed pathway to emergency exits?

Fire Equipment

  • Is the fire protection equipment suitable for the types of risks at the workplace (e.g. foam or dry powder type extinguishers for fires that involve flammable liquids)?

  • Is equipment easily accessible in an emergency?

  • Are Staff trained to use emergency equipment?

  • Have extinguishers been tested within the last six months?

  • Have Fire Services equipment been tested within the last month? (eg sprinklers, alarms)

First Aid

  • Are First Aid Officers onsite? Names and photos on display?

  • Do any First Aid Officers require training?

  • Which training is due?

  • Does the workplace have first aid facilities?

  • How often are first aid kits checked?

  • First Aid kits fully stocked, items within use by date

  • Does the workplace have an AED?

Managing Facilities

  • Is broken or damaged infrastructure, such as plumbing, air-conditioning or lighting, repaired promptly?

  • Is equipment and furniture, like fridges, lockers and seating, maintained in good condition?

  • Is storage suitable? (Built in, fixed to walls)

  • Are heavy items such as paper stored low? (between knees and ground?

  • Is manual handling equipment available to take delivery of heavy consumables (eg paper)


  • Is there enough clear space, taking into account the physical actions needed to perform tasks?

  • Are personal belongings stored away to avoid trip hazards?

  • Is there enough space in walkways and around cupboards, storage, printers or doors?

  • Are the floors maintained to be free of slip and trip hazards?

  • Further Comment


  • Can the work be easily done from a seated position?

  • Can the chair be adjusted for individual needs and is it appropriate to the type of work being carried out?

  • Is there additional seating for Staff who work standing and need to sit from time to time?

  • Are there any concerns relating to the office furniture? (eg broken chairs etc)


  • Is there adequate lighting through the office space?

  • Does the working environment minimise the amount of glare, contrast or reflection?

  • Does lighting provide a natural light?

  • Are there broken light fittings? (flickering etc)

  • Are ventilation and air-conditioning systems serviced regularly?

  • Is sun block available for staff while conducting outdoor activities?

  • Is there access to clean/cool drinking water?


  • No smoking signs in place?

  • Is there a designated smoking area?

  • Means to safely dispose of butts? eg ashtrays


  • If the workplace has more than 10 Staff, are there at least one male toilet for every 20 men and one female toilet for every 15 women?

  • Are the toilet facilities accessible? With handrails?

  • Are toilets clearly marked, and do they have lockable doors, adequate lighting and ventilation?

  • Are toilets cleaned regularly?

  • Is there adequate toilet paper, soap, rubbish bins?

  • Is sanitary disposal available and serviced regularly?

  • Further Comments


  • Is hot and cold water, soap or other cleaning product provided?

  • Are there enough hand washing basins for men and women?

  • Is hygienic hand drying provided that does not involve Staff sharing towels?


  • Are showers provided for Staff?

  • Is there a slip-resistant floor?

  • Are showers accessible? With handrails?

Dining facilities

  • If a shared dining facility is used, can it accommodate all Staff likely to be eating at one time?

  • Have appliances been test tagged?

  • Is kitchen cleaned daily?

  • Are the drinking water outlets separate from toilet and washing facilities?

  • Is filtered water provided?

  • Is the water clean, cool and hygienically provided?

  • Further Comments

Personal storage

  • Is there secure storage at the workplace for Staff’ personal property?


  • Have there been any incidents/injuries in the past 12 months?

  • What type of injury was sustained?

  • Cause of Injury? (Trips, Manual Handling etc)

  • Further Comments


  • Is PPE easily accessible?

  • List PPE available

  • Further Comments

Northcott owned vehicles

  • List safety features available in vehicles?

  • Is a vehicle safety maintenance check completed monthly?

  • Further Comments

Manual Handling

  • Is manual handling equipment used?

  • Have all staff completed Manual Handling training?

  • Is there a scheduled maintenance for manual handling equipment, such as hoists?

  • Is there an equipment register in place?

  • Is there a procedure in place to isolate or tag broken equipment?


  • WHS Representative

  • Site Representative

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.