Title Page

  • Client / Site

  • Location
  • Conducted on

  • Prepared by

General Inspection

  • Are all work areas clean, sanitized, and in order?

  • Is there adequate lighting?

  • Are noise levels acceptable?

  • Is ventilation adequate?

  • Are aisles and passages free of stored material that may present trip hazards?

  • Are tile floors in places like kitchens and bathrooms free of water and slippery substances?

  • Are carpets and throw rugs free of tears or trip hazards?

  • Are handrails provided on all fixed stairways?

  • Are treads provided with anit-slip surfaces?

  • Are step ladders provided for reaching overhead storage and are materials securely stored?

  • Are file drawers kept closed when not in use?

  • Are passenger and freight elevators inspected annually and are the inspection certificates available for online review?

  • Are pits and floor openings covered or otherwise guarded?

  • Are standard guardrails provided wherever aisle or walkway surfaces are elevated more than 48 inches above any adjacent floor or ground?

  • Are all furniture safe and free from damages?

  • Are objects covering heating and air conditioning vents?

  • Are employees advised of proper lifting techniques?

  • Are workstations configured to prevent common problems?

  • Chair height allows employees' feet to rest flat on the ground with thighs parallel to the floor?

  • Top of a computer screen is at or slightly below eye level, the keyboard is at elbow height.

  • Are mechanical aids and equipment, such as lifting devices, carts, dollies provided where needed?

  • Are employees surveyed annually on their ergonomic concerns?

  • Are established emergency phone numbers posted where they can be readily found in case of emergency?

  • Are employees trained on emergency procedures?

Electrical Systems

  • Are all cord and cable connections intact and secure?

  • Are electrical outlets free of overloads?

  • Is fixed wiring used instead of flexible/extension cords?

  • Are the area around electrical panels and breakers free from obstructions?

  • Are high-voltage electrical service rooms kept locked?

  • Are electrical cords routed such that they are free of sharp objects and clearly visible?

  • Are all electrical cords grounded?

  • Are electrical cords in good condition (free of splices, frays, etc.)?

  • Are electrical appliances approved (UL)?

  • Are electric fans provided with guards of not over one-half inch, preventing finger exposures?

  • Are space heaters UL listed and equipped with shutoffs that activate if the heater tips over?

  • Are space heaters located away from combustibles and properly ventilated?

  • In electrical rooms, are all electrical raceways and enclosures securely fastened in place?

  • Are clamps or other securing means provided on flexible cords or cables at plugs, receptacles, tools, equipment, etc., and is the cord jacket securely held in place?

  • Are sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance? (This space is 3 feet for less than 600 volts, 4 feet for more than 600 volts)

Material Storage

  • Are storage racks and shelves capable of supporting the intended load and materials stored safely?

  • Are storage racks secured from failing?

  • Are office equipment stored in a stable manner, not capable of falling?

Recommendation

  • Enter receommendations here

Completion

  • 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.