• Document No.

  • Site

  • Conducted on

  • Personnel

On site checks

  • Is there evidence of the daily and weekly checks being performed?

  • Are there any outstanding corrective actions required?

Fire packs check

  • Is the onsite fire pack complete and up to date?

Food storage temperatures check

  • Are the food storage temperatures being recorded onsite?

Meter readings

  • Gas reading

  • Gas meter reading

  • Electricity reading

  • Electricity meter reading

  • Water reading

  • Water meter reading


  • The temperature of blended water outlets must be distributed in the range of 41 and 43 Degrees Celsius
    The temperature of cold water outlets must be distributed at or below 20 Degrees Celsius
    The temperature of hot water outlets must be distributed at or above 50 Degrees Celsius

    1. Run the outlet for 1 minute on hot and blended water outlets, cold water outlets run water for 2 minutes
    2. Test the temperature with a thermometer

  • Cold supply
  • Upload image

  • Test location

  • Hot supply
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  • Test location

  • Mixed supply
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  • Test location

  • Are all the water temperatures correct?

Electrical Safety

  • Are there any broken plugs or outlets?

  • Are there any frayed or damaged leads?

  • Is there evidence of up to date PAT on electrical items?

  • Are there any extension leads across the floor?

  • Are there multiple double adaptors in a series?

  • Are there signs of overloading of power boards, power points?

Fire Control

  • Principal Legislation Regulatory Reform (Fire Safety) Order 2005

  • Are fire extinguishers in place & signed?

  • Are fire extinguishers within service dates?

  • Are all fire/emergency exit signs in place?

  • Has there been a full fire evacuation in the last 12 months?

  • Has a fire risk assessment been carried out?

  • Is the fire risk assessment up to date all actions carried out?

  • Are exits clear of obstructions?

  • Are all fire doors shut but not locked?

  • Is emergency lighting operable?

  • Are onsite staff fire training records up to date?

  • Does fire equipment appear to be in good condition?

  • Are all Fire doors closed, with a door shutter if necessary and not held open with door wedges or similar?

Walkways, Stairs and Ladders

  • Principal Legislation The Workplace (Health, Safety & Welfare) Regulations 1992

  • Are floor areas clean, dry and free from slip/trip hazards?

  • Are walkways kept clear?

  • Are stairs in good condition?

  • Are handrails in place, where required?

Ladder Safety

  • Ladder

  • Are the Stiles in good condition? No bent or split stiles which could lead to the collapse of the ladder during use.

  • Are the feet in good condition? Worn, damaged, dirty or missing, feet may cause the ladder to slip.

  • Make sure the rungs are not bent, missing or loose which could cause the ladder to become unstable?

  • Make sure the locking bars work and are not bent, worn or damaged or the ladder can collapse

  • Make sure treads are not contaminated or slippery

Chemicals (Hazardous/Dangerous Substances)

  • Principal Legislation The Control of Substances Hazardous to Health Regulations 2002 (COSHH)

  • Is there a Hazardous Substance register?

  • Have risk assessments been completed for hazardous substances?

  • Do arrangements exist to review COSHH implications of new products prior to purchase?

  • Have all employees that are using COSHH products had adequate training to use them?

First Aid/Accident Reporting & Investigations

  • Principal Legislation Health & Safety (First Aid) Regulations 1981, Reporting of Diseases & Dangerous Occurrences Regulations 1995

  • Is there a list of first aider and emergency contact numbers displayed?

  • Is there a first aid kit/cabinet available and accessible?

  • Are employees aware of location of first aid kit?

  • Is the first aid kit adequately stocked?

  • Are first aid records kept?

  • Are detailed accident investigation records kept?

  • Are all accident reports up to date?

  • Are there accident/incident/near miss reports?

General Housekeeping

  • Principal Legislation The Workplace (Health, Safety & Welfare) Regulations 1992

  • Are work areas clear of rubbish?

  • Are items not in use stored appropriately?

  • Are bins regularly emptied & not overflowing?

  • Is there evidence of general clutter?

Office Safety

  • Principal Legislation The Workplace (Health, Safety & Welfare) Regulations 1992 The Health & Safety (Display Screen Equipment) Regulations 1992

  • Are recorded risk assessments completed for workstations of display screen users?

  • Are work station layouts suitable?

  • Is lighting adequate for work tasks?

  • Are light fittings clean and in good condition?

  • Is furniture appropriate and sound?

  • Is air conditioning maintained?

  • Is the office clean and tidy?

  • Are floor coverings sound?

  • Is there adequate ventilation around photocopiers?

  • Are filing cabinets drawers kept closed when not in use?


  • Principal Legislation The Workplace (Health, Safety & Welfare) Regulations 1992

  • Are materials stored so they will not fall?

  • Are materials stored so that good manual handling practices can be applied, therefore safe retrieval?

  • Are storage racks/cupboards in sound condition, not overloaded?

  • Are racks free from projection, sharp edges?

  • Are incompatible hazard substances segregated?

Welfare Matters

  • Principal Legislation The Workplace (Health, Safety & Welfare) Regulations 1992

  • Are toilets clean?

  • Are kitchen facilities/lunchrooms clean?

  • Is drinking water available?

  • Are there washing facilities?

Opportunity for Improvement

  • Corrective Actions

  • Signature of auditor

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.