• Department

  • Location
  • Conducted on

  • Prepared by

  • Personnel involved


  • WHS notice board up to date with the latest information?

  • WHS action plan updated for the current month?

  • Are staff meeting regularly(at least once a month) and latest WHS Committee meeting minutes displayed?


  • Do all staff have clean personal protective equipment?

  • Lights are free of dust/bugs etc?

  • Linen has no stains and/or tears?

  • Air conditioning vent/ducts and Ceiling tiles in a good state of repair? (do random check)

  • Electrical equipment tagged, tested (tested annually) and within date i.e. Vacuum, Carpet shampooers etc. (check 3 pieces of equipment)

  • Electrical equipment and its components free of damage? (Leads, plugs etc.)

  • Patient sinks and toilets are clean, soap and towels are available?

  • Floors are clean, free of trash and boxes on floors?

  • Housekeeping carts are not left unattended or out of sight?

  • Chemicals removed from housekeeping carts at the end of shift when stored on wards?

  • Patient privacy curtains are clean, hung properly and free of defects?

  • Have waste products been identified and separated correctly i.e. correct waste streams?

Hazardous Material & Waste

  • Clinical waste kept in yellow clinical waste bags or containers (purple for Cytotoxic or orange for Anatomical Waste)? (check three spots)

  • Non Clinical and Clinical or related waste separated? (check 3 spots)

  • Are clinical or related waste bins locked at the point of collect i.e. Loading dock or Waste Management holding room.

  • Disposal of waste through licensed authorised waste disposal companies?

  • Rubbish bins not over flowing?

  • Rubbish bins are emptied regularly?

  • Are chemicals decanted through a funnel or decanting mechanism i.e. dispenser?

  • Do staff know what to do in the event of a Chemical Spill? (ask random HK person)

  • Are spill kits located in close proximity of the chemical dispenser where a hazard substance is used and do staff know where its located.

  • Are chemical room surrounds (walls, floors, dispensers) free from chemical residue and clean

  • Do staff members know where and how to access Material Safety Data Sheets for the chemicals being used? (ask a random HK person)

  • Are all chemicals labelled correctly? with warning signs and hazard classification and are labels clear and able to be read

  • Are Safe Work Practices either accessible or on display for staff to refer too?

  • Do staff know how to access ChemAlert?

Housekeeping Stores

  • Housekeeping storerooms/carts are clean and chemicals emptied or securely stored properly at the end of each shift?

  • Stores free of waste bags and unwanted items (furniture, hospital supplies and non-housekeeping equipment)?

  • Stores locked when unattended?

  • Floors are dry and disposal (linen or waste) chute doors are locked and undamaged / works properly?


  • Compactor operation switches are in good working order. (secured, no exposed wires)

  • Compactor is in good working condition?

  • Compactor cage in good repair (e.g. no gaps, no sharp edges)

  • Signage 'Operated by trained and authorised Personnel Only' clearly displayed

  • Safety mechanism operating properly?

  • No trip hazards around both cage, upper dock or lower dock surrounding compactor or walkways

  • Trolley available for transporting mobile bins or loose recyclables safely

  • High Vis Vests are worn and available at all times.

  • Additional Comments

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.