Information

  • Student name

  • Workplace

  • Conducted on

  • Conducted by

  • Assessor name

  • Location
  • Version control

1: Entry Area

  • 1.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 1.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 1.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 1.4 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 1.5 Are lighting levels adequate for the area ? (well maintained and clean)

  • 1.6 Air-conditioning operational and working effectively ?

2: Office Area

  • 2.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 2.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 2.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 2.4 Are all the fixtures and fittings in a good state of repair ? (blinds, joinery, shelving & switches etc.)

  • 2.5 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 2.6 Are lighting levels adequate for the area ? (well maintained and clean)

  • 2.7 Air-conditioning operational and working effectively ?

  • 2.8 Data and cabling arrangements hazard free ? (no piggy backing of powerboards or double adaptors etc.)

3: Staff Area

  • 3.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 3.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 3.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 3.4 Are all the fixtures and fittings in a good state of repair ? (blinds, joinery, shelving & switches etc.)

  • 3.5 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 3.6 Staff toilet in good condition and working order (seat not broken, flushing properly, fixtures in place and operational)

  • 3.7 Are lighting levels adequate for the area ? (well maintained and clean)

  • 3.8 Air-conditioning operational and working effectively ?

  • 3.9 Data and cabling arrangements hazard free ? (no piggy backing of powerboards or double adaptors etc.)

4: Hallways

  • 4.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 4.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 4.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 4.4 Are all the fixtures and fittings in a good state of repair ? (blinds, joinery, shelving & switches etc.)

  • 4.5 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 4.6 Are lighting levels adequate for the area ? (well maintained and clean)

  • 4.7 Air-conditioning operational and working effectively ?

5:Kitchen

  • 5.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 5.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 5.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 5.4 Are all the fixtures and fittings in a good state of repair ? (benchtops, joinery and shelving etc.)

  • 5.5 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 5.6 Are lighting levels adequate for the area ? (well maintained and clean)

  • 5.7 Air-conditioning operational and working effectively ?

  • 5.8 Are all appliances in good working order and operating as per manufacturers specifications ?

  • 5.9 Data and cabling arrangements hazard free ? (no piggy backing of powerboards or double adaptors etc.)

6: Laundry

  • 6.1 Are the floors in a well maintained condition ? (no rips, tears or dirt etc.)

  • 6.2 Are the walls in a good condition ? (painting in tact, no holes or cracks etc.)

  • 6.3 Are the ceilings in a good condition ? (painting in tact, no holes, cracks or sign of water damage etc.)

  • 6.4 Are all the fixtures and fittings in a good state of repair ? (benchtops, joinery and shelving etc.)

  • 6.5 Are all windows and locks operating correctly ? (check handles, locks and latches)

  • 6.6 Are lighting levels adequate for the area ? (well maintained and clean)

  • 6.7 Air-conditioning operational and working effectively ?

  • 6.8 Are all appliances in good working order and operating as per manufacturers specifications ?

  • 6.9 Data and cabling arrangements hazard free ? (no piggy backing of powerboards or double adaptors etc.)

7: External Areas

  • 7.1 Fencing (perimeter): min 1.2 high, good general condition, free of climbing points and finger and neck entrapments

  • 7.2 Fencing (internal): free of climbing points and finger and neck entrapments ?

  • 7.3 Gates: good general condition and operating correctly ?

  • 7.4 Landscaping: lawns, edges and garden beds maintained and in good condition ?

  • 7.5 Trees: limbs and roots not causing a hazards ?

  • 7.6 Car park: surface in tact, line marking clear and visible, kerbs and gutters clean and dirt free, bollards clearly visible, wheel stops in good condition and signage adequate and in good condition ?

  • 7.7 Signage: all signage in good condition and free of graffiti ?

  • 7.8 Roof: gutters, downpipes, roof surface and facia's in good condition and free and clear of debris ?

  • 7.9 Walls: general condition free cracks and paint finishes in good order ?

  • 7.10 Glazing: no cracks or chips and in good order ?

  • 7.11 Footpaths and stairs: good general condition, free of dirt, mould and trip hazards ?

  • 7.12 External air-conditioning components: good general condition, well maintained, rust and dirt free ?

  • 7.13 Bin area: good general condition and clean and tidy ?

  • 7.14 Shade sails: good general condition, free of rips, no exposed wires, clean, posts rust free and posts showing no signs of fatigue ?

  • 7.15 Natural environment components: grass, trees and plants alive and being maintained ?

  • 7.16 Drainage: pits and pipes clear of debris with no signs of pooling or erosion ?

8: Electrical Items

  • 8.1 Switchboards: clearly labelled, clean, tidy, water tight and secure ?

  • 8.2 Test and tag: tags are current ?

  • 8.3 RCD's (Residual Current Devices) installed ?

9: Fire Protection

  • 9.1 Fire protection equipment tested and tagged (with current date) ?

  • 9.2 Fire evacuation plans current and on display ?

  • 9.3 Certificate of Occupancy on display ?

10: General Comments

  • 10.1 First Aid Kit: stocked and in date and located in an appropriate manner ?

  • 10.2 Contractors are signing in and out of the visitors book ?

  • 10.3 Please add any additional comments:

  • Student signature

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.