Title Page
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Department Inspected
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Manager
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Inspector(s)
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Date
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Location
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Instructions:
1. Answer the questions provided below. Please refer below for the Risk Rating*.
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Actions, click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link.
*Risk Rating is based on the possible injury consequences and the likelihood of an injury occurring
High = potential for serious or critical injury or highly likely to cause an injury
Medium = moderate injury (sub-critical) or moderately likely to cause an injury
Low = minor injury or not very likely to cause an injury -
Employee Contacts: List employees contacted and note any safety-related issues/concerns. (click "Add Employee")
Employee
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Employee Number/Job Title/Name
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State any safety-related issues/concerns
1.0 General Workplace Safety
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1.1 Laboratory Safety Manual is available and accessible
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Risk Rating
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1.2 Sunnybrook Emergency Response Plan is available and accessible
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Risk Rating
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1.3 Fire and Security phone number is clearly posted and familiar to staff
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Risk Rating
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1.4 Staff are wearing identification badges
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Risk Rating
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1.5 Visitors/contractors are wearing identification and have been made aware of workplace hazards
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Risk Rating
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1.6 Required signage (e.g. biohazard) is posted in a conspicuous place
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Risk Rating
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1.7 Required signage for CL2 zones posted at entry
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Risk Rating
2.0 Laboratory Environment
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2.1 Work areas are orderly and free of clutter
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Risk Rating
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2.2 Aisles, doorways, passageways and exits are free of obstruction; evacuation routes are clear
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Risk Rating
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2.3 Floors are free of tripping hazards (e.g. unsecured mats, uneven/damaged surfaces, wet areas, extension cords)
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Risk Rating
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2.4 Furniture, shelving and carts are in good repair
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Risk Rating
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2.5 Light fixtures are in good repair and bulbs are functioning
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Risk Rating
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2.6 Emergency lighting is present and operational
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Risk Rating
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2.7 Physical environment is acceptable with respect to noise, lighting temperature, air quality and humidity
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Risk Rating
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2.8 Ceiling vents are clean; ceiling tiles are present and free of water damage
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Risk Rating
3.0 Personel Safety
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3.1 Appropriate personal protective equipment is available, accessible and is used by all staff when required (e.g. fully buttoned lab coats, gloves, safety eye wear, face shields)
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Risk Rating
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3.2 Emergency wash devices are accessible, in working order and tested as required
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Risk Rating
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3.3 Food and drink are not stored or consumed in the laboratory
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Risk Rating
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3.4 Food fridge temperatures are monitored and documented
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Risk Rating
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3.5 Cosmetics/contact lenses are not handled in the laboratory
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Risk Rating
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Risk Rating
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3.6 Personal belongings are not placed on contaminated laboratory surfaces
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Risk Rating
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3.7 Staff do not use cellular phones or other personal devices in the laboratory
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Risk Rating
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3.8 Hair beyond shoulder length is suitably confined to prevent contamination or entanglement with equipment
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Risk Rating
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3.9 Staff are not wearing loose or dangling clothing that could become contaminated or entangled
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Risk Rating
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3.10 Staff are not wearing loose or dangling jewelry that could become contaminated or entangled, or jewelry that could compromise integrity of personal protective equipment
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Risk Rating
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3.11 Appropriate footwear is worn by all staff
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Risk Rating
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3.12 Staff have received mandatory safety training as required (e.g. WHMIS, Fire Safety, TDG)
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Risk Rating
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3.13 Procedures for reporting workplace incidents and acquiring necessary first aid are familiar to staff
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Risk Rating
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3.14 Incident and Hazard report forms are accessible to staff
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Risk Rating
4.0 Biological Safety
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4.1 Specimen transported in leak proof, impact resistant primary container within a leak proof secondary container/packaging, laboratory forms physically separated from primary container to protect against contamination.
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Risk Rating
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4.2 Specimens/cultures are consistently handled using Routine Practices and appropriate level of containment
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Risk Rating
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4.3 Biological Safety Cabinets are certified, maintained and in working order
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Risk Rating
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4.4 Aerosol generating activities are performed using appropriate controls
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Risk Rating
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4.5 Appropriate disinfectants are available and benches are disinfected as required
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Risk Rating
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4.6 Centrifuge lids are locked during use, tubes are properly capped and rotor covers are employed consistently
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Risk Rating
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4.7 Spill management procedure and materials are readily accessible
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Risk Rating
5.0 Chemical Safety
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5.1 An inventory of hazardous chemicals is maintained
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Risk Rating
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5.2 Chemicals, solvents and compressed gases are appropriately labeled, handled and stored
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Risk Rating
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5.3 Flammable storage cabinet doors are closed, side bung is plugged, cabinet is grounded if necessary
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Risk Rating
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5.4 Chemical Fume Hoods are certified, maintained and in working order
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Risk Rating
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5.5 Only working quantities of chemicals are kept on benches; stock flammable materials are stored in flammable storage cabinets
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Risk Rating
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5.6 Material Safety Data Sheets are accessible and current (<3 years)
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Risk Rating
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5.7 Spill management procedure and materials are readily accessible
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Risk Rating
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5.8 Code Brown Response Plan is available and accessible
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Risk Rating
6.0 Electrical and Equipment Safety
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6.1 Electrical equipment is CSA/ULC certified, is in working condition and cords/plugs are free of damage
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Risk Rating
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6.2 Cords are not run across passageways/under mats
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Risk Rating
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6.3 Sufficient outlets are available for laboratory equipment
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Risk Rating
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6.4 Outlets and electrical panels are covered
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Risk Rating
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6.5 Access to electrical panels is not blocked
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Risk Rating
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6.6 Equipment is maintained, tested, cleaned and decontaminated as required
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Risk Rating
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6.7 Moving equipment parts are guarded
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Risk Rating
7.0 Fire Safety and Evacuation
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7.1 Code Red Response Plan is available and accessible
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Risk Rating
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7.2 Fire equipment is properly mounted, accessible and checked regularly
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Risk Rating
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7.3 Fire alarm pull stations are accessible
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Risk Rating
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7.4 Fire doors are closed or close properly with fire alarm
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Risk Rating
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7.5 There is at least 18" radius clearance around sprinklers
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Risk Rating
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7.6 Exit signs are present, illuminated and unobstructed
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Risk Rating
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7.7 Wall penetrations are sealed with fire stop
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Risk Rating
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7.8 Evacuation Plans are posted and familiar to staff
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Risk Rating
8.0 Waste Disposal
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8.1 Sharps are discarded in appropriate containers; containers are not overfilled
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Risk Rating
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8.2 Biohazardous waste is discarded appropriately; containers are removed regularly
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Risk Rating
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8.3 Chemical waste is discarded and logged appropriately; waste is removed as required
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Risk Rating
Other
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Any other safety issues/employee concerns?
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List Other Safety Issues/Employee Concerns (location and details) (click "Add Issue/Concern")
Note: Use the paperclip icon for the Corrective Action or Plan of Action (click the paperclip icon then Add Action).
Issue/Concern
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State Issue/Concern here
Completion
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Inspector's Signature
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Manager or Delegate's Signature
