Safety Focus Visit - D220 - Southwest CA

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Sales Floor

• Are spill kits complete and filled in every station ?

  Yes

  No

  N/A

• Is all furniture tied and secured to prevent from tipping ?

  Yes

  No

  N/A

• Are all ladders and other equipment stored off the sales floor when not in use?

  Yes

  No

  N/A

• Are all tv displays secured to prevent from tipping ?

  Yes

  No

  N/A

• Is the floor clear of all STF hazards ?

  Yes

  No

  N/A

• Are emergency exits free from obstacles ?

  Yes

  No

  N/A

• Is the SHC board current with safety topic and safety winner posted ?

  Yes

  No

  N/A

• Is the safety sweep log being utilized with a response rate of 85% or better?

  Yes

  No

  N/A

Receiving

• Is the hazmat area clear and set up to standard ?

  Yes

  No

  N/A

• Is the forklift operational and free from defects?

  Yes

  No

  N/A

• Is the fork lift inspection sheet being utilized ?

  Yes

  No

  N/A

• Are only authorized ladders in use ?

  Yes

  No

  N/A

• Are QMT ladders secured to prevent use and prevent tipping?

  Yes

  No

  N/A

People

• Ask 3 associates the weight when a team lift is required <br>2/3 must answer correctly

  Yes

  No

  N/A

• Ask 3 associates what the current safety topic of the month is <br>2/3 must answer correctly

  Yes

  No

  N/A

Safety Rating

• What was the store Safety Culture Rating during this visit ?

  Yes

  No

  N/A

Notes

• Notes observed during visit

  Yes

  No

  N/A

• Add media

  Media

• Store Manager

  Sign

• Loss Prevention Manager

  Sign