Information

  • Unit Name

  • Director/Manager

  • Conducted on

  • Building

  • Floor

  • Floor Section

  • Environmental Health & Safety Representative

Fire & Life Safety

  • Fire alarm pull stations & fire extinguishers accessible?

  • At least 18" clearance below sprinkler heads for combustible storage?

  • Egress is free of obstructions and corridors free of clutter?

  • Fire doors and exits signs are visible, labeled, and operable?

  • Area is free of excessive combustible materials such as paper, cardboard, trash?

  • Area free of prohibited heating items (space heaters, toasters, toaster ovens)?

  • Storage & equipment rooms neat & orderly?

  • Area free of any electrical hazards?

Compressed Gasses

  • At least 3" clearance of combustibles from compressed gas storage?

  • Compressed gas cylinders secured to prevent tipping, falling, or rolling?

  • No more than 12 full "E" oxygen cylinders per smoke zone?

General

  • Aisles, walkways, and work areas free of slip, trip, and fall hazards?

  • Emergency Procedures "Quick Reference" guide is available & current?

  • Emergency & SDS (Safety Data Sheet) decals on staff phones?

  • Are Hazardous Material containers (pharmacy, hazardous, Biohazard) appropriate?

  • Microwaves in public areas labeled with "Heating of non-food items & linen strictly prohibited"?

  • Area free of all other safety hazards during inspection?

  • Comments

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.