Information

  • Date & Time of Inspection:

  • Type of Inspection:

  • Country:

  • Branch:

  • Inspected By/ Inspection Team (Name, Job Title):

  • Inspection Area:

  • Customer's Company Name:

  • RI Branch Name:

  • Please indicate which other area. If for residence, please indicate Residence Name/ Address.

A. Work Hours & Rest Hours

A. Work Hours & Rest Hours

  • Spot check with 1 or 2 Technician/ Storeman/ Other RI Personnel at the inspection area.

  • Technician/ Storeman/ Other RI Personnel
  • Name:

  • Job Title:

  • A1 What is your routine work hours per day?

  • Please specify in details.

  • A1.1 What is your number of workdays per week?

  • Please specify in details.

  • A2 Do you carry out overtime (OT) work or night work?

  • A2.1 How frequent do you carry out overtime work or night work?

  • Please specify in details.

  • A3 How many hours do you usually take to do OT & night work?

  • A4 After night work or OT, do you usually get sufficient rest before return to work?

  • Please indicate the reasons below.

  • A4.1 After night work or over-time work, usually how many rest hours / time-off do you have, before you return to work?

  • Please specify in details.

1. Housekeeping

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

1. Housekeeping

  • Is this section applicable to your business?

  • 1.1 Are work areas in clean & tidy state?

  • 1.2 Are floor, aisles, passageways kept clean & dry?

  • 1.3 Are floor holes eg. drains covered?

2. Material Handling & Storage

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

2. Material Handling & Storage

  • Is this section applicable to your business?

  • 2.1 Workers observed safe manual handling technique?

  • 2.2 Regular examination conducted for heavy lifting equipment eg. forklift, hoist?

  • 2.3 Competent persons to operate lifting equipment ?

  • 2.4 Authorised, trained operators for forklifts?

  • 2.5 SWL (Safe Working Load) indicated on lifting equipment & appliances?

  • 2.6 Lifting gears & safety devices in good order?

  • 2.7 Service tags displayed?

  • 2.8 Proper storage for lifting gears & other accessories?

  • 2.9 Is adequate clearance at passageway where material must be moved?

  • 2.10 Are storage area free from ignition source, fire, explosion and pest?

  • 2.11 Materials stacked on firm foundation/ support & do not appear unsteady?

3. Personal Protective Equipment

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

3. Personal Protective Equipment

  • Is this section applicable to your business?

  • 3.1 Suitable PPE provided e.g. safety goggles, glasses, ear muff, gloves, safety shoes, respirator, high visibility vest?

  • 3.2 Are workers using the PPE correctly?

  • 3.3 PPE are stored and maintained properly?

4. Emergency Preparedness

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

4. Emergency Preparedness

  • Is this section applicable to your business?

  • 4.1 Fire fighting equipment (eg. Fire hose reel, extinguishers) provided adequately?

  • 4.2 Fire fighting equipment prominently marked & labeled with signage?

  • 4.3 Fire fighting equipment maintained & in good order?

  • 4.4 Are all fire fighting equipment free from obstruction?

  • 4.5 Emergency response signage displayed where necessary?

  • 4.6 Are means of escape free from obstruction?

  • 4.7 Are first aid boxes inspected & replenished?

  • 4.8 Is First Aid Room properly maintained, if any?

  • 4.9 Emergency shower & eyewash provided & in good condition, if any?

  • 4.10 Are there adequate employees on each shift who are trained in first aid?

  • 4.11 Are exit routes clearly marked & equipped with emergency lighting?

  • 4.12 Are evacuation route, procedure displayed & maintained at various locations?

5. Machinery

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

5. Machinery

  • Is this section applicable to your business?

  • 5.1 Are dangerous parts of machine guarded eg. rollers, cutters, punch, high voltage?

  • 5.2 Guards / Safety devices properly adjusted & in good condition?

  • 5.3 Emergency button unobstructed and safety interlock and sensors tested in order?

  • 5.4 No spillage of coolant / oil on the floor?

  • 5.5 Are tools kept in toolbox or designated area?

  • 5.6 Qualified person engaged for inspection & maintenance?

  • 5.7 Are lockout device and warning sign used during repair / maintenance work on machine?

6. Electrical Safety

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

6. Electrical Safety

  • Is this section applicable to your business?

  • 6.1 Are plugs, sockets & cables in good condition?

  • 6.2 No crawling cable at the working area?

  • 6.3 Cables placed away from sharp edges & wet area?

  • 6.4 Circuit breakers installed?

  • 6.5 Are electrical panels enclosed?

  • 6.6 Are warning signs appropriately displayed at high voltage area?

  • 6.7 Earthing provided for tools in operation eg. drill, screw driver, disc cutter?

7. Chemical Safety

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

7. Chemical Safety

  • Is this section applicable to your business?

  • 7.1 A designated area for chemical storage?

  • 7.2 Adequate ventilation for chemical storage?

  • 7.3 Acidic, alkaline and flammable chemical stored separately?

  • 7.4 All chemical, including chemical waste containers properly labeled and covered?

  • 7.5 No sign of chemical spills or leakage?

  • 7.6 Competent person in-charge of the chemical substances?

  • 7.7 Chemical spill kit for spill/ leakage control provided and in good condition?

  • 7.8 Unused or waste chemical containers covered?

  • 7.9 SDS (Safe Data Sheets) kept for each chemical used & are available to staff?

  • 7.10 No chemicals stored near or above the drains or public/ open water course?

  • 7.11 No disposal of chemicals into the sink, drain/ sewage unless with authority approval?

8. Fumigation Safety

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

8. Fumigation Safety

  • Is this section applicable to your business?

  • 8.1 Can fumigator explain the 5 Golden Rules on “Fumigation”?

  • ANSWER:

    1. Always read and follow fumigant label instructions before each and every use.
    2. Always protect yourself from exposure to fumigants by using suitable respiratory protective equipment (RPE).
    3. Tasks designated to be carried out by two people must never be carried out by one.
    4. Only confirm an environment is 'gas free' after verified by a calibrated digital equipment.
    5. Never try to deal with any emergency where it could endanger your life. Raise the alarm, evacuate to a safe area and allow emergency services to make the situation safe.

  • 8.2 The fumigator has been properly trained by competent manager and competent (and licensed where required by local law) to carry out fumigation work?

  • 8.3 Suitable RPE (Respirator & Cartridge) has been used by fumigator during the fumigation, and they are in good condition?

  • 8.4 Suitable Gas detector (e.g. for methyl bromide or phosphine) is available, used during fumigation, and after fumigation before any gas clearance certification?

  • 8.5 Fumigation Equipment (gas detector, personal gas monitoring device, SCBA - Self-Contained Breathing Apparatus, etc) has been regularly inspected internally by competent person such as fumigation manager/ designated fumigator?

  • 8.5(a) Indicate the frequency of internal inspection of fumigation equipment checked during this inspection.

  • 8.6 Fumigation Equipment (gas detector, personal gas monitoring device, SCBA - Self-Contained Breathing Apparatus, etc) has been regularly calibrated by competent person such as qualified vendor?

  • 8.6(a) Indicate the frequency of calibration of the fumigation equipment checked during this inspection.

  • 8.7 Is the PPE (respirator, cartridge, gloves, goggles etc) used by fumigator regularly inspected internally and before any use?

  • 8.7(a) Please indicate the frequency of inspection for the PPE check.

  • 8.8 Phosphine deactivation is carried at a controlled site that is agreed with the customer, or at a RI site approved by RI and local authority?

  • 8.9 Fumigant are stored properly at designated, approved storage area, and within the approved quantity specified by local authorities?

  • 8.10 Fumigant in the vehicle are properly stored to prevent accidental release/ spillage?

9. Compressed Gas Safety

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

9. Compressed Gas Safety

  • Is this section applicable to your business?

  • 9.1 Empty and full gas cylinders properly labeled and stored separately?

  • 9.2 Valve caps provided during transfer?

  • 9.3 Stored away from heat sources, electrical areas and have flashback arrestors for flammable gases cylinders?

  • 9.4 Stored upright and chained/ strapped to prevent toppling?

  • 9.5 Regulators used and in good condition?

  • 9.6 No physical damage on the cylinder?

10. Pressure Vessels (eg. compressor, boiler)

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

10. Pressure Vessels (eg. compressor, boiler)

  • Is this section applicable to your business?

  • 10.1 Subjected to examination regularly? Label of last test date & pressure rating displayed?

  • 10.2 Is belt drive totally enclosed to cover the front, back, top, and sides?

  • 10.3 Valves are clean and free from damage?

  • 10.4 Trained and qualified person in-charge?

  • 10.5 Area kept clear of combustibles, oil, grease and other chemicals?

  • 10.6 Any shifting, rusty or loose support brackets for piping supports?

  • 10.7 Indicating devices eg. pressure gauge & glass, thermometer in good condition?

  • 10.8 Compressor/ Boiler Room access restricted and labeled Hearing Protection Area?

11. Employee Work Stations and General Areas

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

11. Employee Work Stations and General Areas

  • Is this section applicable to your business?

  • 11.1 Are working environment clean & free from known hazards & diseases?

  • 11.2 Are lighting sufficient for the type of work? Eg. rough, fine work, paper work etc.

  • 11.3 Are fresh air supply, good ventilation & proper exhaust system provided?

  • 11.4 Exposure to noise hazards controlled?

  • 11.5 No overcrowding observed in work area?

  • 11.6 No slip, trip and fall hazard in the work area?

  • 11.7 Reduce, reuse and recycling of paper in practice?

  • 11.8 Power e.g. for lights, air-con, computer are switched off when not required?

  • 11.9 Recycling practices for other materials eg. plastics, metal observed?

12. SHE Promotion

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

12. SHE Promotion

  • Is this section applicable to your business?

  • 12.1 SHE policy, rules, regulations and procedures displayed appropriately?

  • 12.2 SHE posters / signage displayed appropriately?

  • 12.3 Staff understands and can explain the SHE Golden Rules well?

  • 12.4 Staff understands and can explain the relevant Zero Tolerance Policy (ZTP) completely?

13. Vehicle & Pedestrians Routes (at RI Premises)

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

13. Vehicle & Pedestrians Routes (at RI Premises)

  • Is this section applicable to your business?

  • 13.1 Are routes for vehicles & pedestrians clearly marked and safely apart?

  • 13.2 Are there suitable pedestrian crossing points on vehicle routes where needed?

  • 13.3 Are there hump, traffic mirrors & signage where needed?

  • 13.4 Are roads wide enough, avoid sharp / blind bends?

  • 13.5 Are the roads well constructed, ie. have firm, even surfaces & well maintained?

  • 13.6 Are the roads and pedestrian walkway free from obstructions & other hazards?

  • 13.7 Speed Limit sign displayed at the service road around the head office / branch where appropriate?

  • 13.8 Road marks eg. arrow signs, yellow lines are clearly visible to road users?

14. Provisions in the Service Vehicles

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

14. Provisions in the Service Vehicles

  • Is this section applicable to your business?

  • 14.1 Vehicle Inspection Certificate displayed?

  • 14.2 Vehicle equipped with adequate First Aid Items?

  • 14.3 Vehicle equipped with Spill Control Kit, where hazardous chemical substances are stored?

  • 14.4 Spill Control Kit in good condition with sufficient items?

  • 14.5 Vehicle equipped with fresh water supply?

  • 14.6 Vehicle equipped with extinguisher, especially where hazardous chemical substances are stored?

  • 14.7 SDS (Safety Data Sheets) provided in the vehicle?

  • 14.8 Suitable PPE provided in the vehicles eg. safety goggles, gloves, respirator, safety harness, high visibility vests?

  • 14.9 Antidotes provided are properly maintained in the vehicle?

  • 14.10 Good housekeeping observed in the vehicle?

15. Vehicles Activities

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

15. Vehicles Activities

  • Is this section applicable to your business?

  • 15.1 Speed Limit sign displayed at the service vehicle?

  • 15.2 Are warning signs adequate and sufficient for the road users?

  • 15.3 Only trained and qualified drivers are engaged to drive the service vehicles?

  • 15.4 Driver carried with him valid driving license?

  • 15.5 Does the driver use the designated parking areas?

  • 15.6 No speeding observed?

  • 15.7 Driver obeyed traffic rules while working at or near public roads?

  • 15.8 No black smoke observed from the vehicles?

  • 15.9 Driver and passenger use seat belt?

  • 15.10 Motorbike rider is provided with and wore motorbike helmet, gloves and jacket?

16. Incident Reporting & Investigation

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor or enter the email address of the person), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

16. Incident Reporting & Investigation

  • Is this section applicable to your business?

  • 16.1 No accident happened in the last month?

  • Please indicate the number of Lost Time Accident (LTA) and First Aid (FA) incidents under the branch.

  • 16.2 No near miss (with no injury) over the last month e.g. vehicular near hit incident?

  • Please indicate the number of Near Miss (NM) incidents under the branch.

  • 16.3 No poisoning or illness case affecting person (staff/ customer/ public) due to exposure to our chemical agents?

  • Please indicate the number of poisoning or illness case under the branch.

  • 16.4 No dangerous occurrence?

  • Please indicate the number of dangerous occurrence under the branch.

  • 16.5 If any case in 16.1 to 16.4 happens, is the incident report submitted to the Branch Manager & SHE Manager/ Coordinator ?

  • 16.6 If any case in 16.1 to 16.4 happens, is the incident investigated?

  • 16.7 Has corrective / preventive actions been taken to improve the areas/ equipment/ facilities where the incident happen?

17. Others

17. Others

  • Please indicate below if there are other hazards or safety concerns identified from the inspection, but not listed in this inspection checklist.

Signature

  • Inspection Done By

  • Person
  • Name & Signature (click on pen icon to sign):

  • Job Title:

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.