Title Page
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Client / Site
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Location
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Conducted on
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Prepared by
General Inspection
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Are all work areas clean, sanitized, and in order?
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Is there adequate lighting?
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Are noise levels acceptable?
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Is ventilation adequate?
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Are aisles and passages free of stored material that may present trip hazards?
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Are tile floors in places like kitchens and bathrooms free of water and slippery substances?
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Are carpets and throw rugs free of tears or trip hazards?
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Are handrails provided on all fixed stairways?
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Are treads provided with anit-slip surfaces?
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Are step ladders provided for reaching overhead storage and are materials securely stored?
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Are file drawers kept closed when not in use?
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Are passenger and freight elevators inspected annually and are the inspection certificates available for online review?
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Are pits and floor openings covered or otherwise guarded?
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Are standard guardrails provided wherever aisle or walkway surfaces are elevated more than 48 inches above any adjacent floor or ground?
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Are all furniture safe and free from damages?
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Are objects covering heating and air conditioning vents?
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Are employees advised of proper lifting techniques?
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Are workstations configured to prevent common problems?
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Chair height allows employees' feet to rest flat on the ground with thighs parallel to the floor?
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Top of a computer screen is at or slightly below eye level, the keyboard is at elbow height.
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Are mechanical aids and equipment, such as lifting devices, carts, dollies provided where needed?
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Are employees surveyed annually on their ergonomic concerns?
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Are established emergency phone numbers posted where they can be readily found in case of emergency?
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Are employees trained on emergency procedures?
Electrical Systems
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Are all cord and cable connections intact and secure?
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Are electrical outlets free of overloads?
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Is fixed wiring used instead of flexible/extension cords?
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Are the area around electrical panels and breakers free from obstructions?
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Are high-voltage electrical service rooms kept locked?
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Are electrical cords routed such that they are free of sharp objects and clearly visible?
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Are all electrical cords grounded?
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Are electrical cords in good condition (free of splices, frays, etc.)?
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Are electrical appliances approved (UL)?
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Are electric fans provided with guards of not over one-half inch, preventing finger exposures?
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Are space heaters UL listed and equipped with shutoffs that activate if the heater tips over?
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Are space heaters located away from combustibles and properly ventilated?
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In electrical rooms, are all electrical raceways and enclosures securely fastened in place?
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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?
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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
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Are storage racks and shelves capable of supporting the intended load and materials stored safely?
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Are storage racks secured from failing?
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Are office equipment stored in a stable manner, not capable of falling?
Recommendation
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Enter receommendations here
Completion
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Full Name and Signature of the Inspector