Title Page

  • Site conducted

  • Conducted on

  • Inspector 1

  • Inspector 2

  • Location

Inspection Process and Tips:

  • 1. Remember always to have constant contact with a variety of staff during the inspection (s) Remember always to have constant contact with a variety of staff during the inspection (s)

  • 2. Inspect all hazardous equipment/machinery.

  • 3. Conduct inspections the first week of every month.

  • 4. All hazards are to be documented on the “Recording Form” and hazards classified

  • 5. All repeat items should be priorities

General Mandatory Questions:

  • Did you submit you quarterly audit?

  • Tell me the top 3 hazards of your area?

General Housekeeping and Work Environment/Station

  • Is the area maintained in a clean and tidy manner?

  • Are things stored on one side of the corridor?

  • Does electric panels, fire extinguishers/cabinets have 3 feet of clearance? i.e. nothing stored in front of them?

  • Are the waste/recycling and linen bins emptied regularly and not overflowing?

  • Is the staff break areas clean and tidy, including fridges and cupboards?

  • Is all the furniture in good condition and free of any visible damage/ hazards?

  • Are the desk and worktop area spaces sufficient for the jobs performed in the area?

  • Is equipment (i.e. photocopiers, printers) at a convenient height for all staff to access?

  • Are most frequently used items stored between thigh and shoulder height?

  • Are workstations set up so that a worker is not required to work in an awkward/unsafe position?

  • Are caution/safety signs used to warn against potential hazards?

  • There is no food, drink, tobacco or cosmetics consumed, applied or kept in areas where infectious materials, hazardous chemicals, or hazardous drugs are used, handled or stored?

Emergency Equipment / Fire Prevention / Life Safety

  • Is emergency equipment clearly marked / identified and placed in visible accessible / unobstructed locations?

  • Fire Extinguisher / Hose

  • Do the Eye Wash stations have a clear access? Are the monthly checks completed?

  • Is there an Emergency Preparedness Board up (contains immediate action drills, dept. emergency plan, code forms pkg., and additional dept. specific information as required)?

  • Emergency Kit containing (fire/emergency warden vest, first aid kit, bleeding control kit and headlamps/flashlight x2 - check batteries)

Access / Egress / Exits

  • Are exit doors / directions clearly marked with visible / illuminated signs?

  • Are exits/service doors kept free of obstructions, with sufficient space for emergency egress?

  • Are doorways / walkways uncongested and accessible for emergency egress?

  • Are exits doors / routes well lit and equipped with emergency lighting?

  • Are stairwells steps visible and clear of any obstructions?

Floor and Walkways

  • Is there a safe clearance (approx. 3 ft. wide clearance) for walking in aisles where equipment is handed?

  • Are work / walking surfaces kept dry and/or appropriate means in place for walking surfaces to prevent slip hazards ( floor markings/signs, mop, etc.)?

  • Are walking surfaces free of tripping/fall hazards (e.g. damaged carpet, broken tiles, uneven surfaces, loose debris, chipped sidewalk, floor openings)?

Material Handling / Storage / Physical Hazards

  • Is material/ equipment stored that sharp projections will not interfere or harm a person?

  • Is material / equipment stored in a stable/secure manner that will not tip, collapse, or fall (i.e. O2 tanks)?

  • Is material / equipment stored in designated areas when not in use?

  • Are storage areas tidy and free of tripping hazards?

  • Are all storage racks free from damage?

  • Is a safety step stools or ladders provided for access to any high shelves?

  • Are ladders / step stools in good condition (no visual damage), and stored in a secure manner?

Electrical and Machine Safety

  • Are electrical/ telephone cords from computers/machines, tidy/untangled/secure in such a way that they do not cross walkways causing a tripping hazards?

  • Are electrical equipment / outlets well maintained (e.g. not overloaded / blocked, fully plugged into sources)?

  • Are electrical panel boxes closed, labeled, and accessible only to authorized persons?

  • Are all electrical equipment/cords in good condition and free of any visible damage/hazards?

  • Are moving equipment and projecting parts properly guarded and labeled?

  • Is machinery set up that the operator is not required to work in an awkward position?

  • Are lockout procedures being followed during maintenance/ repairs/ cleaning?

Lifting and Moving Devices / Equipment

  • Is the lifting assistance equipment in good condition and free of any visual damage/hazards (i.e. slings)?

  • Are proper lifting/moving devices available, maintained and used where necessary? Is there a current inspection tag on the equipment?

  • Do staff have the necessary equipment to reduce the risk of a musculoskeletal injury occurring? i.e. patient lift equipment, non-patient care lifting devices such as pump trucks, etc

Personal Protective Equipment (PPE) (i.e. Head, Lungs, Hearing, Hand, Foot)

  • Are staff wearing the appropriate closed toe non-slip footwear?

  • Is safety footwear worn in high-risk areas for foot injuries?

  • Is eye protection worn in eye injury risk areas?

  • Are staff protected from harm with the current controls in place?

  • Are cautions signs used to warn against potential hazards or exposures?

Infection Prevention and Control

  • Are there adequate hand sanitizers and wash station available?

  • Are the appropriate Infection Control Precaution signage in place and PPE available?

  • Are bio-hazardous present, identified, and controlled?

  • Are there adequate sharp containers available and not overfilled?

Chemical Hazard and Containers: (Lab, Pharmacy, Environmental Services, Facilities, Food Services, DI)

  • Are WHMIS/chemical warning labels present/ readable on all containers and in good condition?

  • There is no evidence of leaking, damaged, or corroding container?

  • There is no evidence of spilled material in any trenches or on the floor?

Workplace Violence Controls

  • Is there designated meeting rooms that will allow staff to be visible, and able to call for assistance immediately?

  • Are meeting/common or work areas free of objects that could be used as weapons?

  • There are no empty rooms that should be locked?

  • Is furniture in meeting, waiting / work areas arranged to prevent employees from becoming trapped?

  • Is there a panic button/ alarm/ controls in area where a worker can be trapped or alone?

Questions for Staff:

  • Have you checked that your versus pendant battery is current?

  • Are restraints properly stored and easily accessible? Do you know where restraints are stored within your department?

  • Are needles and other sharps being disposed of correctly?

  • Is hospital equipment such as restraints, stretchers, commodes, wheelchairs, beds, pumps, patient/handling transfer devices and IV poles in good working order? If not, please tag and submit work orders.

  • Where are patient transfer slings located? Are they being used within your department?

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.