Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

PREVIOUS INSPECTION

  • HAS THE LAST INSPECTION BEEN REVIEWED

  • ARE THERE ANY OUTSTANDING ACTIONS

GENERAL

  • FIRE EXTINGUISHERS ARE ACCESSIBLE AND UNBLOCKED

  • EXIT PATHS ARE FREE OF BOXES/MATERIALS AT ALL TIMES

  • AISLES, WALKWAYS, AND WORK AREAS ARE FREE OF TRIP AND FALL HAZARDS (TORN CARPETS, TURNED UP EDGES OF DOOR MATS, BOXES, ETC)

  • STAIRWAYS ARE FREE OF OBSTRUCTIONS AND HAVE A NON-SLIP TREAD

  • IS THERE ADEQUATE WALKING SPACE APPROACHING EXITS

  • ARE FLOOR SURFACES CLEAN, DRY, FREE OF DEBRIS AND TOOLS

  • THE ALARM AND INTERCOM SYSTEMS ARE OPERABLE

  • ALL WORK AREAS ARE ADEQUATELY ILLUMINATED

  • ARE THERE ANY SHARP EDGES, POINTS, BURNS, OR SPLINTERS ON FURNITURE

  • ARE SHARP TOLLS SUCH AS SCISSORS AND RAZOR BLADES STORED POINT/BLADE DOWN

  • COMPUTER WORKSTATIONS ARE ERGONOMICALLY CORRECT (DOCUMENT HOLDERS, WRIST RESTS, MONITOR POSITION)

  • DO CHAIRS HAVE LOOSE CASTORS OR RUNGS

  • BULLETIN BOARDS ARE NEAT AND UP TO DATE

STORAGE

  • DESK AND FILE DRAWERS ARE CLOSED IMMEDIATELY AFTER USE

  • FILE CABINETS, STORAGE CABINETS, BOOKSHELVES AND OTHER ITEMS OVER 5 FEET ARE PROPERLY ANCHORED

  • ARE STORAGE CABINETS ORGANIZED SUCH THAT HEAVY ITEMS ARE STORED IN THE LOWER AND MIDDLE SHELVES

  • STORAGE AND EQUIPMENT ROOMS ARE NEAT AND ORDERLY

  • WORK AND STORAGE AREAS ARE FREE OF IMPROPER STORAGE (HEAVY, HIGH, AND OR UNSTABLE STORAGE)

ELECTRICAL

  • 36" CLEARANCE IS MAINTAINED IN FRONT OF ALL ELECTRICAL PANELS

  • ELECTRICAL CORDS AND PLUGS ARE IN GOOD CONDITION

  • EXTENSION CORDS, PHONE CORDS, AND CABLES ARE PROPERLY ROUTED OR COVERED TO AVOID TRIP AND FALL HAZARDS

  • A MAXIMUM OF ONE POWER STRIP PER ELECTRICAL RECEPTACLE IS USED

  • ELECTRICAL RECEPTACLES ARE IN GOOD WORKING CONDITION

  • ARE PERSONAL APPLIANCES SUCH AS SPACE HEATERS OR COFFEE MAKERS COMPLIANT WITH THE BUILDINGS ELECTRICAL CIRCUIT SYSTEM?

STEP STOOLS AND LADDERS

  • STEP STOOLS OR LADDERS ARE READILY AVAILABLE FOR REACHING HIGH PLACES

  • HAND TRUCKS, DOLLIES, OR CARTS ARE AVAILABLE AND USED FOR HANDLING BULK MAIL AND SUPPLIES

HAZARDOUS MATERIALS

  • HAZARDOUS MATERIALS PROPERLY MARKED

  • MSDS SHEETS ARE AVAILABLE FOR ALL HAZARDOUS MATERIALS USED BY EMPLOYEES

  • HAZARDOUS MATERIALS PROPERLY STORED

FIRST AID FACILITIES

  • ARE CABINETS AND CONTENTS CLEAN AND ORDERLY

  • ARE CONTENTS REGULARLY CHECKED

  • IS ANYTHING EXPIRED

  • CABINETS ARE CLEARLY LABELED

  • IS THERE EASY ACCESS TO CABINETS

  • EMPLOYEES AWARE OF LOCATION OF FIRST AID CABINET

  • ARE FIRST AID OFFICERS AVAILABLE

  • ARE EMERGENCY NUMBERS DISPLAYED

AUDITOR SIGNATURE

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FACILITY MANAGEMENT SIGNATURE

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REVIEWED AND SIGNED BY MANAGEMENT

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