Silver Slipper Maintenance/Admin

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Back of House/Administrative

• Is the department Health and Safety Plan in a location known and accessible to all employees?

  Yes

  No

  N/A

• Is there a Safety Bulletin Board established with appropriate information? (OSHA, Emergency Phone List, Health/Safety Information, etc)

  Yes

  No

  N/A

• Are training records maintained and available for review by employees and outside agencies?

  Yes

  No

  N/A

• Are Material Safety Data Sheets (MSDSs) and an inventory sheet of all office products used in the workplace on file and accessible to employees?

  Yes

  No

  N/A

• Does the Emergency Operations Plan include a floor map including emergency evacuation site, procedures, and routes?

  Yes

  No

  N/A

• Are storage containers and boxes 18 inches below the ceiling?

  Yes

  No

  N/A

Maintenance

• Are all areas within 3 fee of hot water heaters cleared of obstruction, debris, or combustible storage?

  Yes

  No

  N/A

• Are all electrical tools in good working order?

  Yes

  No

  N/A

• Are all electrical tools property grounded?

  Yes

  No

  N/A

• Is proper PPE readily available?

  Yes

  No

  N/A

• Are all electrical cords free of frays and cuts?

  Yes

  No

  N/A

• Are all fire extinguishers tagged and charged?

  Yes

  No

  N/A

• Are any pieces of maintenance equipment in need of service or replacement? (Fork lift, lift, etc)

  Yes

  No

  N/A

• Is gasoline contained only in UL listed containers?

  Yes

  No

  N/A

• Auditor/Inspector's Signature

  Sign