Safety Management Audit

• Document No.

• Audit Title

• Department(s)

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Housekeeping

• Slip / trip /fall hazards not present

• Findings

• All areas are neat & organized / there are no open containers on equipment

• Findings

• Aisles & exits are marked and not blocked

• Findings

• No oil on the floor

• Findings

Electrical Safety & Condition of Equipment

• Electrical panels / power cabinets are closed & unobstructed

• Findings

• Pinch points are marked & guarded

• Findings

• Extension cords are not being used as permanent wiring

• Findings

• Guards are in place

• Findings

• No exposed or loose wires, or missing knockouts

• Findings

General Safety

• E-stops are clearly marked & in proper working order.

• Findings

• Proper use of lock out tag out

• Findings

• Fire extinguishers present, in working order, ¬ obstructed

• Findings

• Eye wash & safety showers in proper condition, caps on, proper flow, & inspected regularly

• Findings

• Scissors & small hand tools being used properly & in good condition

• Findings

Other Concerns - please note items outside the scope of this audit that were observed and require corrective action.

• Other concerns

  Yes

  No

  N/A

• Report was discussed with department manager and supervisor

  Yes

  No

  N/A

• My Initials indicate that the report was reviewed with me.

  Sign