Title Page

  • Client / Site

  • Date of Inspection

  • Inspected by

  • Location

GENERAL

  • Any accidents or incidents since last visit

  • Review any non recordable accidents or incidents since the last visit.

  • Review any recordable accidents or incidents

  • All reportable accidents or incidents have been abated properly

  • Does the building conform to standards with respect to use, occupancy, building services, and plumbing facilities?

  • Is the building exterior properly lighted and are all parking and walking surfaces in good condition & free of debris and properly marked?

  • In winter is all ice and snow & cleared from all walking, parking & driving areas & de iced immediately?

  • Are doors and entrances clear from hazards and unobstracted?

  • Are doors and entrances kept unlocked or have suitable panic locks?

  • All ceiling tiles clean and in place [no water damage etc.]?

  • Is there an active safety & health program in place?

  • Is one person clearly in charge of safety & health issues [ competent person]?

  • Are emergency procedures and numbers as well as directions to nearest Doctor & Hospital posted?

  • Is there a procedure for handling complaints regarding safety and health?

  • All doors leading to restricted areas have proper signs?

  • All electric / mechanical rooms must be free of any storage and have proper fire extinguisher?

  • All Emergency generator / mechanical rooms must be free of any storage and have proper restricted access?

  • Are bulletin boards and signs clean up to date and readable?

  • Section notes

Stairways and Aisles

  • Are stairways and aisles clear and unblocked?

  • Are stairways well lighted?

  • Are handrails, handholds in place?

  • Are the aisles marked and visible?

  • Section notes

Floors

  • Are floors free from loose material, debris, worn carpeting etc.?

  • Are floors clean?

  • Is there a sign when floors are slippery, oily or wet?

  • Section notes

Lighting

  • Are lamp reflectors clean and fixtures in good condition?

  • Are bulbs missing or not working?

  • location of missing or burned out bulbs

  • Are any areas dark?

  • List areas not properly illuminated

  • Section notes

Equipment

  • Are guards, screens and sound-dampening devices in place and effective?

  • Are chairs free from defects and in good operating order?

  • Are desks and cabinets free from sharp edges?

  • Are ergonomics (keyboard elevation, chair adjustment) correct?

  • Are ladders safe, and well maintained & used correctly?

  • Are employees trained in the proper use of ladders?

  • Are ladders stored and secured properly when not in use?

  • Are machines properly guarded?

  • Are electrical wiring properly concealed?

  • Is equipment free from sharp metal projections?

  • Are wall and ceiling fixtures fastened securely?

  • Are paper and waste properly disposed of?

  • Are desk and file drawers kept closed when not in use?

  • Are office accessories in secure places?

  • Are materials improperly stacked on desks or cabinets?

  • Are file cabinet drawers loaded below their rated capacity and are cabinets secured to wall?

  • Are file cabinets loaded with the heaviest items in the bottom drawers?

  • Are filing stools or wastebaskets placed in proper area?

  • Section notes

ELECTRICAL / MECHANICAL SYSTEMS

  • ELECTRICAL / MECHANICAL SYSTEMS AUDITED?

  • Is there a LO/TO program in place [for employees & contractors] ?

  • Does air exchange rate meet standard requirements?

  • Are HVAC filters changed & equipment serviced on a regular basis ?

  • Is the system free from sources of contamination (asbestos, microorganisms, dust, fumes)?

  • Only correct heavy duty electric cords used when temporary power is needed ,no surge protector strips etc?

  • GFCI outlets [breakers] are used wherever needed??

  • All electric panels are marked & covered with 3' clear in front at all times?

  • All gas meters are marked properly with 3' clear and protected in front at all times?

  • All electric boxes are covered & marked & wiring is neat and correct ?

  • Is temperature, humidity & air quality correct and even throughout?

  • Portable heaters or fans permitted?

  • Are all wall penetrations properly fire stopped where needed?

  • Section notes

Emergency Equipment & Procedures

  • Are all employees trained what to do in case of a emergency?

  • Are all fire alarm systems and fire sprinkler systems regularly tested and certified?

  • Are all fire alarm systems pull stations kept clear and properly signed?

  • Are maps posted & up to date, showing exit routes [u are here], pull stations & fire extinguisher locations?

  • Is fire control equipment appropriate for the type of fire it must control and are employees trained to use it properly or are employees trained to leave the building immediately ?

  • Are emergency lights, exit signs, panic buttons and fire extinguishers tested & serviced on a regular basis with records kept?

  • Proper amount size, type and locations for fire extinguishers ?

  • Are all emergency exit doors and devices tested on a regular basis and recorded?

  • Are fire / emergency drills carried out on a regular basis and it the area of assembly clearly marked with competent person to check attendance?

  • Are appropriate employees trained in First Aid, CPR & AED use and properly identified

  • Section notes

Dangerous Substances

  • Are there any controlled or dangerous substances?

  • • Are the products properly labelled with corresponding NFPA or SDS numbers?

  • • Are proper NFPA or SDS posters displayed?

  • • Is there a corresponding material safety data sheet (SDS) for each product &are they easily accessible to all workers?

  • • Are all hazardous chemicals stored separated and handled properly?

  • • Are proper cabinets used for storage and properly labeled as needed?

  • • Are gas cylinders stored and handled properly. is signage correct & visible?

  • • Are gas cylinders changed by a properly trained worker using proper PPE?

  • • Are workers trained in how to use, store & dispose of these products safely?

  • • Proper eye wash / emergency showers installed and tested on a regular basis and recorded?

  • • Proper PPE is easily available to all workers. all workers trained in proper PPE and its use?

  • • Is all PPE kept up to date and checked for expiration date & stored properly?

  • Is any gasoline or other fuel is stored in proper safety cans with NFPA labels and a proper rated fire extinguisher nearby?

  • Section notes

Sanitation

  • Lunch room, rest rooms audited?

  • Are washrooms and food preparation areas kept clean,with trash emptied regularly ?

  • • are toilets and wash areas kept clean and provide a rest [couch] section?

  • • showers provided if required?

  • • proper clothing storage provided if required

  • • change rooms if required

  • • clean cool drinking water provided

  • • lunchrooms with seating areas and refrigerator available, if a microwave is available fire extinguisher must be nearby

  • • field accommodations when needed

  • Are measures in place to prevent the spread of disease?

  • Section notes

Material Storage

  • Material storage audited [non hazardous]?

  • Are materials neatly and safely racked or shelved & marked?

  • Are there proper stepladders to get to materials on higher shelves if needed?

  • Are storage shelves loaded below their rated capacity?

  • Are storage shelves secure?

  • Are aisles and walk ways marked and kept clear at all times?

  • Are large and heavy objects stored on lower shelves?

  • Are passageways and work areas clear of obstructions?

  • Section notes

Security

  • Do entry and exit procedures provide workers personal security day and night?

  • Are areas that need to be secure protected by selective entry systems [badges / codes, keys etc.]?

  • Are emergency (evacuation, fire, bomb threat, hostile person) procedures in place?

  • Section notes

Completion

  • Site Notes

  • Write any recommendations here

  • Full Name and Signature of the Inspector

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.