Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Employee Training

  • First Aid/AED certified employees available to assist in an emergency?

  • Ask 2 employees (other than front desk) where AED is located and what it is for. Employee names and responses:

  • Were all employees able to locate and describe purpose of AED?

  • SDS - Ask 3 employees from different departments what an SDS is and where the binder is located.

  • Were all employees able to describe SDS and identify location of SDS binder?

  • Incident Reports/Property Loss - Ask 3 employees from different departments the process for filing an incident report.

  • Were all employees able to describe incident report process?

  • Emergency Procedures - Are the procedures posted somewhere?

  • Photo of emergency procedures posting

  • Ask 3 employees what they would do in case of a fire, earth quake, or if the lights went out.

  • Were all employees able to describe emergency procedures?

Fire

  • Emergency exit signs identifiable and readily visible?

  • Emergency lights working?

  • Water shut off valves accessible?

  • Is there an 18" vertical clearance maintained from sprinkler heads?

  • Fire alarm pull stations and fire extinguishers visible and unobstructed?

  • Fire extinguishers checked monthly for green & signed off?

  • Photo of one signed off extinguisher

  • Carbon monoxide detectors working?

  • Flammables stored in flammable lockers?

Earthquake

  • Bookcases, filing cabinets, shelves, racks, cages, storage cabinets, and similar items over four feet tall secured?

  • Large and heavy objects stored at waist level?

  • In case of power loss, are there working flashlights available in every department?

Electrical

  • Are electrical panels filled with breakers or metal blanks?

  • Are electrical panels unobstructed and easy to get to?

  • Photo of an Electrical Panel

  • Is there a diagram explaining what all fuses are for?

  • Do all tools, equipment, vacuums, extension cords, etc. have electrical cords in good condition with no frays?

  • Do all cords have the grounding plug still attached?

Hazardous Materials

  • Ask two employees the hazards of two different chemicals.

  • Employees:

  • Hazards:

  • Were employees able to identify hazards of the chemicals?

  • Choose two different chemicals and confirm there are SDS sheets.

  • Chemical #1

  • Chemical #1 SDS Sheet

  • Chemical #2

  • Chemical #2 SDS Sheet

  • Are all secondary containers properly labeled per GHS requirements?

  • AED Battery OK?

  • Emergency/First Aid Kit Updated?

  • Emergency Red Binder Updated?

General Housekeeping

  • Are the following areas free of any slip/trip hazards? Clutter or trash?

  • Storage Rooms?

  • Mechanical Rooms?

  • Maintenance Shops?

  • Building Exterior?

  • Offices?

  • Is safety gear/PPE readily available?

  • Photo of available Safety Gear/PPE

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.