Title Page
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Conducted on
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Prepared by
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Location
Inspection Information
Office:
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Office Representative:
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Personnel:
Inspection Criteria
Electrical
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Electrical cords are safely stowed
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Connectors, plugs and outlet sockets are in a safe condition
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Electrical equipment free from any obvious external damage, faulty equipment tagged out
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Are electrical items tested and tagged, and within date?
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Are electrical appliances in a safe working area (e.g. fans, heaters)?
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Power boards are used instead of double adapters
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Electrical Equipment Register is being maintained
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Cables are stowed out of the way or in meeting rooms under protective cover
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Emergency
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Path to the exit is reasonably direct and signposted
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Path to the exit is sufficiently wide and free of obstructions or trip hazards to allow unimpeded passage
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Are fire extinguishers located in an easy to see location, hung on the wall , clear access and appropriate signage in place?
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Smoke detector is installed in/near the work and is properly maintained
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Is a copy of the building’s emergency procedure available?
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Emergency contact numbers and details are known?
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Incident Reporting poster is posted in a prominent location?
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First Aid Kit is readily available for the work area
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First Aiders are nominated in a prominent location?
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Telephone or other communication devices are readily available to allow effective communication in an emergency situation?
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Emergency scenario has been conducted in the past six (6) months?
Inspection Performance Statistics
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Total
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Percentage
Sign-off & Acceptance
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Name
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Signature
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Date