TAC Palmer worker safety

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Items noted during prior visit

• Hazard identified during prior inspection:

  Yes

  No

  N/A

• Status

  Safe

  At Risk

  N/A

• Hazard identified during prior inspection:

  Yes

  No

  N/A

• Status:

  Yes

  No

  N/A

Injuries at this location

• Recent injuries at this club:

  Yes

  No

  N/A

• Cause of injury addressed to prevent recurrence?

  Yes

  No

  N/A

Building exterior - ice housekeeping

• Sidewalk log filled out today?

  Yes

  No

  N/A

• Is the condition of the sidewalk adequate - e.g. If there's ice, is there gravel applied?

  Yes

  No

  N/A

• If parking lot is icy, is there gravel on the surface of customer and employee parking areas?

  Yes

  No

  N/A

• Any other parking lot/curb hazards?

  Safe

  At Risk

  N/A

Entryway

• Mats in good condition, not catching on door?

  Yes

  No

  N/A

• If winter: ice melt available, shovels in good shape?

  Yes

  No

  N/A

• Cart in good shape (guest shoe room) - check wheels

  Yes

  No

  N/A

• Fire safety: exit sign not expired(check tag), emergency light operates, fire extinguisher mounted/charged and service tagged within past year?

  Yes

  No

  N/A

Tanning rooms

• Electrical cords and outlets good shape?

  Yes

  No

  N/A

• Cleaning products available?

  Yes

  No

  N/A

Front desk

• Ergo stand mat for front desk worker?

  Yes

  No

  N/A

• Task Checklists up to date?

  Yes

  No

  N/A

• MSDS book and OSHA 300log available?

  Yes

  No

  N/A

• First aid kit and AED battery good?

  Yes

  No

  N/A

• Medcor phone number displayed?

  Yes

  No

  N/A

• Towel cart available and in good shape?

  Yes

  No

  N/A

Laundry room

• All stepladders in good condition?

  Yes

  No

  N/A

• Chemical caps secure, secondary containers labeled?

  Yes

  No

  N/A

• Electrical panels and outlets free of lint buildup?

  Yes

  No

  N/A

• Wand vacuum available?

  Yes

  No

  N/A

• No excess storage in this room, e.g. Between laundry machines and wall?

  Yes

  No

  N/A

Utility room outside locker rooms

• Housekeeping adequate - not packed with clutter?

  Safe

  At Risk

  N/A

• Tools and electrical cords in good shape?

  Yes

  No

  N/A

• PPE available: eyewear, hearing protection?

  Yes

  No

  N/A

• Ladders in good condition?

  Yes

  No

  N/A

Locker room

• Cleaning supplies available, stored on shelves etc.

  Yes

  No

  N/A

• Towel cart available and in good shape?

  Yes

  No

  N/A

Offices/hallway

• Fire safety: exit sign not expired(check tag), emergency light operates, fire extinguisher mounted/charged and service tagged within past year?

  Yes

  No

  N/A

• Safe

  At Risk

  N/A

Ground level weight room

• Safe

  At Risk

  N/A

Custodial closet off main weight area

• Housekeeping good?

  Yes

  No

  N/A

• Totes available for cleaning supples?

  Yes

  No

  N/A

• Tools and handles in good shape?

  Yes

  No

  N/A

• Good supply of gloves and protective eyewear available?

  Yes

  No

  N/A

Auxiliary weight room

• Fire safety: exit sign not expired(check tag), emergency light operates, fire extinguisher mounted/charged and service tagged within past year?

  Yes

  No

  N/A

Upstairs group fitness studio

• Storage room free of hazards?

  Safe

  At Risk

  N/A

• Pull-up bars solid?

  Yes

  No

  N/A

Upstairs Cardio theater

• Yes

  No

  N/A

Upstairs break area

• Safe

  At Risk

  N/A

Upstairs cycling studio

• Safe

  At Risk

  N/A