Sdx Safety Program Review Copy

• Inspection Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Prevention of Slips, Trips, Falls

Safety processes

Prevention of Manual Material Handling Injuries

Chemicals

• Inventory of hazardous chemicals is current (within one year)

  Yes

  No

  N/A

• SDS readily available for each hazardous material in inventory?

  Yes

  No

  N/A

• Chemicals stored properly (Insecticides, Detergents / Sanitizers, Caustics/Acids/Polishes)

  Yes

  No

  N/A

• All containers properly identified and labeled with hazard warnings.

  Yes

  No

  N/A

• GSH I training received by all employees & documentation in personnel files (current within 1 year)

  Yes

  No

  N/A

• Working eyewash station available with continuous 15-min. flow

  Yes

  No

  N/A

• Copy of HazComm Plan (Chapter 13 SPM, 2001)

  Yes

  No

  N/A

Working areas

• Aisles clear & floor clean

  Yes

  No

  N/A

• Shelves & racks are of adequate strength & are secured

  Yes

  No

  N/A

• Compressed gas cylinders stored in upright position, are individually chained & those not in use have protective caps in place

  Yes

  No

  N/A

• Heavy items stored on shelves between knee & shoulder height

  Yes

  No

  N/A

• Adequate number of step ladders, easily accessible, and free of hazards.

  Yes

  No

  N/A

• No goods over 30 lbs. stored at more than 5 feet above floor

  Yes

  No

  N/A

• Goods have been removed from cartons prior to being placed on shelves

  Yes

  No

  N/A

• Sharp edges are identified & eliminated

  Yes

  No

  N/A

• Bump hazards are eliminated

  Yes

  No

  N/A

• Falling object hazards are eliminated?

  Yes

  No

  N/A

• Cords do not present an entanglement/trip hazard

  Yes

  No

  N/A

• Waking surfaces have no openings, holes, or trip hazard

  Yes

  No

  N/A

Exits

• Exits routes unobstructed

  Yes

  No

  N/A

• Exits and routes to exits clearly marked with illuminated signs and direction of travel, as mandated.

  Yes

  No

  N/A

• Emergency lighting provided for all occupied areas and tested

  Yes

  No

  N/A

• Emergency evacuation plans posted

  Yes

  No

  N/A

• All doors in exit path kept closed

  Yes

  No

  N/A

• Lighting is adequate

  Yes

  No

  N/A

• Handrails provided on all stairs

  Yes

  No

  N/A

• Adequate number of exits provided

  Yes

  No

  N/A

• Exits doors are operable in the path of exit travel without the use of a key or any special knowledge

  Yes

  No

  N/A

• Non exit doors labeled "NOT AN EXIT"

  Yes

  No

  N/A

Electrical

• All electrical cords in good condition

  Yes

  No

  N/A

• Extension cords are not used in place of permanently installed fixed wiring

  Yes

  No

  N/A

• Cover plates, switches, outlets, etc. are in good condition

  Yes

  No

  N/A

• Cords do not present a trip hazard

  Yes

  No

  N/A

• Equipment grounded or double insulated

  Yes

  No

  N/A

• GFCI used as appropriate

  Yes

  No

  N/A

• Ground plugs intact and in good position

  Yes

  No

  N/A

• Emergency shutdown switches installed and easily accessible

  Yes

  No

  N/A

• All Emergency stop (E STOP) buttons colored red

  Yes

  No

  N/A

• Switches & circuit breakers are clearly marked to indicate equipment / areas controlled and arc flash potential

  Yes

  No

  N/A

• Control panels have a minimum of 36" unobstructed workspace in front & are closed

  Yes

  No

  N/A

• Electrical panels closed / locked/and free of exposed terminal screws or knockouts.

  Yes

  No

  N/A

Fire Prevention

• Portable fire extinguishers properly mounted, accessible and serviced annually

  Yes

  No

  N/A

• All EE familiar w/ location of portable fire extinguishers, manual controls on extinguishing systems and fire alarms

  Yes

  No

  N/A

• Hoods are free of grease and all filters in place

  Yes

  No

  N/A

• Minimum of 18" clearance under sprinkler heads

  Yes

  No

  N/A

• Fire doors in proper operational condition & unobstructed

  Yes

  No

  N/A

• Do EE know how to report a fire?

  Yes

  No

  N/A

• Incompatible chemicals (corrosives & flammables / combustibles) stored away from each other; stereo stored correctly

  Yes

  No

  N/A

• All fire alarms unobstructed

  Yes

  No

  N/A

• All equipment shut-off switches unobstructed

  Yes

  No

  N/A

• Employees know where to meet in the event of a fire

  Yes

  No

  N/A

• Deep fryers cleaned

  Yes

  No

  N/A

Personal Protective Equipment

• Completed assessment within 1 year with signatures

  Yes

  No

  N/A

• Does the assessment identify all tasks with potential risk.

  Yes

  No

  N/A

• The use of required PPE is enforced.

  Yes

  No

  N/A

• All PPE identified is available and maintained in a sanitary condition.

  Yes

  No

  N/A

Safety Bulletin Board

• Safety bulletin board maintained, all postings visible and organized

  Yes

  No

  N/A

• Is OSHA 3165 poster or state plan specific poster posted

  Yes

  No

  N/A

• Are emergency phone numbers posted

  Yes

  No

  N/A

• Is the safety policy statement posted

  Yes

  No

  N/A

• Is the fire evacuation diagram posted. Primary & secondary egress designated.

  Yes

  No

  N/A

• Medical providers / workers compensation poster prominent

  Yes

  No

  N/A

• Safety committee minutes from most recent meeting posted

  Yes

  No

  N/A

• Safety goals posted with targeted focus areas identified.

  Yes

  No

  N/A

Loading docks and Trash removal

• Compliance with key control on trash compactor

  Yes

  No

  N/A

• Trash compactor labeled with -Only authorized personnel should be allowed to operate or service this compactor.

  Yes

  No

  N/A

• Area is free of clutter that can cause trip hazard

  Yes

  No

  N/A

• Materials and products are safely brought into the storage area

  Yes

  No

  N/A

• Dock has adequate standard railing per OSHA requirements

  Yes

  No

  N/A

• Disposal of trash is conducted in a safe manner and does not create/ expose employee to risks.

  Yes

  No

  N/A

• Empty boxes are stored so as not to create additional hazard

  Yes

  No

  N/A

Energy Control- lockout tagout

• The site has a written program

  Yes

  No

  N/A

• The site has identified "authorized " personnel

  Yes

  No

  N/A

• The site conducts annual reviews of authorized employees.

  Yes

  No

  N/A

Safety Culture

• Safety Commitment poster visible and signed

  Yes

  No

  N/A

• Safety policy manual available

  Yes

  No

  N/A

• GM aware of safety responsibilities. Safety champion on-site

  Yes

  No

  N/A

• Management leads by example - wearing proper PPE

  Yes

  No

  N/A

• Safety committee meetings held regularly and document progress to hazard identification

  Yes

  No

  N/A

• Weekly safety message communicated

  Yes

  No

  N/A

• ALL (100%) of employees trained monthly

  Yes

  No

  N/A

• Monthly inspection guide completed

  Yes

  No

  N/A

• Inspection item corrective actions specific, measurable, achievable, realistic & time bound

  Yes

  No

  N/A

• Near Miss program used

  Yes

  No

  N/A

• Behavior Based Observations conducted

  Yes

  No

  N/A

• Safety committee participates in inspections and training

  Yes

  No

  N/A

• A visitor's log or alternative is being used to control access to the unit.

  Yes

  No

  N/A

OSHA Recordkeeping

• Each OSHA recordable workplace injury / illness recorded accurately

  Yes

  No

  N/A

• Location understands the incident trends and has an actionable plan to address the risks

  Yes

  No

  N/A

• OSHA 300 / 300A & SDX FROI recorded for 5 years as applicable

  Yes

  No

  N/A

• OSHA 300A posted from 2/1 through 4/30

  Yes

  No

  N/A

• RCA completed for every incident / accident. (3-5 reasons why; 2-4 SMART corrective actions)

  Yes

  No

  N/A

Food safety

• Serv-safe compliant

  Yes

  No

  N/A

• Calibration log maintained for thermometers

  Yes

  No

  N/A

• Food handling license current

  Yes

  No

  N/A

Risk or compliance issues

Top 3 hazard remediation recommendations

• 1)

• 2)

• 3)