Title Page

  • Deck

  • Deck

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Accomodation

Alleyways

  • Ques 1) General Housekeeping/Cleanliness (Good / Satisfactory / Bad)

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) IMO Symbols

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Various Posters

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Lighting<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Fire Dampers Operation / marking

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Galley

  • Ques 1) General Housekeeping / Cleanliness

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Hot Plate and Other Equipment in working order

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Galley Exhaust wire mesh and Trunking free of oil

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) First Aid Kit

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Fire Blanket

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Fixed & Poratble Fire Extinguishing arrangement

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Chopping Boards of different colour codes

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Domestic Fridge cleaniliness and condition

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) Running Hot/Cold Water

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) Garbage Management/Posters

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 11) Utensil Clean and not deformed

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 12) Hand Wash & Towel arrangement

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Pantries

  • Ques 1) General Housekeeping / Cleanliness

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Running Hot/Cold Water

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Garbage Management/Posters

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Hand Wash & Towel arrangement

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Cuttlery Storage arrangement<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Provision rooms

  • Ques 1) General Housekeeping / Cleanliness

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Food Items Expiry Dates

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Quantity Sufficient for the Voyage

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Fridge rooms

  • Ques 1) Appropriate temp

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Defrosting arrangement working

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Drain pipe heating coil working

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) No excessive ice<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Man Lock alarm<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Emergency operating push handle for door

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Door sealing arrangement<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Floor tiles condition

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) No provision stored on floor<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) General Housekeeping / Cleanliness

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Fridge Doors

  • Ques 1) No holes<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Door closer working properly<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) No jury arrangement to keep open<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Fire retardant Packing (If any) condition<br><br>

  • Details (if any)

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  • Action Required

  • Due Date

  • Ques 5) Handles and locking arrangement<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Laundries & Drying room

  • Ques 1) General Housekeeping / Cleanliness<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Sufficient machines in working condition<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Machines Lashed for sea

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Drain pipes clear<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Dryer lint filter clean<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Drying room to have clothes clear of heater<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) No excessive clothes in drying room<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Wash rooms / Common Toilets

  • Ques 1) General Housekeeping / Cleanliness<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Any leaking/damaged facility<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Working WC<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Clean bath curtains<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Running Hot/Cold Water<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Hand Wash & Towel arrangement<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Toilet Rolls<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Gymnasium

  • Ques 1) General Housekeeping / Cleanliness (Should not be used as store)<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Recreation facility in good condition<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Lashing arrangement for facility<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Door & locking arrangement<br><br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Change rooms / Lockers

  • Ques 1) General Housekeeping / Cleanliness (Should not be used as store)<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Cabinets with locking arrangement<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Clean wash basins<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Hand Wash & Towel arrangement<br><br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Staircases

  • Ques 1) Hand rails in good condition

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Handrail covers properly rigged<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Steps clean and not slippery<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Cabins & washrooms

  • Ques 1) General Housekeeping / Cleanliness

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Power plugs - No excessive multiplug usage<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) No unauthorized modifications<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) No smoking in bed - warning sign<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Bed & Table lamp in working condition<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Drawers and closet with closing/locking arrangement<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Clean Linen & Curtains (For cabins facing forward curtains to be dark)<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Furniture condition<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) AC damper closing arrangement condition <br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) Portholes condition<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 11) Any leaking/damaged facility in wash room<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 12) Working WC<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 13) Clean bath curtains<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 14) Running Hot/Cold Water<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 15) Hand Wash & Towel arrangement<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 16) Toilet Rolls<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Store rooms

  • Ques 1) General Housekeeping / Cleanliness <br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Inventory maintained<br><br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Properly stowed/lashed for sea<br><br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Officers Smoke Room / Mess Room

  • Ques 1) SOLAS Training manuals copy duly signed<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) CBA Copy in mess room<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Crew Complaints procedure displayed<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Muster Light<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Recreation facility in good condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Properly stowed/lashed for sea<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Safety / Marpol posters<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Furniture and upholstry including curtains condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) Portholes condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) Menu displayed<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 11) Local TV reception <br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Crews Smoke Room / Mess Room

  • Ques 1) SOLAS Training manuals copy duly signed<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) CBA Copy in mess room<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Crew Complaints procedure displayed<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Muster Light<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Recreation facility in good condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Properly stowed/lashed for sea<br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Safety / Marpol posters<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Furniture and upholstry including curtains condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) Portholes condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) Menu displayed<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 11) Local TV reception <br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Ships Office

  • Ques 1) Ships Plans/Drawing with updated inventory<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Furniture and upholstry including curtains condition<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Computer / Printer & Stationery<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Safety / Marpol posters<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Water Ingress Alarm (No alarms)<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Portholes condition<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Inclinometer<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) Ballast Control panel<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) Remote Draft Gauges (Error)<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

Hospital

  • Ques 1) Bell for call working<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 2) Refrigerator - working<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 3) Medicines / Equipt with inventory<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 4) Medical log book updated<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 5) Stretcher<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 6) Resuscitator / Med Oxygen with reducer<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 7) Bed & Table lamp in working condition<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 8) No expired Medicines Stored<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 9) Garbage bins for medical waste<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 10) Bathroom clean and all sanitary facilities in good working condition<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 12) First Aid Kit<br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 13) Hospital to be clean<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

  • Ques 11) Running Hot/Cold Water<br><br><br>

  • Details (if any)

  • Image

  • Action Required

  • Due Date

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.