Title Page

  • Division

  • Department/Outlet

  • Rooms / Areas (if applicable)

  • Date Inspected

Manager

  • Name

  • Position

Person(s) conducting the Inspection

    Person
  • Name

  • Position

Workplace Heath and Safety Officer

  • Name

  • Position

  • Instructions for completion:
    Complete one form.
    Complete all areas in the Department/Outlet
    Attach additional sheets if required
    Set review date to verify identified actions completed

    Filing instructions:
    Original held at Department/Outlet.
    Copy sent to Workplace Health and Safety Department.

General

  • Is the area tidy, clean and well kept?

  • Are all internal lights working correctly? <br>

  • Are all external lights working correctly?

  • Are there enough rubbish bins, and if so have they been emptied recently?

  • Are the general condition of walls, floors, floor coverings and ceilings good?

  • Is the temperature and ventilation appropriate?

  • Are the noise levels acceptable or measures taken where noise levels are excessive?

  • Are warning signs clearly visible and not faded?

  • Are corridors, hallways and stairs kept unobstructed?

  • Are stairs and passageways well lit?

  • Is there good visual contrast at changes in elevation e.g. steps?

  • Are steps in a good condition, including the edges of steps being non-slip?

  • Are handrails or balustrades provided where needed, and if so are they undamaged and safe and secure to use?

  • Are balustrades or handrails free from any nearby climbable objects?

  • Do ladders appear to be legal, compliant and safe to use?

  • Are entrances provided with wet weather mats?

  • Are there warning signs in place where wet or slippery floors were observed?

  • Are smoking areas at least 5 meters from a building entrance with signs displayed?

Emergency

  • Have emergency exit routes been identified and signage is visible?

  • Are emergency exit lights operational?

  • Are fire exits/doors in good condition, operable, unobstructed and not held open?

  • Are fire stairs free of obstructions?

  • Are fire door automatic closing devices operational?

  • Can evidence be presented as to when the last and next emergency evacuation drill was/will be conducted?

  • Are emergency evacuation diagrams, current and clearly visible?

  • Are all fire extinguishers, hose reels and hydrants sign posted and mounted and do they have clearings around them of at least one metre and is access clear?

  • Do all extinguishers, hose reels and hydrants have inspection tags that have been stamped within the last 6 months?

  • Do all hydrants have secure caps?

  • Are all smoke detectors operational and free of obstructions?

  • Have all staff been inducted into the department / outlet emergency evacuation procedures?

  • Have emergency wardens been assigned and trained in your department / outlet?

  • Have emergency alarms been checked and tested?

  • Has the main gas valve been identified, and have appropriate staff been made aware of its location and emergency shut-off procedure?

  • Is emergency equipment readily available e.g. eye wash, chemical spill kit?

Ergonomics

  • Have adequate storage facilities been provided? For example no improvised storage under benches or on floors.

  • Are areas free from obstruction or items sticking out into pathways?

  • Are items that are frequently used easily accessible?

  • If reaching up is necessary, is a step stool or similar device provided?

  • Have adjustable chairs been provided for workstations with a computer?

  • Have ergonomic aids been provided for computer workstations? For example foot rests and document holders.

  • Have lifting and moving devices (eg: trolleys) been provided for tasks requiring heavy manual work?

Electrical

  • Is all electrical equipment in good condition? I.e. no evidence of frayed, torn, broken or loose electrical leads or outlets.

  • Is there a current Test/Tag attached to every item of electrical equipment onsite not protected by an RCD?

  • Are power boards used instead of double adaptors or piggyback plugs?

  • Are leads secured and not potential trip hazards?

  • Are extension leads used only for temporary power?

  • Are liquids, chemicals and gasses stored away from electrical outlets of items?

  • Are all electrical cupboards/rooms/risers locked and free of combustible storage?

  • Are distribution boards sign posted, kept closed, kept free from obstruction and has access been restricted to authorised persons only.

  • Are any electrical leads lead away from areas that could cause damage to the lead, such as hot surfaces and doorways?

  • Are all electrical cords free from direct exposure to water or other liquids?

First Aid

  • Are first-aiders for the area appointed and trained? This may be staff not in your own area but elsewhere in the building.

  • Are the locations of first aid kits labelled, easily visible, easily accessible and known to staff?

  • Has a first aid cabinet caretaker been assigned?

  • Is the first aid cabinet contents regularly checked?

  • Is the contents of first-aid kits complete and within expiry dates?

Personal Protective Equipment (PPE)

  • Is personal protective equipment (PPE) provided where necessary, eg. gloves, face shield, respirators, hearing protection, safety glasses?

  • Is PPE worn when necessary?

  • Have staff been trained in the use, selection and maintenance of PPE? Comment:

  • Is PPE stored and maintained correctly?

  • Is PPE supplied to visitors in hazardous areas, eg. safety glasses?

Plant / Machinery / Equipment

  • Do operators have relevant licences / training for the plant and equipment they are operating?

  • Do operators of plant requiring WHSQ licences have copies on them?

  • Have pre-starts been completed for all plant and equipment?

  • Have risk assessments been conducted and reviewed within 5 years?

  • Have nip points, v-drives, and chain drives been adequately guarded on machines e.g. compressors?

  • Have quick stops on rotating parts or blades been fitted, and are they in good working order i.e. bench grinders, meat slicers?

  • Are guards adequate for transmissions, gears, pulleys, belts, chain drives, guillotines and presses, etc?

  • Are emergency shut down switches located within easy access of the operator, clearly marked and colour coded?

  • Are fail safe, lock out switches provided where necessary and tested regularly?

  • Are Danger or Isolation tags used during maintenance and repairs?

  • Are hand-tools maintained and stored in good condition?

  • Are operating manuals (or instructions) available?

  • Are air receivers and compressors installed with pressure gauges and relief valves, and are these tested regularly?

Hazardous Chemicals & Dangerous Goods

  • Are there Safety Data Sheets (< 5 years old) for all materials used?

  • Are storage and handling practices in line with the Safety Data Sheets?

  • Do all staff have access to Safety Data Sheets in the area where the chemicals are used?

  • Are chemicals stored in defined areas away from food products or other items that could be contaminated?

  • Is the appropriate type of PPE available for chemicals used?

  • Are all containers with chemicals appropriately labelled?

  • Are chemicals that are taken from bulk storage put in appropriate containers and labelled appropriately? For example food or drink containers are not used to store chemicals.

  • Is absorbent material for chemical spills available?

  • Is the quantity of flammable liquids held for use kept to the minimum possible?

  • Are flammable liquids and other dangerous good stored appropriately and properly segregated?

  • Are there HAZCHEM / warning notices indicating the presence of flammable liquids / dangerous goods?

  • Are compressed air / gas cylinders stored in well ventilated areas and are they properly segregated?

  • Are cylinders adequately secured i.e. individually chained and not accessible to the public?

  • Are empty cylinders stored separately from full cylinders and are they adequately signed?

Staff Amenities

  • Are eating / drinking areas provided away from work areas?

  • Are general kitchen areas kept clean? For example removal of rubbish, cleaning of floors and surfaces.

  • Are storage cupboards and fridges kept clean and tidy?

  • Is there adequate provision of soap, dish cloths and towels?

  • Are appropriate fire extinguishers and fire blankets readily available?

  • Are toilet and washing facilities kept clean and hygienic?

  • Is there adequate provision of soap, hand drying facilities and toilet paper?

  • Are waste containers appropriately stored and correctly labelled? This includes recycling, chemical name/s and dangerous good labels.

  • Are waste bins clean and emptied regularly?

Workplace Kitchen / Catering Areas

  • Are kitchen tools such as knives kept sharp and are they appropriately stored?

  • Are staff appropriately clothed? For example no loose fitting clothing - long hair is confined and closed shoes.

  • Are kitchen utensils kept clean and are they appropriately stored?

  • Is guarding on moving parts adequate?

  • Are hot plates turned off when not in use or left un-supervised?

  • Are combustible materials and chemicals kept at a safe distance from hot surfaces and naked flames?

  • Are spill absorbents available for oil / grease spills?

  • Is there adequate provision of soap and towels?

  • Are range hoods and filters maintained in good condition?

  • Are airflow rates of the range hoods effective and comfortable for staff?

Traffic Management & Parking

  • Is there signage advising vehicles of the speed limits in the workplace?

  • Does the workplace have a documented site specific traffic management plan?

  • Does the workplace have physical barriers separating pedestrians and mobile plant?

  • Does the workplace have signage advising pedestrians where to walk and where not to walk?

  • Are traffic direction markings clearly visible?

  • Are wheel stops, bollards and columns highlighted?

  • Is parking area lighting operational?

  • Are surfaces free from potholes?

Swimming Pool Area

  • Does this location have a pool?

  • Are pool chemicals securely stored?

  • Are any climbable objects located near the pool fence?

  • Is the pool gate handle operating correctly and does the pool gate fully close and latch automatically?

  • Has the pool water been tested within the last week?

  • Are pool rules and CPR signage clearly visible?

  • Are water depth markings clearly visible?

  • Are pool suction fittings and plumbing grates/covers securely in place and in good condition?

Due Diligence

  • Are you a member of an industry body?

  • Do you subscribe to any industry specific publications that include safety issues within your industry?

  • Have you attended any industry training/seminars/professional development courses in the previous 12 months?

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.