Title Page

  • Conducted on

  • Prepared by

  • Location
  • Desks - Offices and desks are maintained according to posted 5S Expectation and Standard

  • Painted Surfaces - Painted surfaces including walls, doors and yellow painted items are clean. Action plan in place?

  • Moveable Items - Homes for all moveable items are clearly defined. (Signage, shadow boxing).

  • Lighting - Lighting is sufficient for safe operation and identification of materials.

  • Cabinets/Shelves - The contents of shelves and cabinets are clearly identified. No items are stored on top of cabinets unless clearly identified.

  • Office Cleanliness - Surfaces including tops of desks, office equipment, window sills, wall trim, pull sheet board, and mail slots do not show dust accumulation.

  • Drivers' Waiting Room - Room is clean, free of grafitti, and fax machine is working properly.

  • Red Tag Areas - Red tag areas appear well managed and do not contain 'aged' items.

  • Signage - Existing signage is in good condition and is sufficient to identify various storage locations, safety issues, and the homes of moveable items etc. within the area.

  • Water Cooler - Water cooler is clean.

  • Unused tools, parts or equipment - Area is free of unused tools, equipment or parts - and free of those used by other departments.

  • Slip/Trip Hazards - No trip/slip hazards.

  • Computers/Printers/Scanners & Related Wiring - Equipment is clean and appears to be operating properly. Cables/wires are well organized and secure.

  • Waste Removal - Standard Waste, Paper, Plastic/Bottle, and Compost bins are in proximity. Bins are clean and not overflowing.

  • Electrical Panels - Verify that nothing is stored on top of panels, that they are secured and in good condition, and that there is 3' of clearance.

  • Floor - Floor appears clean and recently swept/mopped.

  • Communication Boards - Boards are clean and maintained.

  • Auditor signature:

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.