Title Page

  • Conducted on

Walking Surfaces

  • The area is tidy and well kept?

  • Walkways free of obstacles?

  • Is floor free of obstructions?

  • Cords anchored or covered?

  • Floor coverings in good condition?

  • Signage posted if floors are wet?

Furniture & Office Equipment

  • In good mechanical condition?

  • Properly assembled and adjusted?

  • Items secured from tipping?

  • Employees instructed on safe/proper use?

Bookcases, Shelves & Cabinets

  • Secured from tipping?

  • In good condition?

  • Drawers closed when not in use?

  • Material safely stacked and stored?

  • Heavier items between knuckle and shoulder height?

  • Step stools/ ladder available if needed?

Indoor Air Quality

  • Ventilation systems regularly inspected, tested and maintained?

  • Air inlets and exhaust free of accumulation of dust and mould?


  • Surface dust levels low?

  • Material neatly and safely piled?

  • The waste container is sufficient and there is no overflowing garbage?

Worker Awareness (ask nearest staff member)

  • Workers know how to report an accident or a hazard?

  • Workers know the evacuation procedure?

  • Workers know whom to contact for first aid assistance?

  • Workers know the location of fire extinguishers?

Fire Prevention

  • Extinguishers available & accessible?

  • Extinguishers tag dated monthly?

  • Fire exits clear?

  • Emergency numbers close to all phones?

  • Fire doors closed?

  • Fire exits lit?

Electrical Safety

  • Electrical Outlets not overloaded?

  • Electrical cords in good condition?

  • Access to electrical panels is clear and unobstructed?

  • Electrical cords secure?

  • Test and tag in date

  • Faulty equipment is tagged out?

  • Electrical Faceplates secure?

First Aid and Emergencies

  • Warden list posted in visible locations and current?

  • First aid kits available?

  • List of First Aiders posted in visible locations and current?

  • Defibrillator accessible and function testing log completed weekly.


  • Chairs fully adjustable (seat and back)?

  • Monitors adjusted to the right height (Top of the screen should be at eye level)?

  • Footrest available if required?

  • Chairs are set-up so that the thighs are parallel to the floor?

  • Are frequently used items located within the person’s primary zone?


  • Any other observations or recommendations

  • Full Name and Signature of the Inspector

  • Full Name of second 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.