Information

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Work Environment

  • Does all lighting function as intended

  • Is room temperature at a comfortable temperature?

  • Is the air quality acceptable? (presence of dust, airborne contaminants)

  • Are air-conditioning ducts clean and free of debris?

  • Are exhaust ducts clean and free of debris?

  • Is noise at a comfortable level? (can conversations be held without having to raise voices 1m apart)

  • Are floor coverings in good condition? (no rips, tears, chips, loose)

  • Are there small unmarked changes in the height of the floor?

Ergonomics

  • Are frequently used items stored in an easily accessed area?

Chemicals

Safety Data Sheets

  • Are SDS's accessible on site?

  • Are SDS's within 5 years of date of issue

  • Are chemicals used in accordance with the SDS?

Chemical Storage

  • Are chemicals stored in a secure location?

  • Are bulk chemicals stored in a bunded location?

  • Are all containers labelled correctly?

Personal Protection Equipment (PPE)

  • Is appropriate PPE available for use?

  • Are workers trained in the use of PPE

Electrical

  • Is all electrical equipment including leads/power boards tested and tagged?

  • Is the tagging date current?

  • Is all electrical equipment in good condition?

  • Is there clear access to any electrical cupboards/distribution boards?

Mechanical (Tools/Machinery/Equipment)

  • Is the equipment maintained in good condition?

  • Are machinery guards in place?

  • Are machines adequately guarded or protected to prevent contact, entanglement or damage

  • Are emergency stops accessible and labelled?

  • Are machine controls clearly labelled

  • Are there warning labels present on the machine?

  • Are Standard Operating Procedures developed and located near the machine?

  • Is machine maintenance up to date?

Calibration & Testing

  • Are machines within calibration specifications?

  • Are machines within calibration date?

Emergency

  • Are all first aid kits stocked as per the contents list?

  • Have all fire extinguishers been inspected and tagged within the last 6 months?

  • Are fire extinguishers appropriately signed?

  • Are smoke detectors clear of foreign matter (dust, debris, cobwebs etc)?

  • Are all emergency exits clear of obstructions?

  • Are all emergency exit signs and illuminated?

  • Are staff aware of emergency procedures and evacuation routes?

Personal Protection Equipment

  • Is PPE stored in an appropriate area?

  • Is PPE maintained in good condition?

  • Are PPE requirements displayed for the area?

  • Is the PPE appropriate for the area?

  • Is PPE worn by personnel?

  • Are personnel trained to wear PPE?

Manual Handling

  • Is there adequate space for all movements involved in the task?

  • Are heavy/akward objects stored between knee and shoulder height?

  • Are mechanical aids available to assist with manual handling?

  • Do workers demonstrate correct technique?

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.