• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Organization of Work Area


  • Work Surface and work area large enough to hold materials and equipment and perform required tasks

  • Storage space adequate for copies, handbooks, documents, and notebooks

  • Area under desk free of obstructions

  • Area under work surface provides sufficient depth, height, and width for legs to move about freely

Job Aids and Equipment Positioning

  • Job aids, tools and materials placement allows efficient flow of work

  • Items used frequently (telephone, calculators, etc) within easy reach without extensive body movement

  • Document holder available and positioned to avoid frequent eye and head movement

  • Cables and cords positioned to prevent tripping

  • Headset available for high volume telephone use

Body Posture for Seated Position

  • Lower back support

  • Thighs approximately horizontal

  • Lower part of leg approximately vertical

  • Keyboard height allows forearms and wrists to be in a neutral (straight) position

  • Monitor at least 12-18" away from worker

  • Top of monitor screen approximately eye level

  • Mouse positioned to allow forearm and wrists to be in a neutral position

  • Feet rest flat on floor, or footrest provided, when needed

  • No prolonged forward bending

  • Minimum amount (or infrequent) bending or twisting of the back, head or neck


Chair Features

  • Stable with five point base (safe from tipping over)

  • Castors appropriate for safe mobility on floor surface

  • Swivels

  • Are seat dimensions: Seat Pan 15" - 19" deep and a minimum of 18.2" wide

  • Has armrests that are a good fit for user

  • Clearance under work surface for arm rests

  • Rounded front edge to avoid thigh pressure

  • Padded Seat

  • Lumbar support in backrest

  • Guidance / Training for users describing how to make adjustents

Chair Adjustability

  • Chair allows user to assume different postures

  • Seat height adjusts between 16" - 20.5"

  • Adjustable armrests

  • Adjustable height of backrest

  • Backrest adjustable forward / backward

  • Adjustments easily made from seated position


  • Lighting adequate for tasks

  • Display screen free of glare and reflections

  • Screen at right angle to windows

  • Screen character brightness at a comfortable level

  • Room temperature constant between 70F and 73F

  • Noise level less than 55 dBA in task areas requiring intense concentration

  • Noise level less than 65 dBA in routine task areas

  • Environment free from distracting high noise levels (from printers, copiers, etc)

  • Environment free of hot or cold areas under desks, in corners, etc

Workstation Photographs

  • Work station before adjustments

  • Workstation after adjustments

User educational information / Adjustments made

  • "Computer Ergonomics" handout provided

  • Adjusted Monitor

  • Adjusted Chair

  • Adjusted keyboard tray

  • Discussed behavior modification techniques and reminders


  • Add foot rest to work station

  • Add keyboard tray to workstation

  • Add document holder

  • Comments:

Follow up

  • Date and Time

  • Work station after trial period

  • Comments:

Follow up

  • Date and Time

  • Work station after trial period

  • Comments:

Follow up

  • Date and Time

  • Work station after trial period

  • Comments:


  • Comments:

  • Diagrams:

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.