PSU OPP SAFETY - Custodial

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Overall working conditions/job requirements

• Are there any obvious physical hazards that may affect the custodians on site? exposed wiring, loose fittings, damaged walkways, unsafe sharps containers

  No

  Yes

• Are there any environmental issues on site that affect the custodians? snow/ice, extreme heat, poor ventilation...

  No

  Yes

• Is there any health hazard that needs addressed for custodians to perform their job safely?

  No

  Yes

• Are there any unsafe areas the custodians must access or pass through to complete their work?

  No

  Yes

• Is there a procedure in place to ensure safety of a custodian working alone or in an isolated area?

  Yes

  No

  N/A

• Is there adequate lighting on site?

  Yes

  No

  N/A

• Is the site evacuation procedure up to date (training and signage) relevant to the custodians?

  Yes

  No

  N/A

• Will the custodians be working in areas considered a confined space?

  No

  Yes

• Is there easy access to running water for eye wash, in case of severe chemical burn?

  Yes

  No

  N/A

• Is the waste disposal and removal process for the site safe for the custodians?

  Yes

  No

  N/A

• Are fire exits clearly marked, free from obstacles, and emergency lighting in place where ever required?

  Yes

  No

  N/A

Entranceways

• Are all entrances properly illuminated with interior and exterior lighting?

  Yes

  No

  N/A

• Matting/Runners edging is okay and laying flat?

  Yes

  No

  N/A

• Is threshold secure?

  Yes

  No

  N/A

• Is floor tile and carpet in good condition? no loose or damaged tiles..

  Yes

  No

  N/A

Main storage area, custodial closets and break room area

• Are all areas properly illuminated?

  Yes

  No

  N/A

• Is break area kept neat, clean and orderly?

  Yes

  No

  N/A

• Are supplies maintained in an organized manner and properly labeled?

  Yes

  No

  N/A

• Is the area properly ventilated for type of equipment or products in use? (Ventilation is required for charging equipment)

  Yes

  No

  N/A

• Is the area free of tripping hazards?

  Yes

  No

  N/A

• Are products properly labeled, in correct bottles, stored with caps on?

  Yes

  No

  N/A

• Are product dispensing units mounted and secured properly?

  Yes

  No

  N/A

• Are product dispensing units disconnected from water supply?

  Yes

  No

  N/A

• Is product dispensing unit free of bottles?

  Yes

  No

  N/A

• Are product dispensing unit levers in neutral position?

  Yes

  No

  N/A

• Are product dispensing unit and docking mechanism clean and residue free?

  Yes

  No

  N/A

Personal Protective Equipment

• Is appropriate PPE available? Head, Eye, Hand, Hearing, Foot?

  Yes

  No

  N/A

• Is appropriate PPE used as necessary?

  Yes

  No

  N/A

• Is PPE properly stored, clean and in good condition?

  Yes

  No

  N/A

Mechanical Room Safety

• Are all areas properly illuminated?

  Yes

  No

  N/A

• Area is cleaned and orderly?

  Yes

  No

  N/A

• Are areas free of visible fungal/mold growth moisture and associated odors?

  Yes

  No

  N/A

• Are air intake areas free of odor-causing materials or hazardous chemicals?

  Yes

  No

  N/A

• Is area free from tripping hazards?

  Yes

  No

  N/A

• Are electrical panels free from obstacles and accessible?

  Yes

  No

  N/A

• Is OPP Save Space Area clean and orderly?

  Yes

  No

  N/A

Elevated Work Surfaces

• Are ladders in good condition?

  Yes

  No

  N/A

Notes/Comments/Actions Required or Taken

• Is corrective action required?

  No

  Yes

• Have all deficiencies been properly reported?

  Yes

  No

  N/A

• Please note all corrective actions taken