Safety/5S Gemba Walk

• Document No.

• Safety Gemba Walk

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• What line are you inspecting this week?

  Select

Line/Facility

• Are employees wearing proper PPE (glasses, gloves, mittens, facemask, ear plugs, safety shoes etc..) And wearing properly?

  Yes

  No

  N/A

• Is there a clear and open path to the closest fire exit and any fire protection equipment in the area (i.e. fire extinguishers, sprinkler control valves).

  Yes

  No

  N/A

• Are the fire exit signs well lit?

  Yes

  No

  N/A

• Are mops, brooms, dust pans etc.. hung up, and is floor free of clutter and trip hazards?

  Yes

  No

  N/A

• Are there any unnecessary or obsolete items in the immediate work area?

  Compliant

  Non-Compliant

  N/A

• Is the area clean and free from unnecessary debris (glass, trash, grease, water, rags, etc...)

  Yes

  No

  N/A

• Are all chemicals on, or around, the line clearly marked and identified by name and the safety pictogram?

  Yes

  No

  N/A

• From a 5S perspective, what stands out as positive and what, if anything, stands out as negative on this line?

• Comments