Slip-Trip- Falls Prevention Audit 12/11/2013

• Document No.

• Slips/Trips/Falls Prevention Audit SILPS 2013

• Location

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Outdoor walkways:

• Are the surfaces level and free of cracks?

  Safe

  At Risk

  N/A

• Do surfaces have proper drainage?

  Yes

  No

  N/A

• Are walkways properly illuminated?

  Safe

  At Risk

  N/A

• Are walkways free of debris?

  Safe

  At Risk

  N/A

Parking lots:

• Does the parking lot have proper lighting?

  Safe

  At Risk

  N/A

• Are the surfaces smooth and free from potholes?

  Safe

  At Risk

  N/A

• Is the spacing for cars properly marked off?

  Safe

  At Risk

  N/A

• Is there wheel stops or curbing provided for each space?

  Safe

  At Risk

  N/A

• Is the speed bumps highlighted or brightly painted?

  Safe

  At Risk

  N/A

• Are the handicapped zones are marked off?

  Safe

  At Risk

  N/A

• Are the parking lot walkway routes marked off?

  Safe

  At Risk

  N/A

Indoor walkways:

• Are the floor surfaces level and free of cracks/bulges/breaks/tears?

  Safe

  At Risk

  N/A

• Are the floor surfaces free of highly waxed areas?

  Safe

  At Risk

  N/A

• Are the carpets firmly fastened in place and free of gaps?

  Safe

  At Risk

  N/A

• Are the terrazzo, marble or flooring tiles slippery?

  Safe

  At Risk

  N/A

• Are the entryway mats in place during rain or snow conditions?

  Safe

  At Risk

  N/A

• Are the floor surfaces free of debris?

  Safe

  At Risk

  N/A

Ramps:

• Are the floor surfaces treated with non-slip materials?

  Safe

  At Risk

  N/A

• Are the ramps equipped with handrails?

  Safe

  At Risk

  N/A

• Are landings provided at points of turning, entrance and exit?

  Safe

  At Risk

  N/A

Stairways:

• Are the steps uniform and well maintained with no broken edges?

  Safe

  At Risk

  N/A

• Are handrails provided and secure?

  Safe

  At Risk

  N/A

• Do doors open into stairways without landings?

  Safe

  At Risk

  N/A

• Are the landings level and well maintained?

  Safe

  At Risk

  N/A

• Are the stairways and landings well illuminated?

  Safe

  At Risk

  N/A

• Are the landings and stairways free of debris?

  Safe

  At Risk

  N/A

• Is emergency lighting provided with proper coverage?

  Safe

  At Risk

  N/A

Restrooms:

• Are the floor surfaces free of irregularities?

  Safe

  At Risk

  N/A

• Are the floor surfaces free of water?

  Safe

  At Risk

  N/A

• While floors are wet mopped, is the area barricaded or signs in places?

  Safe

  At Risk

  N/A

• Are buckets, mops, brooms, etc.,kept out of walking areas?

  Safe

  At Risk

  N/A