PCYC Annual Cleaning

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

PCYC Annual Cleaning Safety Checklist

• Branch

• Date

• Cleaner

• Add signature

  Sign

• Supervisor

• Add signature

  Sign

• This form must be completed every 12 months
  Check every section that is appropriate for your branch or location
  If items are checked as "not ok", action must be noted

A. Safety Signage

• 1. Safety and hazardous chemical signs inside & outside cleaners areas are displayed prominently,

• At appropriate heights for best sight

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Clean and undamaged

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Suitable for the hazards present in the areas

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

B. Health & Hygiene

• 1. Access to toilets and shower areas for cleaners is available, clean and tidy.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. Satisfactory hand washing facilities provided - soap & water available and used by cleaning staff to prevent spread of micro organisms.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Vermin and pests are controlled in cleaner work areas

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

C. Personal Protective Equip (PPE)

• 1. PPE is easily available and appropriate for the type of hazardous tasks or substances used or decanted

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. All PPE is checked monthly for condition , cleanliness and use by dates

• Hearing - ear muffs/plugs

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Eye/Face - full face shields/safety goggles

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Hand - chemical resistant gloves selected and matched to substances

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Respiratory - for dust particle - P1, P2 or P3, for vapours, gases or mists - cartridge or filters to suit substance.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Work clothing is suitable for work undertaken e.g. chemical contact.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 4. Storage of PPE is appropriate e.g. respiratory protection, hearing protection.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 5. Cleaning staff have been trained in proper use and care.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 6. PPE signage is in place where it is require to be worn for decanting.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

D. Cleaners equipment/plant

• 1. Electrical cleaning equipment is in safe condition, have safety guards fitted and are actually in place.

• E.g. no cracked casings, no damage (eg. twists, kinks) to cords:

• Back Pack vacuum cleaners

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Wet/Dry vacuum cleaners

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Floor Polish

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Floor scrubbers

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Leaf Blower (Fuel or Electric)

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Steam Cleaner

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Battery Charger

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Water pressure cleaners

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• Other

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. Emergency Stop Buttons are within easy reach of user and are tested to be fully functional. Eg: kill switches or buttons intact, triggers not taped on equipment.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. All cleaning equipment users have been trained in correct use of all equipment.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 4. Standard Operating Procedures for all items of cleaning equipment are displayed or readily available (or manufacturer's instructions).

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 5. Random checks - verify "specified electrical equipment" used for services type work has tested and tagged as per Electrical Safety Regulations.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 6. Portable power equipment is stored in appropriate places when not in use.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 7. Portable RCDs are available and used with portable powered cleaning equipment.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 8. Out of Service tags are readily available and used properly on unsafe cleaning services equipment.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

E. Hand tools or equipment

• 1. Hand tools/equipment is in good condition - random checks. E.g. brooms, mops, squeegees, brushes

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. Handles/ shafts free of splits, gouges or other damage which cause injury.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Hand tool heads are securely on shafts

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

F. Eye Wash/ Emergency shower

• 1. Eyewash or emergency shower is available if risk assessment requires.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. This equipment is regularly checked and tested - e.g.cleanliness, water flow, clear access etc

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Emergency signage identifies locations of equipment.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

G. Height Access & Safety

• 1. All cleaners ladders or portable steps are in good condition and stored correctly (i.e. no domestic rated ladders, no bent supports or damaged treads or locking mechanisms, must be rated at 120kg or greater).

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. No cleaning work is done from ladders unless 3 points of contact are able to be maintained on the ladder (ie. 2 feet and 1 hand or other)

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Mobile scaffolds used by cleaning contractors are only erected by competent personnel.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

H. Hazardous Chemicals

• 1. All hazardous chemicals are correctly stored. All chemical cupboards/rooms are locked at all times.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. Appropriate decanting methods are in use - to prevent spills / leaks or personal exposure

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. All containers are labelled and correctly applied - including spay trigger bottles.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 4. Ventilation is adequate in areas where chemicals are decanted, used and stored.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 5. All hazardous chemicals in this area are recorded on the chemical register.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 6. SDS is up to date for any new purchased substances and made available to users.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 7. Risk assessments have been completed for DG Classes 3, 5 or 8 dangerous goods used or stored.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 8. A suitable spill kit is provided and located near to areas of use or decant.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 9. Spill Kit contents is checked against stock lists at least twice per year and consumables are replenished immediately if kit is used. (A record is maintained in monthly checks).

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 10. Unwanted substances or chemicals are disposed of correctly.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

I. Noise

• 1. Noise hazards from cleaning processes are clearly identified and measured e.g. plant and equipment in operation.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 2. Noise hazards have been appropriately controlled at the source where possible.

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 3. Appropriate hearing protection is provided for staff if elimination is not possible e.g. ear muffs or plugs

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

• 4. Ear Muff (if used) are checked regularly & stored correctly - check foam liners and cups for cracks, cleanliness etc

  OK

  Not OK

  N/A

• Photo

  Media

• Action to be taken

Other Safety issues not included on checklist

Further action for any issues identified on any checklists

• Including responsibility for corrective action and date due

Signature

• Person Completing Report

  Sign

• PCYC Annual Cleaner's Checklist v1, September 2014. Review date: 2017.