Title Page
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Conducted on
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Prepared by
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Location
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Building Name
Fire and Life Safety
Fire Safety & Evacuation Plans
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Are all exit doors unlocked during business hours?
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Are all exits, aisles, corridors, or stairways clear and free of obstructions?
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Does the hardware of all exit doors in good condition and functioning properly?
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Is the area beneath stairs free of stored items?
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Do all lighted exit signs and emergency lighting functioning properly?
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Is there adequate emergency lighting throughout the building?
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Are monthly 30 second activation tests performed on all emergency lights?
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Are fire safety and evacuation plans implemented and communicated to all occupants?
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Are evacuation drills conducted periodically?
Housekeeping
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Are all areas free from combustible waste material that creates a fire hazard?
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Are combustible materials kept clear of ignition sources?
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Are oily and greasy rags kept in self-closing metal cans?
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Are exits and exit enclosures clear of combustible material storage?
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Are mechanical, electrical, and boiler rooms clear of combustibles?
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Are flammable liquids stored away from exits, aisles, corridors, or stairways?
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Are flammable liquids stored in approved portable containers?
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Are flammable liquid containers in excess of 10 gallons stored in approved flammable storage cabinets?
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Are all sprinkler heads unobstructed with a minimum of 18 inches of clearance?
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Are all sprinkler heads free from any hanging materials or decorations?
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Are all compressed gas cylinders properly used, stored, and secured upright to prevent tipping?
Fire Prevention/Protection
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Are fire alarms inspected, tested and maintained according to NFPA 72?
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Are sprinkler systems (water) inspected, tested and maintained according to NFPA 25?
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Are other fire suppression systems inspected, tested and maintained?
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Are fire pumps inspected, tested and maintained according to NFPA 25?
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Are emergency generators tested monthly?
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Are smoke detectors located in proper areas and tested periodically?
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Is the sprinkler system water supply valve accessible and locked in the "ON" position?
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Are the sprinkler control valves are on and all zones are pressurized?
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Do fire lanes provide access to the building and remain unobstructed?
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Is access to all fire protection equipment unobstructed (OSY valves, etc.)?
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Are fire extinguishers visually inspected monthly/ tested annually (NFPA 10)?
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Are fire extinguishers available, visible, and unobstructed (NFPA 10)?
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Are there designated smoking areas with "No Smoking" signs posted and is the policy enforced?
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Are self-closing fire doors function properly and free of obstruction?
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Are all portable heat producing appliances visually inspected regularly or have an auto shut-off?
Hazardous Materials
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Are Safety Data Sheets readily available on the premises with an inventory of all hazardous materials?
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Are there visible hazard identification signs at the entrances where hazardous materials are stored?
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Are all chemical containers properly labeled?
Electrical Safety
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Are computer rooms properly wired and provided with adequate electrical services?
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Is back up power and sure protection provided to sensitive electronic equipment?
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Is extension cord use kept to a minimum and used only for temporary service (less than 90 days)?
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Are all electrical cords in good condition and properly grounded (no damaged external housing, electrical tape, or missing grounding pin)?
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Are outlets and switch cover plates present?
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Is there any evidence of daisy chaining (surge protectors plugged into other surge protectors)?
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Are Ground Fault Circuit Interrupter outlets used on all exterior outlets and within 6 feet of any plumbing fixture?
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Are circuit breakers protected against tampering (access panels locked in public areas)?
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Do transformers and electrical panels have 3 feet of clearance maintained around them?
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Is there signage or brightly colored tape on the floor to remind employees to maintain clearance?
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Do all electrical panels have dead front covers in place and no open slots?
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Are electrical panel circuits properly labeled?
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Is Lockout Tagout equipment available to employees (locks, tags, group locks, etc.)?
Walking/Working Surfaces
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Are floors, doorways, stairs, and hallways in good condition and free of trip hazards?
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Are there areas that routinely become slippery when wet?
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Are these areas handled appropriately?
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Are there adequate walk-off mats at all entrances?
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Are walk-off mats in good condition with no frayed or curling corners and edges?
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Are walk-off mats replaced when saturated?
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Are stairs treads free of defects (smooth or rounded edges)?
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Are sidewalks, curbs, parking lots, and public areas in good condition and free of slip, trip, or fall hazards?
Security
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Is the entire building protected by a security alarm?
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How is the alarm monitored?
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Are high value areas (PC, labs, video, music, etc.) provided with additional security (locks, alarms, etc.)?
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Are all doors to the building kept locked during non-business hours?
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Are all staff members wearing identification badges?
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Is the building routinely patrolled by a security guard?
Kitchens/Dining Services
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Does this building have a kitchen?
Kitchen Fire Safety
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Are automatic wet-chemical extinguishing systems installed in the hoods and ducts above ranges, grills, and fat fryers?
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Are extinguishing systems inspected and serviced by a qualified person on an annual basis?
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Do fuel supplies for cooking equipment have automatic shut-off valves that activate with the extinguishing system?
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Are the proper types and quantity of fire extinguishers (class K) unblocked and readily available?
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Are fire extinguishers properly charged, tagged, and inspected?
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Is food served in this building?
Food Handling Practices
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Is food kept in pans of containers located off of the floor?
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Are perishable or potentially hazardous food properly stored and not held at room temperature?
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Are fruits and vegetables thoroughly washed prior to preparation and serving?
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Are food warmers and steam tables used to heat prepared foods and holding temperature?
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Are frozen foods properly thawed under refrigeration or under cold running water or cooked directly from frozen state?
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Are cutting boards washed and sanitized when switching between raw food and cooked/ready-to-serve food?
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Are utensils (not hands) used to pick up rolls, bread, butter, pats, ice, or other food to be served?
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Do employees wash hands after wiping tables and busing soiled dishes prior to handling place settings and serving food?
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Are food servers careful to not touch food contact surfaces of plates, cups, and silverware when setting tables or serving customers?
Kitchen & Food Operations
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Are kitchen waste materials stored in metal containers with tight-fitting lids kept in designated areas and removed by carts to compactor or dumpster?
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Are deep fryers controlled and provided with high-temperature shut offs and overflow gutters?
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Are exhaust system filters cleaned daily?
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Are exhaust systems hoods and ducts located away from any combustible materials?
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Are vapor-proof electric lights and conduit wiring provided fro electrical equipment located in exhaust-system hoods?
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Are floors adjacent to deep fryers dry and free of grease?
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Are floors adjacent to soft drink syrup tanks cleaned regularly?
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Are proper guards installed on all meat slicing machines?
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Are chairs and tables free of pinch points and sharp edges?
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Are slip resistant mats provided for dish washing areas?
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Are knives placed in sheaths when not in use?
Performing Arts/Theater
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Does this building have a performing arts theater?
Storage
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Are storage shelves arranged in a safe manner (no risk of tipping) and not overloaded?
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Are file draws kept closed when not in use?
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Are materials stored to minimize unecessary climbing, reaching, and bending?
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Are flammable and combustible materials stored away from ignition sources?
Walking Surfaces, Stairways, & Ramps
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Are the building entrances, aisles, and work areas free of any slip, trip or fall hazards?
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Are walk off mats used and extended during wet weather?
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Are walk off mats replaced as needed (curling edges and soaked mats)?
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Is good housekeeping practiced with no trip hazards such as materials, cords, wires, paper, and equipment?
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Are carpets and rugs secure and in good condition?
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Are floors clean, dry, and free of slippery materials?
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Are stairways, ramps, and corridors clear and free of stored materials?
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Do ramps have non-slip surfaces?
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Are handrails and guardrails present where required and in good condition?
General Safety and Housekeeping
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Are work tables, desks, and chairs in good condition?
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Are step stools and ladders available to facilitate reaching items stored overhead?
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Are sharp and pointed tools shielded to prevent accidental contact?
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Are good housekeeping practices in place?
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Are restrooms clean and fixtures secure?
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Are Safety Data Sheet Inventories up to date and accessible?
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Are primary and secondary chemical containers labeled and identify contents and hazards?
Grids/Catwalks
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Is access to tension grids and catwalks controlled and restricted to unauthorized personnel?
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Are pall prevention or arrest systems in place and functional on all fixed ladders?
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Are guardrails (top and mid rails) and toe boards secure on all tension grids and catwalks?
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Are gates/guards on ladder access openings kept closed?
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Are counter weights stacked below the top level of toe boards?
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Are signs present to warn against stacking counter weights higher than the top of the toe boards?
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Are counter weights evenly distributed along the loading platform?
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Are tension grids and catwalks free of other stored items?
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Are tension grids and catwalks free of graffiti?
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Are light and audio fixtures/equipment secured to battens with primary and secondary restraints?
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Are all rigging ropes and cables in good condition and routinely inspected by a qualified person?
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Are all rigging ropes and cables inspected by a qualified outside contractor every 5 years?
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Are hoists and beams clearly labeled with maximum capacities?
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Are line set weight-capacity signs present on the loading bridge?
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Are personnel using personal fall protection devices appropriately?
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Are personnel wearing hard hats with chin straps areas with low overhead clearance?
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Do personnel tie off tools when working on elevated surfaces?
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Are personnel wearing other personal protective equipment as required by the task?
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Safety and warning signs present in appropriate areas?
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Is access to controlled areas restricted to unauthorized personnel?
Science Laboratories
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Does this building have a Science Laboratory?
Administrative
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Do the lab staff have access to the current version of the Notre Dame Laboratory Safety Manual?
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Do all lab personnel have access to written SOPs that document safety procedures?
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Do all lab staff know how and when to report accidents, incidents, or near-misses?
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Is food and drink prohibited in laboratory areas?
Signage
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Are emergency contact numbers for lab staff, including after hours emergency contact numbers, posted within the laboratory?
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Is a lab hazard caution sign posted and current?
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Is a bio-safety sign posted when agents are in use?
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Are additional hazard warning signs (laser, magnetic fields, high voltage, etc.) posted in the lab near the hazard?
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Is a laboratory floor plan as described in the Laboratory Safety Manual posted?
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Are caution signs posted on entrance doors identifying hazards in the lab (bio-hazards, UV light, radiation, etc.)?
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Are "No Food/Drink" signs posted throughout the lab?
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Are all foodstuffs intended for lab use labeled "Not for Human Consumption" or "For Laboratory Use Only"?
Hazard Communication
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Has the lab's chemical inventory been reviewed and updated within the last year?
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Can all lab staff readily access an MSDS/SDS either digitally or by hard copy?
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Are all containers clearly labeled with their contents and primary hazard(s)?
Emergency Kits
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Does the laboratory have access to chemical/biological spill kits?
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Do lab staff have access to a fully stocked first aid kit?
Personal Protective Equipment
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Has a PPE hazard assessment been completed for all laboratory activities?
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Have all lab personnel and students completed PPE training?
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Are safety googles and lab coats required for all lab activities?
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Is additional PPE required for task specific lab activities (chemical resistant gloves, face shield, respirators, etc.)?
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If respirators are being used, have personnel and students been fit tested?
Emergency Eyewash/Shower
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Are eyewashes and showers easily accessible in each laboratory?
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Are eyewashes and showers routinely flushed?
Fume Hoods
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Are processes that emit vapors, gasses, or fumes adequately captured by local ventilation?
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Are activities involving hazardous chemicals restricted to the fume hoods?
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Are fume hoods kept uncluttered and are rear ventilation slots within the hood unblocked/covered?
Hazardous Waste Disposal
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Are chemical waste containers in good condition and compatible with their contents?
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Are chemical waste containers kept closed?
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Are incompatible chemical wastes segregated by hazard class?
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Are all chemical waste containers labeled?
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Are Bio-hazard waste containers available for disposal of biologically contaminated waste?
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Is lab glass placed in sturdy cardboard boxes that are labeled "BROKEN GLASS"?
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Are Sharps containers available for the disposal of blades and needles?
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Is all waste being disposed of in its appropriate container?
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Are all waste containers emptied regularly to avoid excessive accumulation?
Chemical Storage
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Are flammable chemicals stored in an approved flammable storage cabinet?
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Are hazardous materials dated, rotated, inventoried annually, and disposed of properly?
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Are all chemical containers in good condition (no corrosion or leaking)?
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Are all chemical containers kept closed?
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Are incompatible chemicals segregated when they are being stored?
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Are chemicals stored per a recognized system (i.e.: Flinn)?
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Are chemicals stored on shelves below eye level?
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Are chemicals stored on shelves with abrasive surfaces or lips to prevent spills?
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Are all chemicals properly labeled following the Globally Harmonized labeling system?
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Are all chemicals routinely rotated and disposed of as needed?
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Are all expired chemicals promptly disposed of?
Compressed Gas Cylinders
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Are highly toxic gas cylinders stored in a gas cabinet, ventilated enclosure, or fume hood?
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Are incompatible compressed gas cylinders segregated?
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Are gas cylinder valve protection caps in place for gas cylinders not in active use?
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Are compressed gas cylinders secured to prevent them from falling or tipping?
Housekeeping
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Is the lab free of slip and trip hazards?
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Is the lab adequately organized, orderly, and clean to provide sufficient work space for operations without spills, accidents, and other preventable incidents?
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Is there minimal glassware stored in the sink or on the bench top?
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Are lab coats regularly laundered?
Fire Safety
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Are fire extinguishers available, easily accessible, and free of obstructions?
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Are the appropriate class of fire extinguishers provided for the lab activities (Class B for Flammable Liquids, Class D for Metals, etc.)?
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Is a fire blanket provided in the lab room?
Machinery
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Are all hazardous pieces of machinery mounted or secured to prevent movement or tipping?
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Are all points of operation, rotating components, and other moving parts of machinery properly guarded to prevent injury?
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Is laboratory equipment with potential hazards routinely inspected and maintained or serviced as recommended?
Art Department
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Does this building have any art studios?
General Safety
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Does the studio/shop present a clean and overall safe working environment?
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Is there a telephone nearby with emergency numbers posted? Do Shop personnel know who to contact in the event of an emergency?
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Is everyone in the studio/shop wearing proper personal protective equipment for the task they are performing (coveralls, safety glasses, gloves, respirators, hearing protection)?
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Are eyewash/showers properly located, clearly visible, and unobstructed?
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Are eyewash/showers tested and flushed monthly?
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Are spray painting operations performed inside a an approved spray painting booth?
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Is food and drink kept out of the studio/shop at all times?
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If NIOSH approved respirators are used, have personnel been fit tested and trained on proper use and limitations?
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Are machinery and tools inspected periodically and maintained/repaired as needed?
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Are kilns ventilated, inspected, and managed appropriately?
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Are all machine guards installed per the manufacturer's recommendation and in working condition?
Hazardous Waste Management
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Are waste containers being used for the correct type of waste?
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Are all liquid hazardous waste containers stored in a secondary containment unit?
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Are all waste containers labeled with hazardous waste labels?
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Are incompatible wastes segregated by distance or secondary containment?
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Are the waste containers in good condition and compatible with the waste they contain?
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Are all oily/solvent soaked rags collected in an appropriate metal flameproof container with a lid?
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Are waste containers kept securely closed except when adding waste?
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Is the hazardous waste vendor contacted promptly when a container is filled?
Pools
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Does this building have a pool on site?
General Safety
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Are "No Diving" signs clearly posted and legible?
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Are pool depths are clearly and accurately marked?
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Is safety and rescue equipment is available and in working order (shepherd's hook, life ring, backboard, first aid kit, etc.)?
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Is the pool area secured during non operating hours?
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Is unauthorized entry prevented during non-operational hours by using enclosures such as fencing, gates, locks, etc.?
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Are "No lifeguard on duty" signs clearly posted when pool is not staffed?
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Is pool lighting sufficient and working properly?
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Are documented inspections of the pool area lerformed on a regular basis to ensure the safety and security of the area?
Are lifeguards required to:
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Be at least 16 years old?
Maintain a current lifeguarding certification from a nationally recognized agency such as:
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American Red Cross?
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YMCA?
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StarGuard?
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Ellis & Associates?
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Other?
Maintain certification in life saving skills such as:
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Cardiopulmonary Resuscitation (CPR)?
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First Aid?
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Automated External Defibrillator (AED) use?
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Emergency Oxygen administration?
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Other?
Emergency Planning
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Does the facility have a response plan for bodily fluids (feces, vomit, or blood)?
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Does the facility have a response plan for inclement weather?
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Does the emergency plan include methods of communication with first responders, emergency services, and pool patrons?
Operations Manual
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Is the operations manual accessible at the pool?
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Does the manual include a list of pool chemicals and instructions for their safe handling?
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Does the plan detail communication protocols for notifying administrators and closing the pool?
Water Quality Monitoring
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Does the facility maintain a chemical inventory that provides a list of chemicals used?
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Is proper Personal Protective Equipment provided for safe handling of pool chemicals?
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Is an eye wash station located in the pool chemical storage area?
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Is water quality and chemical levels monitored on a daily basis?
Facilities Department
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Does the building contain a facilities department?
General Work Environment
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Are all work sites clean and orderly? (Include pictures).
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Are all work areas adequately illuminated?
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Are covered metal waste cans used for oily and paint soaked waste?
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Are all hand and power tools stored properly and kept in good condition?
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Are flammable liquids and chemicals stored properly and kept in a reasonable quantity?
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Are fire extinguishers easily accessible and fully charged?
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Are aisles and walkways that pass near moving or operating machinery arranges so employees are not subjected to hazards?
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Are materials and equipment stored in such a way that protuberances do not interfere with the walkway?
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Are materials and equipment stored in such a way that they cannot shift or fall?
Personal Protective Equipment (PPE)
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Are approved safety glasses required to be worn at all times in areas where there is a risk of eye injuries such as punctures, abrasions, contusions, or burns?
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Does the facility have adequate eye wash stations in areas where there is a risk of eye injuries?
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Are protective gloves, aprons, shields, or other means provided to protect against cuts, corrosive liquids, and chemicals?
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Are hard hats provided and worn where there is a danger of falling objects?
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Are hard hats inspected periodically for damage to the shell and suspension system?
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Is appropriate foot protection required where there is a risk of foot injuries?
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Is all PPE maintained and stored in a sanitary condition and ready for use?
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Is specialized equipment such as gloves provided when working with electricity?
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Is hearing protection provided for jobs or in areas with excessive noise?
Portable Ladders
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Are all ladders maintained in good condition, joints between steps and side rails tight, all hardware and fittings securely attached, and no signs of excessive ware?
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Are all ladders equipped with non-slip safety feet that are in good condition?
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Are all ladder rungs and steps free of grease and oil?
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Is it prohibited to place a ladder in front of doors opening toward the ladder except when the door is blocked open, locked, or guarded?
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Are all ladder rungs uniformly spaced at 12 inches apart?
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Are all ladders regularly inspected for damage?
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Are employees instructed to tag and remove all damaged ladders from service?
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Are employees instructed to not use the top two steps of ordinary stepladders as a step?
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Are employees instructed, when gaining access to an elevated surface, to tie off ladders or extend the top at least three feet above the elevated surface?
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Are employees instructed in safe ladder practices such as maintaining three points of contact, remaining within the side rails, and facing the ladder when ascending/descending?
Hand Tools & Equipment
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Are all tools and equipment (both college and employee owned) in good condition, free of cracks, burns, corrosion, or other signs of ware?
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Are hand tools such as chisels and punches, which develop mushroomed heads during use, reconditioned or replaced as necessary?
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Are broken or fractured handles on hammers, axes, and similar equipment replaced immediately?
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Are worn or bent wrenches replaces regularly?
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Are cutting tool edges kept sharp so the tool will move smoothly without binding or skipping?
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Are tools stored in a dry and secure location where they will not be tampered with?
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Are employees made aware of hazards caused by faulty or improperly used hand tools?
Power Operated Tools & Equipment
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Are all power operated tools provided with appropriate safety guards as recommended by the manufacturer?
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Are all guards properly installed and show no signs of removal or tampering?
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Are all cord-connected, electrically operated tools and equipment effectively grounded or of the approved double insulated type?
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Is hoisting equipment available and used for lifting heavy objects and are the hoist ratings/characteristics appropriate for the task?
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Are pneumatic and hydraulic hoses on power-operated tools checked regularly for deterioration or damage?
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Are the work rests on all abrasive wheels adjusted to within 1/8 inch of the wheel?
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Are the top guards on all abrasive wheels adjusted to within 1/4 inch of the wheel?
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Do the side guards on all abrasive wheels cover the spindle, nut, flange, and 75% of the wheel diameter?
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Is the maximum RPM rating of each abrasive wheel compatible with the RPM rating of the motor?
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Are the benches and pedestals for all abrasive wheels permanently mounted?
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Are all new abrasive wheels visually inspected and ring tested prior to mounting?
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Are dust collectors provided on all grinders used in operations that produce an abundance of dust?
Power Actuated Tools
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Are employees who operate power actuated tools trained in their use and carry a valid operator's card?
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Is each power actuated tool stored in its own locked container when not in use?
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Are signs reading "POWER ACTUATED TOOL IN USE" conspicuously posted in the areas where the tools are being used?
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Are power actuated tools left unloaded until they are actually ready to be used?
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Are power actuated tools inspected for obstructions or defects each day prior to use?
Groundskeeping
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Does the building have a groundskeeping department?
Personal Protective Equipment
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Are all employees required to wear long sleeved shirts and pants while performing grounds keeping tasks?
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Are safety glasses, goggles, and face shields used for appropriate tasks?
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Are appropriate gloves provided and used for task specific jobs?
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Are steel toed, slip resistant boots used when appropriate?
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Is appropriate head ware provided and used for specific tasks (straw hats, baseball caps, hard hats)?
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Is PPE in good working condition, free from cracks, burns, or sun damage?
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Is sun screen (minimum 30 SPF) available to employees when necessary?
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Is bug spray available to employees when necessary?
General Safety
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Have all employees been properly trained on all pieces of equipment?
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Have all employees read and know where to find the safety manual?
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Are all employees aware of the hazards associated with operating specific equipment?
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Are emergency telephone numbers clearly posted?
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Is a first aid kit available and do employees know how to use the contents?
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Do all employees have access to the Safety Data Sheet?
Boilers/HVAC
Boilers
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Are boiler safety relief valves inspected and tested monthly?
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Are boiler low water cut-off valves inspected monthly?
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Are boiler and other mechanical rooms secured against unauthorized entry?
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Are boiler logs maintained and on-site fore review?
HVAC
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Is the facility free of any standing water?
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Are there any signs of mold or indoor air quality issues?
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Are ceiling tiles, air handling units, intakes, and mechanical rooms free of excessive moisture?
Employee Interviews
Training
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Are employees trained in fire safety and evacuation plans at orientation and again annually?
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Have all employees been trained in Emergency Evacuation and Response?
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Is the training documented?
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Have all employees been trained in the location and use of emergency equipment such as emergency shut offs, spill kits, eyewash/shower, AED, and first-aid kits?
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Have all employees been trained in Bloodborne Pathogen Response?
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Is the training documented?
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Have all employees been trained in Hazard Communication and the Globally Harmonized System?
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Is the training documented?
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Are employees aware of the location of Safety Data Sheets?
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Are appropriate employees trained in electrical safety practices such as Lockout Tagout?
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Are employees aware of the location of Safety Data Sheets?