Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Conditions Codes: S = Satisfactory N = Needs Improvement U = Unsatisfactory - not acceptable

Section 1 - Campus Facility Condition

  • Previous inspection reports are available

  • Previous inspection findings and issues have been addressed

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  • Adequate work space is provided for personnel

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  • Floors & aisles are in good conditions, clean, free of debris, uncluttered,

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  • Door locks and handles are in good conditions

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  • Portable electric heaters have at 3ft of clearance from combustible materials (ex - paper)

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Section 2 - Safety Education

  • Would staff like to have safety education

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  • Other

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  • What topics are important?

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Section 3 - Fire Safety

  • Are fire alarms and fire extinguishers visible and accessible.

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  • Are wall,floor, and ceiling penetrations for cables, wires, pipes, and mechanical systems (such as ductwork) seal to prevent the spread of fire and smoke?<br><br>Sealed wall penetrations prevent the spread of fire and smoke from one room to another. <br><br>Penetrations can be sealed with drywall, fire retardant pipe seal or fire stop pillows

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  • Have the facility's sprinklers and/or fire alarm systems been inspected in the past 12 months? Is the fire suppression system tagged to verify this inspection?

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  • Fire doors (ex: stairways) are kept closed unless equipped with automatic closing device

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  • 18" vertical clearance from material stored below sprinkler heads<br><br>This clearance is required by OSHA and is necessary for proper functioning of the sprinkler system.

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  • Are fire extinguishers visible, readily accessible,and serviced every 12 months

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  • Exits signs are clearly marked and equipped with emergency lighting

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  • Emergency lighting is regularly tested and available

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  • Emergency evacuation plans are posted (stairway, elevators landing, entrances areas)

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  • Emergency exits are not blocked

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  • Corridors & Stairwells are kept free of obstruction and not blocked or used for storage.

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  • Other

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Section 4 - Electrical Safety

  • Lock-out procedures are utilized prior to any work on electrically energized systems or equipment

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  • Are electrical panels and circuit breaker labeled. <br><br>The wording on the label of a panel or circuit should adequately identify the panel and circuits so emergency personnel or the operating engineer can rapidly identify them for emergency shutdown or disaster recovery.

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  • 36" clearance maintained for electrical panels

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  • Electrical outlets, cords, and plugs are in good condition with proper grounding<br><br>OSHA and National Electric Code do not allow extension cords to be used as permanent wiring. Only use surge protectors on equipment (computers, printers, etc) when recommended by the manufacturer. <br><br><br><br><br><br>

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  • Electrical equipment and power cords are in good condition and properly maintained

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  • Personnel staff are aware of electrical hazards in the work environment

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  • Extension cords and power strips are not daisy chained and not used for permanent use<br><br>

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  • Other

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Section 5 - Tool Safety

  • Personnel staff are appropriately educated in the use of equipment

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  • Personnel staff are aware of the hazards associated with the use of the equipment

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  • Equipment/tools are in good operating conditions and properly maintained

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  • Are drive mechanism guarded (no open belts, gears, chains, and shafts)

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  • Is equipment/tools turned off when not in use or unattended

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  • Elevating device capacities are posted on equipment & inspected regularly and maintained

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  • Is proper PPE worn during operations that create hazards from flying particles, liquid chemicals, or potentially injurious light radiation. <br><br>Eye protection should be worn while performing any cutting, grinding, nailing, spraying or welding operations. The ANSI Z87.1 designation on the eyewear indicates approved eye protection

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  • Machine guarding is in place and not modified

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Section 6 - Personal Protective Equipment

  • Personnel staff are aware of requirements regarding PPE

  • Personnel are wearing appropriate clothing and PPE for the type of work being conducted

  • PPE is in good condition, readily available and properly maintained

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  • Personnel requiring the use of respiratory protection are fit tested

  • Respirators are appropriately maintained after every use (examples: cleaned and stored in a convenient, clean, and sanitary location)

Section 7 - Hazardous Materials Safety

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.