Title Page

  • Company/ Facility Name

  • Site

  • Facility Area

  • Conducted on

  • Prepared by

  • Location

Assessment Part One

Training

  • Is training provided for each person newly assigned to a job?

  • Does initial training include a thorough review of hazards and accidents associated with the job?

  • Is adequate instruction in the use of personal protective equipment provided?

  • Is training for the use of emergency equipment provided?

Environment

  • Are work surfaces and grip surfaces safe when wet?

  • Are elevated work areas properly guarded?

Work Process

  • Are repetitive motion tasks properly paced and kept to a minimum?

  • Are the material safety data sheets placed in locations accessible to all employees?

  • Are hazards signalled by signs and tags?

  • Have all trucks, forklifts and other equipment been inspected and maintained?

  • Are lockout or tagout procedures in place and followed?

  • Is ventilation equipment working effectively?

  • Is the dust collection system working correctly?

  • Are the safety showers and eye wash stations in the proper locations and in good working condition?

Fire Emergency Procedures

  • Is there a clear fire response plan posted for each work area?

  • Do all workers know the plan?

  • Are drills held regularly?

  • Are fire extinguishers chosen for the type of fire most likely in that area?

  • Are there enough extinguishers present to do the job?

  • Are extinguisher locations conspicuously marked?

  • Are extinguishers properly mounted and easily accessible?

  • Are all extinguishers fully charged and operable?

  • Are extinguisher inspections up to date on all extinguishers?

Means of Exit

  • Do employees have easy access to exits?

  • Are exits unlocked to allow egress?

  • Are exits clearly marked?

  • Are exits and exit routes equipped with emergency lighting?

  • Are exits and exit routes unblocked and free of clutter?

Warehouse and Shipping

  • Are dock platforms, bumpers, stairs and steps in good condition?

  • Are light fixtures in good condition?

  • Are all work areas clean and free of debris?

  • Are stored materials properly stacked and spaced?

  • Are floors free of oil spillage or leakage?

  • Is absorbent available for immediate clean-up of spills and leaks?

  • Are all flammable and combustible products stored appropriately? For example: Are Class I (one) flammable products (as per NFPA or your local fire code) stored in Class I approved buildings or outside the warehouse?

Loading/Unloading Racks

  • Are steps, railings and retractable ramps on raised platforms in good repair?

  • Is piping and in-line equipment in good condition and free of leaks?

  • Are loading arms operating satisfactorily?

  • Are bonding and grounding cables free of breaks or damage?

  • Are connections tight and sound?

  • Is the general condition of wiring and junction boxes, etc. in good condition (visual inspection)?

Lighting

  • Is the level of light adequate for safe and comfortable performance of work?

  • Is emergency lighting adequate and regularly tested?

Machine Guards

  • Are all dangerous machine parts adequately guarded?

  • Do machine guards meet standards?

  • Are lockout procedures followed when performing maintenance with guards removed?

Electrical

  • Are all machines properly grounded?

  • Are portable hand tools grounded or double insulated?

  • Are junction boxes closed?

  • Are extension cords out of the aisles where they can be abused by heavy traffic?

  • Is permanent wiring used instead of extension cords?

  • Please proceed to the next section.

Assessment Part Two

Tools and Machinery

  • Are manufacturers' manuals kept for all tools and machinery?

  • Are defective tools/machinery tagged and removed from service as part of a regular maintenance program?

  • Are tools and machinery used so as to avoid electrical hazards?

  • Is proper training given in the safe use of tools and machinery?

Confined Spaces

  • Are the confined space procedures and training available and followed by all involved?

  • Are confined spaces properly identified and marked?

  • Are entry and exit procedures adequate?

  • Are emergency and rescue procedures in place (e.g. trained safety watchers)?

Housekeeping

  • Is the work area clean and orderly?

  • Are floors free from protruding nails, splinters, holes and loose boards?

  • Are aisles and passageways kept clear of obstructions?

  • Are permanent aisles and passageways clearly marked?

  • Are covers or guardrails in place around open pits, tanks and ditches?

Stairs, Ladders and Platforms

  • Are stairs and handrails in good condition?

  • Are ladders free of defects?

  • Are ladders set up properly before use?

  • Are the elevated platforms properly secured and do they have handrails?

Sound Level/Noise

  • Are regular noise surveys conducted?

  • Is hearing protection available and used properly?

Employee Facilities

  • Are facilities kept clean and sanitary?

  • Are facilities in good repair?

  • Are cafeteria facilities provided away from toxic chemicals?

  • Are hand washing facilities available?

Medical and First Aid

  • Do all employees know how to get first aid assistance when needed?

  • Do the first-aiders know when and to which hospital or clinic an injured person should be taken?

  • Are there employees trained as first-aid practitioners on each shift worked?

  • Are first-aid kits provided as per jurisdiction’s first-aid regulations?

  • Are first-aid supplies replenished as they are used?

Personal Protective Equipment (PPE)

  • Is required equipment provided, maintained and used?

  • Does equipment meet requirements?

  • Is it reliable?

  • Is personal protection utilized only when it is not reasonably practicable to eliminate or control the hazardous substance or process?

  • Are the areas requiring PPE usage properly identified by warning signs?

Materials Handling and Storage

  • Is there safe clearance for all equipment through aisles and doors?

  • Is stored material stable and secure?

  • Are storage areas free from tipping hazards?

  • Are only trained operators allowed to operate forklifts?

  • Are necessary warning devices and signs in use for railway sidings?

  • Are specifications posted for maximum loads which are approved for shelving, floors and roofs?

  • Are racks and platforms loaded only within the limits of their capacity?

  • Are chain hoists, ropes and slings adequate for the loads and marked accordingly?

  • Do personnel use proper lifting techniques?

  • Is the size and condition of containers hazardous to workers?

  • Are elevators, hoists, conveyors, balers, etc., properly used with appropriate signals and directional warning signs?

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