Information

  • Safety Inspection

    This form is designed to assist safety coordinators to perform effective safety inspections. Please review conditions. If possible correct any unsafe conditions while performing the investigation. Any pending items should be corrected promptly.

  • Area Inspected

  • Location
  • Date

  • Coordinator:

  • Assisted By:

1. Volunteer Habits and Actions

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

2. Lockout/Tagout

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

3. Personal Protective Equipment

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

4. Equipment Safeguards

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

5. Hand and Power Tools

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

6. Heavy Equipment/Materials Handling

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

7. Ergonomics

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

8. Personal Safety/Passersby Hazards

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

9. Hazards (chemical, electrical, environmental, fire, etc.)

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

10. Emergency Response

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

11. Fall Prevention

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

12. Ladders

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

13. Housekeeping/Storage Methods

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

14. Building Integrity

  • Add an issue

  • Incident
  • Specific Location

  • Describe Unsafe Condition and Recommended Solution

  • Date

  • Initials

Sign Off

  • Coordinator:

  • Assisted By:

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.