SUI and Affiliated Companies Office Safety Template

• SUI and Affiliated Companies Office Safety Template

• Client / Site

• Conducted on

  Date

• Prepared by

Layout

• Floor free of obstructions

  Yes

  No

  N/A

• Are adequate storage areas provided

  Yes

  No

  N/A

• Are all areas clean, tidy, and well kept

  Yes

  No

  N/A

• Is there adequate space for employees to access their workstations

  Yes

  No

  N/A

Environment

• Temperature is between 68 and 72 degrees F.

  Yes

  No

  N/A

• Lighting is adequate

  Yes

  No

  N/A

• Are lights all working correctly (free from flickering)

  Yes

  No

  N/A

• Are blinds provided to protect against sunlight and glare

  Yes

  No

  N/A

• Is building free from water damage? (no ceiling tile damage)

  Yes

  No

  N/A

Emergency procedures

• Exit signs in place and illuminated

  Yes

  No

  N/A

• First aid facilities available and stocked

  Yes

  No

  N/A

• Escape routes and emergency doors clear

  Yes

  No

  N/A

• Is there proper egress in order to facilitate timely evacuation in an emergency

  Yes

  No

  N/A

• Are all workers aware of the first aid locations

  Yes

  No

  N/A

• Names of first aid trained employees displayed and up to date and posted at the employee information center

  Yes

  No

  N/A

• Emergency action plan on site and up to date

  Yes

  No

  N/A

• Date of last fire drill

  Date

• Portable fire extinguishers provided and maintained

  Yes

  No

  N/A

• List the names of the emergency coordinators below

• Are the mustering locations clearly marked for employees to gather during emergency evacuations

  Yes

  No

  N/A

General facilities

• Washing facilities clean and functional

  Yes

  No

  N/A

• Are stairs and storage rooms well lit

  Yes

  No

  N/A

• Walls, windows, and doors in good condition

  Yes

  No

  N/A

• Are all required Employee Right-to-Know posters properly displayed

  Yes

  No

  N/A

• Are Workers Compensation information booklets available

  Yes

  No

  N/A

• Are the preferred providers locations displayed

  Yes

  No

  N/A

Security

• Are building entry doors properly secured

  Yes

  No

  N/A

• Is the building and/or area free of concern regarding threats/security issues

  Yes

  No

  N/A

• Is the parking area free of concern? Lighting, reports of vehicle damage etc.

  Yes

  No

  N/A

Material handling

• Are heavy objects stored below shoulder height

  Yes

  No

  N/A

• Are hand carts available to move heavy items? Boxes of paper, delivery items, etc.

  Yes

  No

  N/A

• Storage areas designed to minimize heavy lifting

  Yes

  No

  N/A

Electrical

• Are portable heaters in use

  Yes

  No

  N/A

• Are the minimum clearance requirements for space heaters compliant? (3')

  Yes

  No

  N/A

• Are all outlets covers in place?

  Yes

  No

  N/A

• Are electrical cords in good condition

  Yes

  No

  N/A

• Surge protectors are not daisy chained together? (Overloading hazard)

  Yes

  No

  N/A

• Is the IT room free from clutter

  Yes

  No

  N/A

• Are the minimum clearance requirements for electrical panels compliant? (3')

  Yes

  No

  N/A

• Emergency lighting present

  Yes

  No

  N/A

Break Room

• Is break area clean and orderly? (free of dishes, overflowing trash, etc.)

  Yes

  No

  N/A

Slips, Trips, and Falls

• Are there wet floor warning signs available

  Yes

  No

  N/A

• Are all transition strips fasted securely

  Yes

  No

  N/A

• Are the floor mats in good condition and laying flat to reduce tripping hazards

  Yes

  No

  N/A

• Are walking paths free of concern? Snow removal, low hanging branches etc.

  Yes

  No

  N/A

Condition of Office Furniture

• Is all furniture that is in use, in safe and usable condition?

  Yes

  No

  N/A

• Are file cabinet doors left in the closed position

  Yes

  No

  N/A

• Are areas under desks free and clear of obstruction?

  Yes

  No

  N/A

Corrective Actions: List any concerns below not addressed above

• Add signature

  Sign

• Add media

  Media

Final Observations or Comments