Information

  • Document No.

  • Inspection Location

  • Conducted on

  • Inspection conducted by

  • Inspection conducted by (SESA Number)

Checklist

  • Version: Draft R2

Personnel

  • List persons accompanying inspector

  • Persons
  • Name

  • SESA Number

1.0 Building & Facilities

  • 1.1 Are floors clear of obstructions/fluids/oil/grease etc.?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.2 Are floors and coverings even, level and in good condition?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.3 Are doors unobstructed and free to open and close?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.4 Are walkways and passages free from hazards and marked appropriatley?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.5 is a thermometer available to all staff?

  • Corrective Actions

  • Corrective action to be carried out by (SESA number)

  • Enter the indicated temperature.

  • 1.6 Do heating/cooling systems work?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.7 Is ventilation adequate but draft free?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.8 Is lighting adequate in all areas?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.9 Are windows clean and unobstructed and do window blinds work?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.10 Is emergency lighting tested periodically?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Enter date of last test.

  • 1.11 Are there sufficient seats and are they in good condition?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 1.12 Are welfare facilities (canteen/restaurant/rest rooms/smoking areas/toilets, etc.) adequate, maintained and in clean condition?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

2.0 Fire Precautions

  • 2.1 Are extinguishing media suitable?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 2.2 Are extinguishers available, unobstructed, in date and correct type?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 2.3 Are evacuation routes and exits clearly marked and free from obstructions?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 2.4 Are blue fire information notices displayed and, where applicable, in date?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 2.5 Are fire wardens appointed, named on signage and available?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Name(s) of wardens

  • Person
  • Name

  • 2.6 Have regular alarm maintenance, alarm tests and drills been carried out?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Date of last alarm maintenance

  • Date of last alarm test

  • Date of last fire drill

  • 2.7 Is the Fire risk assessment by a responsible person up to date?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Date of last revision of fire risk assessment

3.0 First Aid

  • 3.1 Are incident records maintained?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Date of last recorded incident

  • 3.2 Are first aid kits (including eye wash) available, adequately stocked and in date?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Expiry date of Eye Wash

  • 3.3 Are First Aiders appointed, named on signage and on duty?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • List First Aiders

  • Person
  • Name

  • 3.4 Are green First Aid notices displayed and in date?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

4.0 Health & Safety

  • 4.1 Is the Health & Safety Law poster current and clearly displayed?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 4.2 Is there a signed copy of the Health & Safety Policy statement displayed?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Date of Policy Document

  • 4.3 Are Risk Assessments and Method Statements current, available to staff, are staff trained and do staff know where they are stored?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Name of one document

  • Date of document

  • 4.4 Are Display Screen Equipment assessments completed?

  • Details

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Name of one assessed person

  • Date of their assessment

5.0 Storage

  • 5.1 Are cupboard/cabinet tops clear of material/clutter and are they closed when not in use?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 5.2 Is all furniture fit for purpose and used as intended?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 5.3 Are heavy items stored at an appropriate height?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 5.4 Are lockers, cabinets and cupboards stable?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

6.0 Electrical

  • 6.1 Are electrical supplies adequate?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 6.2 Are electrical appliances regularly inspected and tested?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Detail one item

  • Date of next inspection/test

  • 6.3 Are electrical connections in a safe condition?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

7.0 General

  • 7.1 Are staff observed to behave in a safe manner and complying with signage?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 7.2 Are contractors observed to behave in a safe manner and complying with signage?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • List contractor company and person

  • Contractor and person
  • Company and name

  • 7.3 Are "Prohibition" (red), "Warning" (yellow) and "Mandatory" (blue) signage fit for purpose?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 7.4 Is smoking policy being complied with?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 7.5 Is the area generally clean and tidy with rubbish regularly and suitably disposed of?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • 7.6 Is there sufficient space?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

Conclusion

  • Enter additional topics

  • Additional topic
  • Inspected area

  • Is this topic compliant?

  • Details

  • Media

  • Corrective action

  • Corrective action to be carried out by (SESA number)

  • Give examples of any good behaviours or practices observed

  • Good examples
  • Add media

  • Inspection completed by

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.