Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

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Work Environment

  • Are floor surfaces even and without trip hazards?

  • Is lighting adequate? (Able to read documentation clearly without eye strain)

  • Are noise levels distracting from task concentration?

  • Is ventilation (natural or artificial) adequate?

  • Are walkways cleared of trip hazards such as trailing electrical cords?

Electrical Services

  • Are power points, power boards, and cords free of visible damage, and not overloaded? (No double adaptors or piggyback plugs)

  • Are there an adequate number of power points?

  • Are power points and light switches not damaged and in good working condition?

  • Are electrical appliances free from visible damage and in good working order? (Switches, buttons, casing)

  • Are all electrical items marked either “New to Service” or have been tested, tagged and in date?

Emergency

  • Are emergency site plans displayed and oriented to their position (i.e. nearby corridor)?

  • Are all fire exits accessible, not blocked & uncluttered?

  • Is fire equipment accessible & unobstructed?

  • Are emergency exit lights functional?

  • Has fire equipment been serviced within the last 6 months (check tag)?

Floors, aisles, stairs & landing

  • Are all walkways free from cords, trip hazards and rubbish?

  • Are all entrances/exits and doorways kept clear?

  • Are all floors safe and not slippery?

  • Are paths, corridors, and floor coverings in good state of repair?

  • Are slip resistant strips on edge (nosing) of steps in place?

  • Are handrails present and in good condition?

General

  • Are the lights working and is the lighting adequate for work being performed?

  • Are windows and doors in good working condition?

  • Is there adequate ventilation?

  • Is furniture in good condition?

  • Are desks and chairs suitable for the occupant?

  • Are ceilings in good condition and intact?

  • Are suitable and sufficient facilities provided for storage?

  • Are materials and equipment stored safely?

  • If kitchen facilities present, are appliances free of damage, tidy and hygienic?

  • Are work areas clean and tidy?

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.