TOMPKINS COUNTY OFFICE SAFETY AUDIT

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Previous inspection

• 1.1 - Has the last inspection been reviewed?

  Yes

  No

  N/A

• 1.2 - Are there no outstanding actions?

  Yes

  No

  N/A

2.0 - Fire Prevention

• 2.1 - Evacuation plan displayed and understood by all employees?

  Yes

  No

  N/A

• 2.2 - Evacuation procedures discussed annually?

  Yes

  No

  N/A

• 2.3 - Extinguishers in place, clearly marked for type of fire?

  Yes

  No

  N/A

• 2.4 - Extinguishers recently serviced? (Check 6 monthly punch mark on tabs.)

  Yes

  No

  N/A

• 2.5 - Extinguishers clear of obstructions?

  Yes

  No

  N/A

• 2.6 - Extinguishers inspected monthly and tag initialed?

  Yes

  No

  N/A

• 2.7 - Combustible material at least 2 feet from heat sources?

  Yes

  No

  N/A

• 2.8 - Adequate direction notices for fire exits?

  Yes

  No

  N/A

• 2.9 - Exit doors easily opened from inside?

  Yes

  No

  N/A

• 2.10 - Exits clear of obstructions?

  Yes

  No

  N/A

• 2.11 - Fire alarm and sprinkler head systems checked by contractor once a quarter? Documentation of these checks are being maintained by Facilities?

  Yes

  No

  N/A

• 2.12 - Fire Drills conducted every 6 months? Last drill on ___________________________.

  Yes

  No

  N/A

• 2.13 - Do employees know where they must assemble in case of fire?

  Yes

  No

  N/A

3.0 - General Lighting

• 3.1 - Good natural lighting?

  Yes

  No

  N/A

• 3.2 - Reflected light from walls & ceilings not causing glare to employees?

  Yes

  No

  N/A

• 3.3 - Light fittings clean and in good condition?

  Yes

  No

  N/A

• 3.4 - Backup lights in place and operable?

  Yes

  No

  N/A

• 3.5 - Emergency exit lights in place and operable?

  Yes

  No

  N/A

4.0 - Building & Office Safety

• 4.1 - Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 4.2 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 4.3 - Walkways adequately and clearly marked?

  Yes

  No

  N/A

• 4.4 - Intersections kept clear of boxes etc?

  Safe

  At Risk

  N/A

• 4.5 - Stair and risers kept clear?

  Yes

  No

  N/A

• 4.6 - Are liquid spills removed quickly?

  Yes

  No

  N/A

• 4.7 - Are railings in good condition?

  Yes

  No

  N/A

• 4.8 - Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• 4.9 - Conditions of chairs? Are they of the five star based?

  Yes

  No

  N/A

• 4.10 - Observe electrical cords not draped around hooks or sharp objects?

  Yes

  No

  N/A

• 4.11 - Observe electrical power cords are not frayed or broken, plugs inspected and have three prongs?

  Yes

  No

  N/A

• 4.12 - No surge protectors were observed linked togeather?

  Yes

  No

  N/A

• 4.13 - No permanent extension cords observed through walls, doors, ceiling, windows or under mats or rugs?

  Yes

  No

  N/A

• 4.14 - Panel boxes have 3 foot clearance in all directions?

  Yes

  No

  N/A

• 4.15 - Breakers are marked?

  Yes

  No

  N/A

• 4.16 - Signs were observed on every floor warning not to use Elevator in event of fire?

  Yes

  No

  N/A

• 4.17 - Desks in good condition with no damage?

  Yes

  No

  N/A

• 4.18 - No floor surface chipped?

  Yes

  No

  N/A

• 4.19 - Carpeting does not show holes or tears or other tripping hazard?

  Yes

  No

  N/A

• 4.20 - Are aisles sufficiently wide to provide easy side to side movement for two persons?

  Yes

  No

  N/A

• 4.21 - Employees were not observed standing on chairs, desk, or other improvised ladder?

  Yes

  No

  N/A

• 4.22 - Screen based equipment positioned to reduce glare from windows, lights, etc.?

  Yes

  No

  N/A

• 4.23 - No more than one file drawer open at one time was observed?

  Yes

  No

  N/A

• 4.24 - Doors to enclosed stairwells were observed to be closed?

  Yes

  No

  N/A

• 4.25 - Good ergonomic body mechanics are being used as observed?

  Yes

  No

  N/A

• 4.26 - Photocopiers positioned to avoid fumes?

  Yes

  No

  N/A

• 4.27 - Tasks designed to prevent Ergonomic injuries? Breaks are included?

  Yes

  No

  N/A

• 4.28 - Has workplace violence assessment been done?

  Yes

  No

  N/A

• 4.29 - Have employees been informed of and/or trained on the items identified in the workplace violence assessment?

  Yes

  No

  N/A

• 4.30 - HVAC systems regularly maintained? Maintenance records are kept in the building for employees to verify this maintenance?

  Yes

  No

  N/A

Other Ergonomic Assessments

• 4.31 - Is seating suitable and in good condition?

  Yes

  No

  N/A

• 4.32 - Is workstation and monitor at a suitable height?

  Yes

  No

  N/A

• 4.33 - Is there sufficient workspace?

  Yes

  No

  N/A

• 4.34 Are there tripping hazards around the workspace?

  Yes

  No

  N/A

• 4.35 - Are wrists and arms in a neutral position?

  Yes

  No

  N/A

5.0 - Work Benches. - For Public Works departments only

• 5.1 - Clear of rubbish?

  Yes

  No

  N/A

• 5.2 - Tools not in use kept in place?

  Yes

  No

  N/A

• 5.3 - No damaged hand tools in use?

  Yes

  No

  N/A

• 5.4 - No damaged power tools in use?

  Yes

  No

  N/A

• 5.5 - Work height correct for the type of work and the employee?

  Yes

  No

  N/A

• 5.6 - No sharp edges?

  Yes

  No

  N/A

6.0 - Rubbish Removal

• 6.1 - Bins located at suitable points around site?

  Yes

  No

  N/A

• 6.2 - Bins emptied regularly?

  Yes

  No

  N/A

• 6.3 - Oily rags and combustible refuse in covered metal containers?

  Yes

  No

  N/A

7.0 - Storage Design and Use

• 7.1 - Materials stored in racks and bins wherever possible?

  Yes

  No

  N/A

• 7.2 - Storage designed to minimize lifting problems?

  Yes

  No

  N/A

• 7.3 - Floors around racking clear of rubbish?

  Yes

  No

  N/A

• 7.4 - General condition of racks and pallets?

  Yes

  No

  N/A

8.0 - Machines - For Public Works departments

• 8.1 - Are they kept clean?

  Yes

  No

  N/A

• 8.2 - Are the floors around the machines kept clean?

  Yes

  No

  N/A

• 8.3 - Guards in good condition?

  Yes

  No

  N/A

• 8.4 - Starting and stopping devices within easy reach of operator?

  Yes

  No

  N/A

• 8.5 - Waste/off cuts removed and stored safely?

  Yes

  No

  N/A

• 9.3 - Electrical outlets are properly wired and grounded when tested with outlet tester?

  Yes

  No

  N/A

• 8.6 - Drip pans on floor to prevent spillage?

  Yes

  No

  N/A

• 8.7 - Adequate work space?

  Yes

  No

  N/A

• 8.8 - Is lighting adequate?

  Yes

  No

  N/A

• 8.9 - Noise levels controlled?

  Yes

  No

  N/A

• 8.10 - No bending or stooping required?

  Yes

  No

  N/A

• 8.11 - Duck-boards in good repair?

  Yes

  No

  N/A

• 8.12 - Operators trained on the safe operation of the machines?

  Yes

  No

  N/A

• 8.13 - Is the training recorded?

  Yes

  No

  N/A

• 8.14 - Do operators comply with the training?

  Yes

  No

  N/A

• 8.15 - Are lockout procedures implemented and followed?

  Yes

  No

  N/A

• 8.16 - Are gas bottles secured?

  Yes

  No

  N/A

9.0 - Other Electrical Safety

• 9.1 - LOTO audits are being done by Public Works employees?

  Yes

  No

  N/A

• 9.2 - LOTO procedures are done for complicated systems by Public Works departments?

  Yes

  No

  N/A

• 9.3 - Appliances such as refrigerators and microwaves properly wired and grounded?

  Yes

  No

  N/A

• 9.4 - Electrical outlets wired and grounded correctly when electrical tester used?

  Yes

  No

  N/A

10.0 - Chemical Safety

• 10.1 - Are all containers labeled properly?

  Yes

  No

  N/A

• 10.2 - Material Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• 10.3 - Supplies on hand to control and clean up small chemical spills?

  Yes

  No

  N/A

• 10.4 - Least toxic chemicals are being used?

  Yes

  No

  N/A

• 10.5 - Unused substances disposed of?

  Yes

  No

  N/A

• 10.6 - Do special storage conditions apply?

  Yes

  No

  N/A

• 10.7 - If applicable are special storage conditions followed?

  Yes

  No

  N/A

• 10.8 - Workers trained in the use of hazardous substances?

  Yes

  No

  N/A

• 10.9 - If required is PPE available?

  Yes

  No

  N/A

• 10.10 - Is adequate ventilation provided?

  Yes

  No

  N/A

• 10.11 - Are eye washes and showers easily accessed?

  Yes

  No

  N/A

11.0 - Ladders

• 11.1 - Are all ladders Industrial strength? (Non Household rated, check label.)

  Yes

  No

  N/A

• 11.2 - Are ladders in good condition?

  Yes

  No

  N/A

• 11.3 - If used for electrical work are they non conductive? (Wood or fibre glass.)

  Yes

  No

  N/A

• 11.4 - Used according to instructions?

  Yes

  No

  N/A

• 11.5 - For extension ladders - are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

12.0 - First Aid Facilities

• 12.1 - Are cabinets and contents clean and orderly?

  Yes

  No

  N/A

• 12.2 - Are contents regularly checked?

  Yes

  No

  N/A

• 12.3 - No contents past their expiry date?

  Yes

  No

  N/A

• 12.4 - Cabinets clearly labelled?

  Yes

  No

  N/A

• 12.5 - Is there easy access to cabinets?

  Yes

  No

  N/A

• 12.6 - Employees aware of location of first aid cabinet?

  Yes

  No

  N/A

13.0 - Outside of Building

• 13.1 - Drain covers and grates are in good condition?

  Yes

  No

  N/A

• 13.2 - Outside areas are kept clear and/or shoveled?

  Yes

  No

  N/A

• 13.3 - Sidewalks and parking lot has no holes or other tripping hazards?

  Yes

  No

  N/A

14,0 - Training & Medical Records (To be done only during Jan audit)

• RTK training for. 2012<br> <br>Eligible #. Trained #

  Yes

  No

  N/A

• 14.1 - Employees know how to obtain MSDS?

  Yes

  No

  N/A

• 14.2 - Employees know about their NY State rights?

  Yes

  No

  N/A

• 14.3 - Employees know about exposure record tests and medical records and know how to obtain copies of them?

  Yes

  No

  N/A

• 14.4 - Employees know about annual chemical exposure records and who to contact for a copy?

  Yes

  No

  N/A

• 14.5 - All at risk employees have met HEP B vaccination or signed declination form?

  Yes

  No

  N/A

• 14.6 - All required employees have had TB screening? Records maintained at department for 3 years?

  Yes

  No

  N/A

• 14.7 - All required employees were trained on BBP for 2012?

  Yes

  No

  N/A

• 14.8 - All required employees were trained on TB for 2012?

  Yes

  No

  N/A

• 14.9 - All required employees were trained on CRR/FIRST AID for 2012?

  Yes

  No

  N/A

• 14.10 - All required employees were trained on LOTO ?

  Yes

  No

  N/A

• 14.11 - All required employees were trained on Electrical safety to include Arc Flash?

  Yes

  No

  N/A

• 14.12 - All required employees were trained on Ground Fault Protection?

  Yes

  No

  N/A

• 14.13 - All required employees were trained on Hearing Protection for 2012?

  Yes

  No

  N/A

• 14.14 - All required employees were trained on PPE for 2012?

  Yes

  No

  N/A

• 14.15 - All required employees were trained on Asbestos Awareness for 2012?

  Yes

  No

  N/A

• 14.16 - Annual Training done in 2012 for workplace violence?

  Yes

  No

  N/A

• 14.17 - RTK Annual training records are easily located at the department and are being kept for the duration of an employee employment with the county?

  Yes

  No

  N/A

• 14.18 - All other training records are being kept for last three training sessions?

  Yes

  No

  N/A

15.0 - Other Violations

• 15.1

  Yes

  No

  N/A

• 15.2

  Yes

  No

  N/A

• 15.3

  Yes

  No

  N/A

• 15.4

  Yes

  No

  N/A

• 15.5

  Yes

  No

  N/A

• 15.6

  Yes

  No

  N/A

• 15.7

  Yes

  No

  N/A