Poudre Valley Office Inspection Checklist

• Employee Work Area Inspected

• Conducted on

  Date

• Prepared by

• Instructions:
  
  1. Answer "Yes", "No", "N/A" for the questions below.
  2. Add photos and notes by clicking on the paperclip icon.
  3. To add a Corrective Measure, click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
  4. Complete audit by providing digital signature.
  5. Share your report by exporting as PDF, Word, Excel or Web Link.

General Housekeeping

• Overall Cleanliness

  Satisfactory

  Un-Satisfactory

• Are desk and file drawers kept closed when not in use?

  Yes

  No

  N/A

• Are file cabinets loaded with the heaviest items in the bottom drawers?

  Yes

  No

  N/A

• Are wastebaskets placed where they will not create a tripping hazards?

  Yes

  No

  N/A

• Are surge protectors and/or extension cords properly used? No daisy-chaining

  Yes

  No

  N/A

• Is area free from trip hazards such as electrical or telephone cords exposed in areas where employees walk?

  Yes

  No

  N/A

• Is electrical wiring properly concealed?

  Yes

  No

  N/A

• Are paper and waste properly disposed of?

  Yes

  No

  N/A

• Is area free from excessive amounts of materials/items stacked on desks or cabinets?

  Yes

  No

  N/A

First Response Knowledge

• Do they know where the closest fire extinguisher is?

  Yes

  No

  N/A

• Do they know where the closest first aid and AED stations are located?

  Yes

  No

  N/A

• Can they look up a chemical on SDS online in case of an emergency?

  Yes

  No

  N/A

Emergency Action Plan

• Do they know what to do in case of a fire, tornado, active shooter, lockdown?

  Yes

  No

  N/A

• Do they know the code word for an active shooter event? "Paging Jeremiah"

  Yes

  No

  N/A

• Are they knowledgeable on where the rally points are for fire/active shooter?

  Yes

  No

  N/A

• Additional Comments

• Employee Signature

  Sign