Waco regional Office

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Main Building entrances and exterior

• Front door clean, clear and serviceable

  Yes

  No

  N/A

• Rear door clean clear and serviceable

  Yes

  No

  N/A

• Sidewalks, ramps and steps clear of obstructions and clearly marked

  Safe

  At Risk

  N/A

• Landscape in presentable condition

  Yes

  No

  N/A

• Do any hazard trees exist

  Safe

  At Risk

  N/A

• Are any trees touching the building (that may allow ants to enter the roof)

  Safe

  At Risk

  N/A

• Quarterly inspection of roof condition, in accordance with warranty agreement

  Yes

  No

  N/A

• If pic nic tables are present- are they in good condition

  Yes

  No

  N/A

• Yes

  No

  N/A

Main building interior

• Do the front entry doors conform to State Fire Marshal Standards

  Yes

  No

  N/A

• Front Entry Lobby free of clean, clear and free of obstructions

  Yes

  No

  N/A

• Front lobby area lighting in good operating order

  Yes

  No

  N/A

• Yes

  No

  N/A

• Main Hallway free of obstructions

  Yes

  No

  N/A

• Exit signs present and operational

  Yes

  No

  N/A

• Fire extinguishers present and properly inspected

  Yes

  No

  N/A

• Are fire extinguisher inspections current

  Yes

  No

  N/A

• Is an AED present

  Yes

  No

  N/A

• Is AED current with inspection

  Yes

  No

  N/A

• Are Safety Data Sheets Present

  Yes

  No

  N/A

• Is SDS up to date with inspection

  Yes

  No

  N/A

Kitchenette and rest rooms

• Are appliances clean and well maintained

  Yes

  No

  N/A

• Is there evidence of electrical hazard (Extension cords, etc..)

  Yes

  No

  N/A

• Do GFCI outlets exist within 6 feet of a water source in Kitchenette

  Yes

  No

  N/A

• Does the GFCI pass testing

  Yes

  No

  N/A

• Do GFCI outlets exist within 6 feet of water source in Men's rest room

  Yes

  No

  N/A

• Does GFCI pass testing

  Yes

  No

  N/A

• Do GFCI outlets exist within 6 feet of water source in Women's rest room

  Yes

  No

  N/A

• Does GFCI pass testing

  Yes

  No

  N/A

Stock Room

• Is stock room clean and well organized

  Yes

  No

  N/A

• Are materials stored properly on stable metal shelving

  Yes

  No

  N/A

• Do any potentially unsafe conditions exist

  Safe

  At Risk

  N/A

• Do any fire hazards exist

  Safe

  At Risk

  N/A

General office spaces

• Is furniture is good working condition

  Yes

  No

  N/A

• Are file cabinet drawers in closed position when not in use

  Yes

  No

  N/A

• Are there any extension cords visible in walk ways

  Yes

  No

  N/A

• Are there any power strips or power strips

  Yes

  No

  N/A

• Are power strips plug into each other (piggy back or Daisy chain)

  Yes

  No

  N/A

• Are unsafe conditions present

  Yes

  No

  N/A

Annex Building

• Entry door free of obstructions

  Yes

  No

  N/A

• Exterior of building in good condition

  Yes

  No

  N/A

• Ramp and stairs in good condition

  Yes

  No

  N/A

• Fire extinguisher is present

  Yes

  No

  N/A

• Fire extinguisher is current with inspection

  Yes

  No

  N/A

• Interior is free of obstructions

  Yes

  No

  N/A

• Walkways are free of obstructions

  Yes

  No

  N/A

• GFCI outlets exist within 6 feet of water sources

  Yes

  No

  N/A

• GFCI pass testing

  Yes

  No

  N/A

• All appliances are well maintained and properly powered

  Yes

  No

  N/A

• No extension cords visible

  Yes

  No

  N/A

• Are power strips present

  Yes

  No

  N/A

• Are power strips plugged into each other (piggy back or daisy chain)

  Yes

  No

  N/A

• Lighting is in good working order

  Yes

  No

  N/A

• Do potential fire hazards exist

  Yes

  No

  N/A

• Rest rooms are clean and well maintained

  Yes

  No

  N/A

• First aid kit is readily available

  Yes

  No

  N/A

• First aid kit is current with inspection

  Yes

  No

  N/A

Warehouse

• Entry doors are free of obstructions

  Yes

  No

  N/A

• Overhead doors appear in good working order and free of obstructions

  Yes

  No

  N/A

• Lighting is in good working order

  Yes

  No

  N/A

• Exit signs are in place and working properly

  Yes

  No

  N/A

• Fire extinguishers are readily available

  Yes

  No

  N/A

• Fire extinguisher is current with inspection

  Yes

  No

  N/A

• First aid kit is readily available

  Yes

  No

  N/A

• First aid kit is current with inspection

  Yes

  No

  N/A

• Eye wash station is available and in good working order

  Yes

  No

  N/A

• Eye wash station has been tested quarterly

  Yes

  No

  N/A

• GFCI outlets exist within 6 feet of water sources

  Yes

  No

  N/A

• GFCI outlets pass testing

  Yes

  No

  N/A

• General area is free of obstruction

  Yes

  No

  N/A