Title Page

  • Conducted on

  • Prepared by

  • Location

Exits

  • Are all exit doors marked and illuminated by a reliable light source (are EXIT signs illuminated)?

  • Are all exits free of obstructions?

Walkways/Building Evacuation Routes

  • Are all aisles and passageways kept clear and clean?

  • Are building evacuation routes posted in appropriate areas?

  • Are stairways in good shape and kept clear?

Housekeeping / Ergonomics

  • Are workstations, kitchens and collaboration areas free of clutter that may cause slips, trips or falls?

  • No extension cords on floor in walk areas

  • Furniture arranged in such a manner that allows for easy employee access throughout work areas

  • No protruding sharp edges on furniture or accessories

  • No books or other objects hanging off overhead ledge

  • Closet shelves and file cabinets free of clutter that is in danger of falling off

  • Any other ergonomic issues?

  • Are storage rooms objects stacked appropriately and at recommended height?

Environmental

  • Are work areas properly illuminated (are any bulbs missing in light fixtures)?

  • Are ventilation systems working properly (are there any noticable odors or other foul smells)?

Fire Protection (Brittany to request information from Brookfield)

  • When was the last fire drill conducted?

  • Has the audible system been tested? When was it last tested?

Electrical

  • Are all electrical cords in good condition (no exposed electrical wires)?

  • Do all electrical switches and outlets have wall plate cover in good condition?

  • Are electrical power strips being used properly (following extension cord instructions)

  • Power strips and electrical cords are located away from chair wheels

  • Electrical closet: Are panels closed? Is area clean of debris? Is there easy access to panels?

COVID Related Items

  • Are hand sanitizer stations available and in working condition?

  • Is signage installed in common areas (conf. room capacity, social distancing stickers, etc.)?

  • Is office, kitchen and collaboration area furniture arranged appropriately following company COVID protocol

  • Is the Safety Assurance designation listing posted and up to date?

Other

  • Is the Fire Warden designation listing posted and up to date?

  • Are the First Aid/CPR/AED designation placards posted and certifications up to date?

  • Are the Fire Warden designation placards posted and certfications up to date?

  • Is the HSE Policy posted on the floor up to date?

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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.