Title Page

  • Conducted on

  • Prepared by

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

  • Paperwork Current: All paperwork (including that posted on the Team Board) and signage is current.

  • Slip/Trip Hazards: Area is free of trip/slip hazards

  • Safety Item Accessibility: Exits, fire extinguishers, eyewash stations, spill kits, e-stops, etc are accessible.

  • Scrap and Non-Conforming Material: Scrap and non-conforming material is stored in proper, identified locations.

  • Racks/Bins/Cabinets/ Furniture: All are clean, in good appearance and being used for intended purpose.

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

  • Fans: All fans in the area are clean with no dust accumulation or debris on blades or grille.

  • Lighting: Lighting appears sufficient for area. All bulbs are working and clean.

  • Electrical Panels: Nothing is stored on top of panels, they are secured and in good condition, and there is 3' clearance.

  • Please correct condition immediately.

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

  • Under Conveyors: Areas under conveyors appear clean.

  • Painted Surfaces: Painted surfaces are in good condition - in particular, yellow painted surfaces that are prone to damage.

  • Walls & Columns: Walls, including mesh and tarp walls, are clean.

  • Work cells and individual stations are identified.: Cell/Line and individual stations are identified with standard MAFACT signage.

  • Movable items: Movable items have homes defined by shadowboxing/signage and items are located to standard.

  • Labels/Kanban tags & Product Identification: ALL labels, Kanbans and Product ID signs are clean and of good appearance. Contents match labelling.

  • End of Shift 5S Expectations are posted: 5S Expectations (Form 4766) is available for every employee.

  • Please enter Auditor's 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.