Title Page

  • Location

  • Completed by

  • Conducted on

PPE

  • If Team Member(s) do not have correct PPE, ensure they retrieve it immediately.

  • Do all Team Members have on the correct PPE? (i.e. Gloves, Ear Plugs, Safety Glasses, etc...)

First Aid

  • Is there an adequate number of First Aid trained Team Members available?

Walking & Working Surfaces

  • Are all Walking and Working Surfaces clear of obstructions and slip, trip, fall hazards? (i.e. Water in the Floor, High Volumes of Dust, Staves, Floor Bolts, etc...)

  • Are all Holes covered or repaired on the walking surface?

Fire Protection

  • Are all Fire Doors clear from obstruction?

  • Are all Fire Extinguishers the appropriate type and properly mounted in an accessible location?

  • Did all Fire Extinguisher in this department pass inspection? (i.e. Arrow in the Green, No Major Dents, No Rust, etc...)

General Working Environment

  • Are all Equipment Gauges clearly visible and free of cracks?

  • Are JSAs posted?

  • Are SOPs posted?

  • Are there any leaking Hydraulic lines?

  • Are there any leaking Air lines?

  • Is the Workplace clean and sanitary? (i.e. Garbage / Trash)

  • Proper housekeeping? (i.e. workplace is organized, free of tripping hazards, and other problems associated with a messy workplace do not exist)

  • Are there any areas in need of a crossover?

Egress and Evacuation Routs

  • Are escapeway Maps clearly marked if applicable?

  • Are all Egress and Evacuation Routs free of obstruction and clearly marked?

  • Are Exits labeled with an exit sign and properly illuminated so they are always visible?

Ladders

  • Are all Ladders in good working condition and receive proper maintenance when necessary?

  • Have all Team Members received training about how to properly and safely use ladders?

Hand Tools & Power Tools

  • Are all Hand and Power Tools in good condition and functioning properly?

  • When not in use, are Tools properly stored?

Machine Guarding

  • Are all safety cages, or applicable machines, equipped with safety interlocks and or light curtains? (i.e. Monnots and Weinig)

  • Have all Hazards, at the point of operation, been guarded against? (i.e. Pinch Points, Ingoing Nip Points, Rotating Parts, etc...)

  • Are all Machine hazards identified with proper warning decal? (i.e. Pinch Points, Moving Parts, Keep Hands Clear, etc...)

  • Is all Machine Guarding in place and secured?

  • Are E-Stops and power shut-offs within reach of the Machine Operator?

  • Are all Emergency Stop Buttons red?

  • Is there any area in need of Machine Guarding?

Lockout Tagout

  • Have Team Members received LOTO Training?

  • Are Authorized Team Members trained on how to de-energized and lockout their equipment?

  • Are LOTO stations properly stocked? (i.e. Locks, Tags, Hasps, etc...)

  • Are their LOTO procedure for all equipment that requires LOTO?

Forklifts

  • Are Team Members who operate forklifts properly trained on the vehicles they use?

  • Are Forklifts equipped with all safety parameters? (i.e. Functioning Horn, Back-Up Alarm, Blue Spotlight, etc...)

  • Has Pre-Operations Inspection been completed before the forklift is operated?

Environmental Controls

  • Do all work areas have adequate Lighting?

  • Do all work areas have appropriate ventilation systems?

  • Are all Hazardous Materials properly Identified?

  • Is there an adequate drinking water dispenser located close to operators?

HAZCOM & Handling Combustible / Flammable Materials

  • Are there proper storage containers and methods used to prevent spontaneous combustion of materials?

  • Are propane cages locked and secured?

  • Are all combustible waste, debris, and scrap stored in metal containers and appropriately removed from the workplace?

  • Are Team Members trained so they will understand the hazards of the materials? (i.e. Read SDSs, Properly Handling Techniques, etc...)

  • Is proper PPE provided when handling certain hazardous materials?

  • Is there a comprehensive list of hazardous substances in the workplace, and their corresponding SDS?

  • Have Team Members been trained to understand OSHAs bloodborne pathogen standard?

Electrical

  • Has all electrical equipment been appropriately installed and receives regular maintenance?

  • Are the appropriate labels used for all devices that pose an electrical hazard? (i.e. Electrical / Breaker Boxes)

  • Have all Team Members that work on or near electrical equipment received the proper training?

  • Is all temporary wiring properly ran to not cause a tripping hazard? (i.e. Extension Cords)

  • Are there any extension cords that are in place for permanent use?

Notes Section

  • Please any Notes and 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.