General information

  • SMAT date

  • Location

  • If selected location is 'other', please specify:

  • SMAT Team

  • Spoken with:

SMAT part A: open conversation

The first part is a (safety related) open conversation with an employee. The following questions could be used as guidance:

  • 1. What are your day-to-day work activities?

    2. Are you satisfied with the setup of the workplace / working area?

    3. What kind of tools do you use for work?

    4. Could your work activities lead to (health / environmental) risks?

    5. If any, do you take any measures to reduce these risks?

    6. In general, do you feel safe during work?

    7. Did you ever intervene during an unsafe situation?

    8. Are you confident with the training / instructions you received to perform your work activities in the correct and safe manner?

    9. Are you familiar with the procedures and work instructions regarding your activities?

  • Notes / remarks / issues:

SMAT part B: inspection

1. House rules:

  • Are there house rules applicable?

  • Were these rules explained to the members of the SMAT team?

  • Pictures (optional)

2. HSEQ notice boards:

  • Is there an HSEQ notice board present?

  • If so, is the information on it up to date?

  • Is the most recent safety (FOS) journal placed on the notice board?

  • Is the emergency response (E.R.) chart placed on the notice board?

  • Picture notice board (if present)

3. Toolbox meetings

  • Are toolbox meetings held on a regular basis?

  • If so, are toolbox reports filed and visible?

4. E.R. bullet points:

  • Is the evacuation floorplan clearly visible?

  • Is the staff familiar with relevant information of the emergency response plan?

  • Is there a first aid kit present and sealed?

  • Are the fire extinguishers placed in a logical position and within reach?

  • Are the fire extinguishers sealed?

  • Are the fire extinguishers recently serviced?

  • Pictures (optional)

5. Condition of the workplace (general):

  • Is there a sufficient number of bins present?

  • Is the electrical equipment tested (including test label) and in good condition?

  • Is the temperature acceptable?

  • Is the ventilation adequate?

  • Are the lights in good condition?

  • Is the noise level acceptable?

  • Is housekeeping adequate?

  • Pictures (optional)

5.A. Condition of the workplace (quayside / yard / warehouse) - if applicable:

  • Are the spill kits in place and clearly visible?

  • Are the spill kits in good condition?

  • Are the walkways clearly indicated?

  • Are the walkways in good condition and free of trash / obstacles?

  • Is housekeeping adequate?

  • Pictures (optional)

5.B. Condition of the workplace (office) - if applicable:

  • Is the furniture height adjustable and in good condition?

  • Are the stair treads and handrails in good condition?

  • Is housekeeping adequate?

  • Pictures (optional)

5.C. Condition of the kitchen - if applicable:

  • Is the kitchen equipment (microwave, sandwich toaster, oven) clean?

  • Is the odor acceptable?

  • If refrigerators are present, are they clean?

  • Is content of refrigerator found to be still in date?

  • Is housekeeping adequate?

  • Pictures (optional)

6. Smoking areas - if applicable:

  • Is the ventilation adequate?

  • Is there a sufficient number of ashtrays present?

  • Is there a fire extinguisher available that meets the requirements as pointed out in chapter 4 of this SMAT model?

  • Is housekeeping adequate?

  • Pictures (optional)

7. Miscellaneous

  • Is the correct branding (logos) used?

  • Additional issues:

  • Additional pictures:

  • Initials SMAT Team leader

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.