Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Number of workers onsite?

  • Number of ALP workers onsite?

  • Are employees instructed in proper first aid and other emergency procedures?

  • Are employees wearing the proper personal protective equipment (safety helmet, gloves, safety glasses, safety vest, steel toe boots)?

  • Is there a hospital, clinic, or infirmary for medical care near your workplace or is at least one employee on each shift currently qualified to render first aid?

  • Where employees may be exposed to toxic substances or harmful physical agents, has appropriate information concerning employee access to medical and exposure records and Material Safety Data Sheets (MSDSs) been posted or otherwise made readily available to affected employees?

  • Is there an eye-wash station or sink available for quick drenching or flushing of the eyes and body in areas where corrosive liquids or materials are handled?

  • Is the required OSHA Job Safety and Health Protection Poster displayed in a prominent location where all employees are likely to see it?

  • Are emergency phone numbers posted?

  • Are portable fire extinguishers provided in adequate number and type and mounted in readily accessible locations?

  • Is worksite clean, sanitary, and orderly?

  • Are work surfaces kept dry and appropriate means taken to assure the surfaces are slip-resistant?

  • Are wet surfaces covered with non-slip materials?

  • Are all work areas adequately illuminated?

  • Are pits and floor openings covered or otherwise guarded?

  • Are aisles and passageways kept clear and marked as appropriate?

  • Is material on elevated surfaces piled, stacked, or racked in a manner to prevent it from tipping, falling, collapsing, rolling, or spreading?

  • Are all exits marked with an exit sign and illuminated by a reliable light source?

  • Are there sufficient exits to permit prompt escape in case of emergency?

  • Are ALP employees who operate power tools trained in their use and required to carry a valid operator's card?

  • Is there adequate supervision to ensure that employees are following safe operating procedures?

  • Is employee exposure to chemicals in the workplace kept within acceptable levels?

  • Is the work area ventilation system appropriate for the work performed?

  • Are employees' physical capacities assessed before they are assigned to jobs requiring heavy work?

  • Is PPE provided, used and maintained wherever required?

  • Where heat is a problem, have all fixed work areas been provided with cooling or air conditioning spot?

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  • Observations and recommendations

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.