Risk and Safety Site Inspection

• Risk and Safety Inspection Number

• Inspection Month

  Select

• Region - District - Location Type - City - Site

• District Manager

• Operations Manager

Training - Answer after asking random staff

• Do managers know how to handle hazardous materials?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do managers know which donations are prohibited?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do managers know where the gas shut off is located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do managers know where the electrical shut off is located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do managers know where the water and sprinkler shut off valves are located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do staff know where the fire extinguishers are located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Have staff been trained on the use of fire extinguishers?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do staff know where the nearest Emergency Exit is located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do staff know where their emergency assembly are is located and how to get there?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do staff understand Biohazard Controls?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do staff know where the First Aid and Bloodborne Pathogen kits are located?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are staff demonstrating proper lifting techniques?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

Safety Data - Answer if each of these items is current and present

• Safety Rules and Regulations on Safety Board

  Yes

  No

  N/A

• What needs improvement?

• List of CPR/First Aid trained associates on Safety Board

  Yes

  No

  N/A

• What needs improvement?

• Emergency shut down procedures on Safety Board

  Yes

  No

  N/A

• What needs improvement?

• OSHA 300 Summary page posted on Safety Board between February 1 and April 30

  Yes

  No

  N/A

• What needs improvement?

• Safety Data Sheets (SDS) Manual

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Corporate Polices poster in central location

  Yes

  No

  N/A

• What needs improvement?

• Department of Labor (DOL) poster in central location

  Yes

  No

  N/A

• What needs improvement?

• Clear Emergency Evacuation Plans posted in central locations

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

First Aid and Chemicals

• Is the Eye Wash Station bottle present and within expiration date?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there First Aid and Bloodborne Pathogen supplies available and readily accessible?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• If an AED is present, is it inspected monthly with the log completed?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are all chemicals properly stored?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are secondary chemical containers properly labeled and stored?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

Workstations

• Are workstations clean and accessible with no hazards?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are associates wearing appropriate PPE, such as gloves or safety glasses?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are sharp containers available and in use?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are needle-type ticket guns capped when not in use?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Workplace Hazard Assessments/PPE posted at each workstation and updated every 2 years

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

Merchandise and Storage

• Are all items, toys, merchandise, and storage out of the aisles, hallways, and walkways?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are materials stacked so nothing will fall and nothing is closer than 18" from the ceiling or sprinkler heads?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are all pallets in good condition?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are unused pallets stacked in a safe manner?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

Safety and Security

• Are electrical panels unobstructed?

  Yes

  No

  N/A

• What needs improvement?

• Is the water heater unobstructed?

  Yes

  No

  N/A

• What needs improvement?

• Is the sprinkler system unobstructed?

  Yes

  No

  N/A

• What needs improvement?

• Is the sprinkler system being inspected annually, and then more thoroughly every 5 years with tags completed?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are fire extinguishers charged and inspected monthly (by staff) and annually (by fire representative) with log completed?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there emergency lights and are they operational?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there exit signs lit and is the battery functional?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are Emergency Exits and egress paths clearly marked and unobstructed?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Do doors swing in the direction of exit?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are all floors clean and accessible with no tripping hazards?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there any exposed wires on equipment cords or plugs?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• If extension cords are being used, are they properly fused with circuit breakers?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are compactors, balers, and scissor lifts free of visual defects, such as worn labels or loose controls?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are external doors, server-room doors, and sensitive areas locked?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there any dangerous fixtures, equipment, or sharp objects on the sales floor?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there any unattended needle-type ticket guns on the sales floor?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Is the workplace secure so employees are not in danger?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Is the workplace secure so merchandise is not easily stolen?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Are there hazards in the parking lot, such as damaged tire stops, pot holes, or sidewalks?

  Meets Expectations

  Needs Improvement

  Unacceptable

  N/A

• What needs improvement?

• What needs improvement?

• Date inspection completed

  Date

• Inspection completed by - printed name

• Signature

  Sign

• Comments