PFP -Temporary gym health and safety audit

• Audit Title

• Prepared by

• Site name

• Conducted on

  Date

• Attendees

Inspection report requirements and metrics

• Cleaning/H&S inspection shall be performed Daily by the Gym manager (or authorized representative).

• Key:
  
  Good = 10 points
  Fair = 5 points
  Poor = 0 points
  
  Yes = 10 points
  No = 0 points
  NA = 10 points

Equipment Checks

• Recumbent Cycles

  Safe

  At Risk

  N/A

• Rowers

  Safe

  At Risk

  N/A

• Benches

  Safe

  At Risk

  N/A

• Leg Press

  Safe

  At Risk

  N/A

• Seated Leg Curl

  Safe

  At Risk

  N/A

• Seated Leg Extension

  Safe

  At Risk

  N/A

• Converging Chest Press

  Safe

  At Risk

  N/A

• Chest Press

  Safe

  At Risk

  N/A

• Lat Pulldown

  Safe

  At Risk

  N/A

• Diverging Seated Row

  Safe

  At Risk

  N/A

• Shoulder Press

  Safe

  At Risk

  N/A

• Converging Shoulder Press

  Safe

  At Risk

  N/A

• Core Bags

  Safe

  At Risk

  N/A

• Bosu Ball

  Safe

  At Risk

  N/A

• Exercise Ball

  Safe

  At Risk

  N/A

• Medicine Balls

  Safe

  At Risk

  N/A

• Upright Bikes

  Safe

  At Risk

  N/A

• Cross Trainers

  Safe

  At Risk

  N/A

• Treadmills

  Safe

  At Risk

  N/A

• Decline Bench

  Safe

  At Risk

  N/A

• Floor area

  Good

  Average

  Poor

• Matted Streching Area

  Good

  Average

  Poor

• Desk area

  Good

  Average

  Poor

• Cleaning Stations

  Good

  Average

  Poor

Assessors signatures

• Gym Manager or authorized representative

  Sign