Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Opening Conference
1: Transportation: 29 CFR 1910.178
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1.1 Are gladhand locks being used?
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1.2 Straight truck/box truck securement (air brake locks)?
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1.3 Are wheel chocks being used?
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1.4 Training Documentation?
2: Lockout/Tagout (Hazardous Energy): 29 CFR 1910.147, 29 CFR 1910.332
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2.1 Does the location have a Lockout/Tagout Written Program?
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2.2 Was there a list of Authorized Employees (FSB Online Training (MFG006), Employee Training Packet /Training Quiz & Annual Certification records); Are all maintenance employees accounted for?
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2.3 Is there training documentation for authorized/affected/other employees (NEOP Packet)? Please provide 3 examples.
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2.4 Are there records of Periodic Inspections being completed?
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2.5 Could the company provide a table of contents for all LOTO procedures?
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2.6 Are specific procedures put in place for each piece of equipment?
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2.7 Does the facility have an LOTO station?
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2.8 Did the location provide their corrective action policy for when employees don't follow standard protocol?
3: Fall Protection: 29 CFR 1910.27, 29 CFR 1910.23, 29 CFR 1910.140 (c)(21)
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3.1 Does the location have a Fall Protection Written Program?
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3.2 Was there a list of Authorized Employees?
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3.3 Is there training documentation for authorized employees?
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3.4 Are there inspection reports for harnesses and lanyards?
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3.5 Did the location provide their corrective action policy for when employees don't follow standard protocol?
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3.6 Did the location provide a fall protection rescue plan?
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3.7 Are there inspection reports for Gantry/Bridge cranes?
4: Forklifts/Powered Industrial Trucks: 29 CFR 1910.178
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4.1 Does the location have a Forklift Written Program?
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4.2 Did the location provide a list of certified drivers?
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4.3 Did the location provide a list of certified trainers?
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4.4 Are there inspection reports for forklifts?
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4.5 Did the location provide their corrective action policy for when employees don't follow standard protocol?
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4.6 Is there proof of employees completing the online portion of forklift training?
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4.7 20-hour behind the wheel documentation?
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4.8 Did the location provide forklift driver certification records?
5: Forklift (objectives): 29 CFR 1910.178
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5.1 If an incident occurs, what is the disciplinary action that takes place? (E.g: points taken off, re-training or possible termination)
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5.2 Obvious damage
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.3 Seatbelt; Equipped with interlocks?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.4 Horn
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.5 Tires
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.6 Leaks
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.7 Forks
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.8 Do all forklifts maintain blue lights and lights are facing the floor?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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5.9 Are all powered industrial trucks governed to 5 mph operating speed?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
6: Other Documents
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6.1 Does the location have a visitor sign-in sheet?
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6.2 Is the location utilizing the visitor online safety video?
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6.3 Did the location provide injury reports for the current year?
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6.4 Did the location provide safety committee meeting minutes for the current year?
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6.5 Is the New Employee 90 day review being conducted?
7: Contractor Safety: 29 CFR 1926.16
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7.1 What type of contractor did the location show?
- Fire Suppresion
- Rug Cleaning
- Forklift Maintenance
- Dock Plates
- HVAC
- Electricians
- Lawn Care/Snow Removal
- Machine Calibration
- General Contractor
- Miscellaneous
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7.2 Did location provide contractor acknowledgement form?
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7.3 Did location provide liability insurance proof?
Leadership Questions
Safety Committee
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8.1 How often are your team leads conducting Toolbox Talks?
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8.2 Do you have a Safety Committee?
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8.3 How many members are on your Safety Committee?
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8.4 How often does the Safety Committee meet?
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8.5 Is someone represented from each department?
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8.6 What departments are not represented?
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8.7 Provide all Safety Committee meeting minutes for the current year?
Job Safety Analysis (JSA) and Job Safety Observations (JSO)
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9.0 Are you familiar with JSA's and JSO's?
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9.1 Are your team leads understanding of the JSO process?
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9.2 How often are the team leads conducting JSO's right now?
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9.3 Did the location provide two JSA's and the corresponding JSO?
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9.4 If the location provided JSA/JSO documentation, were they created correctly?
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9.5 Did the company provide completed JSO's for the current quarter?
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9.6 JSO duration meets 3-minute minimum time limit?
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9.7 Do affected JSA's indicate weight restrictions?
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9.8 Can the location provide non-routine JSA's? (Provide at least 2 examples).
JSA Specific Discovery
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Item Description:
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Piece of equipment:
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Was there a signed JSA for the employee working on the piece of equipment?
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Can location provide proof of revision dates on JSA within the last year?
Near Miss Forms
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10.1 Does the location use Near Miss forms?
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10.2 How many Near Miss forms did the location have last month?
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10.3 How many Near Miss forms did the location have two months ago?
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10.4 How many Near Miss forms did the location have three months ago?
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10.5 Does the location have an active Near Miss program?
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10.6 Does the Safety Committee go over Near Miss Forms that were filled out since the last Safety Committee Meeting?
Injury Review and Analysis
11: Injury Review
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Department with the highest number of injuries?
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How many injuries in this department:
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Department with the second highest number of injuries?
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How many injuries in this department:
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Department with the third highest number of injuries?
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How many injuries in this department:
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How did the location review and communication injury investigations across the departments and leadership?
Injury Progression
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Has the HUB shown improvement over the last five years with regards to reducing injuries?
Employee/Lead Interviews
- Employee/Lead Interviews by Location
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Location/Department?
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Does your lead conduct Toolbox Talks? If so, how often?
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Do you know what a JSA or JSO are? How does management conduct these?
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Have you ever filled out a Near Miss Form? Do you know what these are?
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Team lead behavior toward safety?
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What is good with our safety program?
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What needs improvement with our safety program?
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Does your supervisor talk to you about safety?
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Do you know we have a safety committee?
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Are expectations to high or manageable to keep a safe environment?
Discovery Phase
12: Building safety: 29 CFR 1910.22, 1910.23, 1910.29, 1910.178
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12.1 Are floors safe and even?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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12.2 Are railings all in place?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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12.3 Are ramps and ledges protected properly?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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12.4 Are walkways kept clear?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
13: Confined space: 29 CFR 1910.146
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13.1 Does the facility have a written program and procedures for entering permit-required confined spaces as indicated in 1910.146?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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13.2 Are all confined spaces clearly marked?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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13.3 Are all confined spaces closed off and secured?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
14: Conveyors: 29 CFR 1910.28, 1910.212, 1926.555
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14.1 Is the location's conveyor fall protection in order?
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14.2 Are all facility conveyors within 7' of the walking surface/working platform completely guarded?
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14.3 Crossovers/passageways provided to pass over conveyors?
15: Personal Protection Equipment (PPE)
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15.1 Are forklift drivers wearing safety toe shoes/boots?
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15.2 Are at risk employees using appropriate PPE?
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15.3 Eye protection?
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15.4 Hearing protection?
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15.5 Appropriate clothing?
16: Emergency preparedness: 29 CFR 1910.36, 1910.37, 1910.157, 1910.165
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16.1 Is an emergency action plan in place and communicated to all employees?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.2 Do the employees have an alarm method?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.3 Is there a floor plan with escape routes and emergency information?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.4 Are all fire extinguishers regularly maintained?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.5 All extinguishers free of obstructions?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.6 Are all exit signs located properly?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.7 Exits clear of obstructions?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.8 Is the location conducting annual emergency/fire drills?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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16.9 Are OSHA labor law posters posted in a conspicuous location?
17: First Aid and Blood Spill Kits: 29 CFR 1910.151, 1910.1030
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17.1 Are first aid kits stocked and clean?
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17.2 Are blood-borne pathogen kits stocked and clean?
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17.3 Are first responder lists posted?
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17.4 Are first responder lists updated?
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17.5 Training certification provided for first responders? (Basic first aid, Blood borne pathogens, AED & CPR)
18: General lighting: 29 CFR 1910.305
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18.1 Good natural lighting?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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18.2 Light fittings clean and in good condition?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
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18.3 Emergency lighting operable?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
19: Hazardous communications: 29 CFR 1910.1200, 1910.253, 1926.252
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19.1 Are all containers properly labeled?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
19.2 Proper labeling/use of secondary chemical containers?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
19.3 Proper containment for chemicals?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
19.4 Does the location have an emergency spill clean-up team and/or kit if needed?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
19.5 Proper waste disposal? (E.g: fire resistant waste bins)
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
20: Electrical equipment requirements: 29 CFR 1910.303, 1910.304
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20.1 Are all breaker box doors closed?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
20.2 Are there openings located in breaker boxes?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
20.3 Are all extension cords up to compliance? (Ends, electrical tape, etc.)
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
20.4 Are all electrical outlets within 6 feet of water GFCI outlets?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
20.5 Do all electrical panels maintain 36" of clearance in front of them, and an unobstructed path of access?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
21: Hot work permit: 29 CFR 1910.252, 1910.253
-
21.1 Method of site review.
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
21.2 Permit process.
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
21.3 Does permit require a fire watch?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
22: Housekeeping: 29 CFR 1910.22, 1910.28, 1910.176(b), 1926.250
-
22.1 Frequency and method of reducing the accumulation?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
22.2 Is the location maintaining the 6s program?
-
22.3 Rod and Strut material securement?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
22.4 Racking Storage Securement?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
22.5 Surface load limits indicated?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
23: Ladders: 29 CFR 1910.23
-
23.1 Are ladders industrial strength?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
23.2 In good condition?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
23.3 Are cages put in place where needed?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
23.4 Are all work platforms guarded with a swing gate to protect employees from fall hazards?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
23.5 Are all ladders in storage chained properly?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
23.6 Are ladder inspections performed and documented?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
24: Machine guarding: 29 CFR 1910.212
-
24.1 Are all machines properly guarded?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
24.2 Are all machine interlocks working properly?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
24.3 Are all grinders/sanders properly guarded?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
24.4 Are all belts, pulleys, etc. guarded correctly?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
24.5 Are all pinch points effectively guarded?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
24.6 Exposed sharp edges?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
25: Safety Knives
-
25.1 Is the location using the correct safety knives?
26: Other Items Found during Initial Discovery Phase.
-
Area of Concern
-
Item Number (i.e. 26.1)
-
Where was Item Located?
-
Potential Hazard/Violation
-
What scope does it fall under?
- Compliance: Item meets regulatory requirements.
- Compliance: Item has minor deficiencies and requires minor improvements.
- Compliance: Item has opportunity for improvement, action required immediately.
- Risk Management: Item meets regulatory requirements.
- Risk Management: Item has minor deficiencies and requires minor improvements.
- Risk Management: Item has opportunity for improvement, action required immediately.
- Leadership/Management: Item meets regulatory requirements.
- Leadership/Management: Item has minor deficiencies and requires minor improvements.
- Leadership/Management: Item has opportunity for improvement, action required immediately.
- Item meets regulatory requirements.
- Item has minor deficiencies and requires minor improvements.
- Item has opportunity for improvement, action required immediately.
- N/A
-
Was Item mitigated immediately