Title Page
-
Site conducted
-
Conducted on
-
Prepared by
-
Location
Contamination and Irregularities (Indoor Walking and Working Surfaces)
-
Do tiles, linoleum, or other flooring have holes, cracks, or bumps?
-
Is carpeting buckled, loose, or frayed?
-
Are carpet edges curled up?
-
Does floor feel greasy or slippery?
-
Are liquid contaminants present (water, grease, oil, cleaning solutions, coffee, body fluids)?
-
Are dry contaminants present (powder, sawdust, dirt, flour, food, wax chips)?
-
Are there sudden changes in indoor floor elevation > 1/4"?
-
Are there metal grates or mesh flooring in the walkway?
-
Are water absorbent walk-off mats used in entrances?
-
Are slip-resistant mats used in wet areas?
Contamination and Irregularities (Outdoor Walking and Working Surfaces)
-
Are there gaps, cracks, or holes in the outdoor walkway > 1/2"
-
Are there metal grates or mesh flooring in the walkway?
-
Is the walkway uneven, with abrupt changes in level > 1/2"?
-
Is there debris (pebbles, rocks, leaves, grass clippings) on the walkway?
-
Are there any slippery conditions present (water, grease, ice, snow)?
-
Are concrete wheel stops in the parking areas highlighted with paint?
Drainage: Pipes and Drains
-
Are drains clogged or filled with debris?
-
Are pipes splashing water onto a walking surface?
-
Are outside drain pipes or down spouts spilling water on walkways?
-
Are pipes properly aligned with drains inside and outside of the facility?
Weather Conditions (Ice and Snow)
-
Are bins containing ice melting chemicals and scoops provided at areas of heavy pedestrian traffic?
-
Are ice-melting chemicals swept up once walkways are dry?
-
Is winter weather communications distribution system in place?
-
Is snow removal appropriately scheduled?
Stairs and Handrails
-
Are all handrails 34-38" from the floor?
-
Are handrails provided on slopes, ramps, stairs?
-
Do handrails extend at least as far as the last step?
-
Are handrails provided at steps (employee shuttle bus stop, entrances, conference and training rooms)?
-
Are the edges/noses of each step painted or marked?
-
Are stairway risers and steps all of uniform size?
Tripping Hazards (Clutter, Loose Cords, Hoses, Wires, and Medical Tubing)?
-
Are cords bundled using a cord organizer?
-
Are cords on the floor covered with a beveled protective cover or tape?
-
Are cords mounted under the desk or on equipment?
-
Are hallways, stairs, and walkways clear of clutter (boxes, cords, equipment)?
-
Is there appropriate storage (closet, shelves, hooks, lockers)?
-
Are stepstools available for use in areas with overhead storage?
-
Do rolling office chairs have a sturdy base (no less than 5 legs)?
Lighting (Indoors and Outdoors)
-
Are light bulbs burned out?
-
Are any areas dim, poorly lit, or shadowy?
-
Are lighting levels compliant with local codes, ANSI, and/or Illuminating Engineering Society (IESNA) recommendations?
Mats
-
Do mats have abrupt squared-off edges, lacking a bevel?
-
Are mat edges curled up or flipped over?
-
Do mats slide around on the floor?
Slip-Resistant Shoes
-
Are employees wearing slip-resistant shoes (safety shoe marked as slip-resistant)?
-
Do shoe soles have worn-down tread?
-
Is the shoe sole tread clogged with dirt, food, debris, or snow?
-
Are employees that must work outside wearing slip-resistant footwear?
Visual Cues
-
Are changes in walkway elevation highlighted?
-
Are curbs highlighted?
-
Are highly visible wet floor signs available and used correctly?
-
Are barriers available and used to prevent access into wet or dangerous areas?
-
Are wet floor signs removed promptly once floor is dry/clean?
Safety Products
-
Are the following products available and conveniently located throughout the facility?
-
Wall-mounted spill absorbent pads or paper towels?
-
Cups near water fountains?
-
Trash cans?
-
Pop-up tent floor signs?
-
Umbrella bags?
-
Barrier and access restriction devices?
Employee Communication
-
Do all employees know the contact number for the housekeeping department?
-
Are winter weather warnings distributed to staff through email?
-
Are all employees aware of the housekeeping procedures?
-
Do employees know where safety products are stored?
-
Are cleaning methods for all floors and paths recorded and displayed?
-
Are employees that use ladders trained in safe ladder use and maintenance?