Safety and Housekeeping Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Floors and aisles

• Are floors and aisles clean and free of dirt, scrap, and tripping hazards?

  Safe

  At Risk

  N/A

• Are materials and equipment stacked in aisles?

  Safe

  At Risk

  N/A

• Is there any water, oil, or grease patches on floors from spillage or dripping

  Safe

  At Risk

  N/A

• Which cell would you consider the cleanest

  Safe

  At Risk

  N/A

Stairs/Platforms/Ladders

• Are exits clear of scrap and stored materials inside, and clear of debris and snow outside

  Safe

  At Risk

  N/A

• Are stairways provided with railings

  Safe

  At Risk

  N/A

• Are trash containers available and properly marked

  Safe

  At Risk

  N/A

• Are ladders in good repair and properly used

  Safe

  At Risk

  N/A

Scrap Handling and DIsposal

• Are trash containers available and properly marked

  Safe

  At Risk

  N/A

• Are containers emptied regularly

  Safe

  At Risk

  N/A

• Does scrap tend to collect and become a fire hazard

  Safe

  At Risk

  N/A

Material Storage

• Are materials/finished goods damaged and stacked safely

  Safe

  At Risk

  N/A

• Are returnable containers (full or empty) on floor level

  Safe

  At Risk

  N/A

• Do piles of material interfere with exits or sprinkler pipes

  Safe

  At Risk

  N/A

• Are there broken/damaged pallets or pieces of skids in manufacturing or shipping area

  Safe

  At Risk

  N/A

Fire Protection/Prevention

• Are exits properly marked

  Safe

  At Risk

  N/A

• Are fire extinguishers conveniently located and properly marked

  Safe

  At Risk

  N/A

• Are extinguishers checked periodically for damage and is recharging date indicated. Use facility map to locate all extinguishers. Initial and date tag on each if all is ok.

  Safe

  At Risk

  N/A

• Is hot work permit system current or any permits expired

  Safe

  At Risk

  N/A

• Is maintenance staff familiar with the Sprinkler Work Permit system and requirements

  Safe

  At Risk

  N/A

Electrical Equipment, Lighting, and Wiring

• Are electrical circuits, equipment, and powered hand tools properly grounded

  Safe

  At Risk

  N/A

• Are extension cords adequate, in good condition, and properly used

  Safe

  At Risk

  N/A

• Is the required 36 inches clearance in front of electrical panels maintained

  Safe

  At Risk

  N/A

Storage of Flammable Liquids

• Are storage buildings and cabinets adequate, properly marked and well maintained

  Safe

  At Risk

  N/A

• Are all flammable liquids for in plant use kept in safety containers

  Safe

  At Risk

  N/A

• Are flammable liquids properly marked

  Safe

  At Risk

  N/A

• Is there any location in the plant with more than 60 gallons of flammable material in one location, excluding hydraulic oil

  Safe

  At Risk

  N/A

Machinery, Equipment, Tools, Fixtures

• Are point of operation guards in place and properly adjusted

  Safe

  At Risk

  N/A

• Are safety switches and gates in place and operating properly

  Safe

  At Risk

  N/A

• Are all noise abatement guards in place

  Safe

  At Risk

  N/A

• Do you have any suggestions for reducing noise in the production area

  Safe

  At Risk

  N/A

• Use facility map and check all pedestal grinders. Tool rest adjustment - 1/8 inch max. Tongue guard adjustment - 1/4 inch max.

  Safe

  At Risk

  N/A

• Are all overhead doors safety switches functioning properly

  Safe

  At Risk

  N/A

• Is equipment in the manufacturing cells clean and wiped down

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Are safety glasses/face shields provided and used in designated areas

  Safe

  At Risk

  N/A

• Are gloves provided and used when handling solvents or working in purge areas

  Safe

  At Risk

  N/A

• Are ear plugs provided for use in high noise areas

  Safe

  At Risk

  N/A

• Are eye wash fountains/safety showers provided where required

  Safe

  At Risk

  N/A

• Are logs for testing of hard plumbed eyewash/showers maintained. Use facility map for locations.

  Safe

  At Risk

  N/A

Safety Program and Education

• Is an active safety program in place

  Safe

  At Risk

  N/A

• Are safety committee meetings held on a regular basis with documentation of minutes

  Safe

  At Risk

  N/A

• Are all accident reports reviewed with action plans put into effect to prevent reoccurrence

  Safe

  At Risk

  N/A

• Are safety meetings conducted on a regular basis to train employees in safe working procedures

  Safe

  At Risk

  N/A

• Is safety information posted regularly and distributed to employees when appropriate

  Safe

  At Risk

  N/A

• Is there a follow up corrective action plan to correct safety discrepancies

  Safe

  At Risk

  N/A

First Aid

• Are trained personnel available on all shifts to render first aid

  Safe

  At Risk

  N/A

• Are first aid supplies and facilities adequate

  Safe

  At Risk

  N/A

• Is there a posted list of personnel trained in first aid

  Safe

  At Risk

  N/A

• Does AED battery read OK

  Safe

  At Risk

  N/A

• Record use before date of AED unit (upper right corner of unit)

  Safe

  At Risk

  N/A

HCS Compliance

• Are all personnel aware of and trained in the requirements of the hazardous communication program and right to know laws

  Safe

  At Risk

  N/A

• Are the appropriate personnel trained in regard to hazards associated with specific chemical substances used in their department

  Safe

  At Risk

  N/A

• Is the written HCS available to employees for their review

  Safe

  At Risk

  N/A

• Are current inventory lists of all chemical substances available for each department

  Safe

  At Risk

  N/A

• Is a MSDS available for each chemical on the list and if not has one been requested

  Safe

  At Risk

  N/A

• Are MSDS's available to personnel in the using departments

  Safe

  At Risk

  N/A

• Are legible labels applied to all containers

  Safe

  At Risk

  N/A

Gas Cylinders ( LP/Oxygen/Acetylene )

• Are cylinders stored properly

  Safe

  At Risk

  N/A

• Are cylinders chained to hand carts or properly strapped to lift trucks

  Safe

  At Risk

  N/A

Unsafe Practices

• Failure to use protective equipment

  Safe

  At Risk

  N/A

• Climbing on presses or other equipment

  Safe

  At Risk

  N/A

• Improper lifting

  Safe

  At Risk

  N/A

• Improper use of air hoses

  Safe

  At Risk

  N/A

• Horseplay or other unsafe acts

  Safe

  At Risk

  N/A

• Are lift equipment (forklift,man lift,order pickers) safety checklists filled out and up to date

  Safe

  At Risk

  N/A

Emergency Procedures and General Safety Precautions

• Are emergency procedures setup and are employees aware of plans and what to do in the event that the building must be evacuated

  Safe

  At Risk

  N/A

• Have emergency plans been setup in the event of severe weather warnings

  Safe

  At Risk

  N/A

• Do you have any specific instructions for making this facility safer

  Safe

  At Risk

  N/A

Part/Material Containment(document with pictures)

• Are floors and aisles clear of molded product

  Safe

  At Risk

  N/A

• Are floors and aisles clear of raw material(pellets/regrind)

  Safe

  At Risk

  N/A

• Is auxiliary equipment (assembly and material handling ) clear of raw materials, grindings, dust, debris

  Safe

  At Risk

  N/A

• Are molding machines/assembly equipment clear of molded product or fallout

  Safe

  At Risk

  N/A