Title Page
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Division
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Department/Outlet
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Rooms / Areas (if applicable)
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Date Inspected
Manager
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Name
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Position
Person(s) conducting the Inspection
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Person
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Name
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Position
Workplace Heath and Safety Officer
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Name
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Position
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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
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Is the area tidy, clean and well kept?
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Are all internal lights working correctly? <br>
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Are all external lights working correctly?
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Are there enough rubbish bins, and if so have they been emptied recently?
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Are the general condition of walls, floors, floor coverings and ceilings good?
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Is the temperature and ventilation appropriate?
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Are the noise levels acceptable or measures taken where noise levels are excessive?
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Are warning signs clearly visible and not faded?
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Are corridors, hallways and stairs kept unobstructed?
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Are stairs and passageways well lit?
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Is there good visual contrast at changes in elevation e.g. steps?
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Are steps in a good condition, including the edges of steps being non-slip?
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Are handrails or balustrades provided where needed, and if so are they undamaged and safe and secure to use?
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Are balustrades or handrails free from any nearby climbable objects?
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Do ladders appear to be legal, compliant and safe to use?
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Are entrances provided with wet weather mats?
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Are there warning signs in place where wet or slippery floors were observed?
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Are smoking areas at least 5 meters from a building entrance with signs displayed?
Emergency
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Have emergency exit routes been identified and signage is visible?
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Are emergency exit lights operational?
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Are fire exits/doors in good condition, operable, unobstructed and not held open?
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Are fire stairs free of obstructions?
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Are fire door automatic closing devices operational?
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Can evidence be presented as to when the last and next emergency evacuation drill was/will be conducted?
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Are emergency evacuation diagrams, current and clearly visible?
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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?
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Do all extinguishers, hose reels and hydrants have inspection tags that have been stamped within the last 6 months?
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Do all hydrants have secure caps?
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Are all smoke detectors operational and free of obstructions?
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Have all staff been inducted into the department / outlet emergency evacuation procedures?
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Have emergency wardens been assigned and trained in your department / outlet?
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Have emergency alarms been checked and tested?
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Has the main gas valve been identified, and have appropriate staff been made aware of its location and emergency shut-off procedure?
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Is emergency equipment readily available e.g. eye wash, chemical spill kit?
Ergonomics
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Have adequate storage facilities been provided? For example no improvised storage under benches or on floors.
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Are areas free from obstruction or items sticking out into pathways?
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Are items that are frequently used easily accessible?
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If reaching up is necessary, is a step stool or similar device provided?
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Have adjustable chairs been provided for workstations with a computer?
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Have ergonomic aids been provided for computer workstations? For example foot rests and document holders.
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Have lifting and moving devices (eg: trolleys) been provided for tasks requiring heavy manual work?
Electrical
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Is all electrical equipment in good condition? I.e. no evidence of frayed, torn, broken or loose electrical leads or outlets.
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Is there a current Test/Tag attached to every item of electrical equipment onsite not protected by an RCD?
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Are power boards used instead of double adaptors or piggyback plugs?
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Are leads secured and not potential trip hazards?
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Are extension leads used only for temporary power?
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Are liquids, chemicals and gasses stored away from electrical outlets of items?
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Are all electrical cupboards/rooms/risers locked and free of combustible storage?
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Are distribution boards sign posted, kept closed, kept free from obstruction and has access been restricted to authorised persons only.
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Are any electrical leads lead away from areas that could cause damage to the lead, such as hot surfaces and doorways?
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Are all electrical cords free from direct exposure to water or other liquids?
First Aid
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Are first-aiders for the area appointed and trained? This may be staff not in your own area but elsewhere in the building.
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Are the locations of first aid kits labelled, easily visible, easily accessible and known to staff?
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Has a first aid cabinet caretaker been assigned?
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Is the first aid cabinet contents regularly checked?
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Is the contents of first-aid kits complete and within expiry dates?
Personal Protective Equipment (PPE)
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Is personal protective equipment (PPE) provided where necessary, eg. gloves, face shield, respirators, hearing protection, safety glasses?
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Is PPE worn when necessary?
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Have staff been trained in the use, selection and maintenance of PPE? Comment:
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Is PPE stored and maintained correctly?
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Is PPE supplied to visitors in hazardous areas, eg. safety glasses?
Plant / Machinery / Equipment
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Do operators have relevant licences / training for the plant and equipment they are operating?
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Do operators of plant requiring WHSQ licences have copies on them?
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Have pre-starts been completed for all plant and equipment?
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Have risk assessments been conducted and reviewed within 5 years?
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Have nip points, v-drives, and chain drives been adequately guarded on machines e.g. compressors?
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Have quick stops on rotating parts or blades been fitted, and are they in good working order i.e. bench grinders, meat slicers?
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Are guards adequate for transmissions, gears, pulleys, belts, chain drives, guillotines and presses, etc?
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Are emergency shut down switches located within easy access of the operator, clearly marked and colour coded?
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Are fail safe, lock out switches provided where necessary and tested regularly?
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Are Danger or Isolation tags used during maintenance and repairs?
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Are hand-tools maintained and stored in good condition?
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Are operating manuals (or instructions) available?
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Are air receivers and compressors installed with pressure gauges and relief valves, and are these tested regularly?
Hazardous Chemicals & Dangerous Goods
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Are there Safety Data Sheets (< 5 years old) for all materials used?
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Are storage and handling practices in line with the Safety Data Sheets?
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Do all staff have access to Safety Data Sheets in the area where the chemicals are used?
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Are chemicals stored in defined areas away from food products or other items that could be contaminated?
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Is the appropriate type of PPE available for chemicals used?
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Are all containers with chemicals appropriately labelled?
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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.
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Is absorbent material for chemical spills available?
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Is the quantity of flammable liquids held for use kept to the minimum possible?
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Are flammable liquids and other dangerous good stored appropriately and properly segregated?
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Are there HAZCHEM / warning notices indicating the presence of flammable liquids / dangerous goods?
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Are compressed air / gas cylinders stored in well ventilated areas and are they properly segregated?
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Are cylinders adequately secured i.e. individually chained and not accessible to the public?
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Are empty cylinders stored separately from full cylinders and are they adequately signed?
Staff Amenities
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Are eating / drinking areas provided away from work areas?
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Are general kitchen areas kept clean? For example removal of rubbish, cleaning of floors and surfaces.
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Are storage cupboards and fridges kept clean and tidy?
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Is there adequate provision of soap, dish cloths and towels?
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Are appropriate fire extinguishers and fire blankets readily available?
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Are toilet and washing facilities kept clean and hygienic?
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Is there adequate provision of soap, hand drying facilities and toilet paper?
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Are waste containers appropriately stored and correctly labelled? This includes recycling, chemical name/s and dangerous good labels.
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Are waste bins clean and emptied regularly?
Workplace Kitchen / Catering Areas
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Are kitchen tools such as knives kept sharp and are they appropriately stored?
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Are staff appropriately clothed? For example no loose fitting clothing - long hair is confined and closed shoes.
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Are kitchen utensils kept clean and are they appropriately stored?
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Is guarding on moving parts adequate?
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Are hot plates turned off when not in use or left un-supervised?
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Are combustible materials and chemicals kept at a safe distance from hot surfaces and naked flames?
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Are spill absorbents available for oil / grease spills?
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Is there adequate provision of soap and towels?
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Are range hoods and filters maintained in good condition?
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Are airflow rates of the range hoods effective and comfortable for staff?
Traffic Management & Parking
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Is there signage advising vehicles of the speed limits in the workplace?
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Does the workplace have a documented site specific traffic management plan?
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Does the workplace have physical barriers separating pedestrians and mobile plant?
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Does the workplace have signage advising pedestrians where to walk and where not to walk?
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Are traffic direction markings clearly visible?
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Are wheel stops, bollards and columns highlighted?
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Is parking area lighting operational?
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Are surfaces free from potholes?
Swimming Pool Area
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Does this location have a pool?
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Are pool chemicals securely stored?
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Are any climbable objects located near the pool fence?
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Is the pool gate handle operating correctly and does the pool gate fully close and latch automatically?
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Has the pool water been tested within the last week?
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Are pool rules and CPR signage clearly visible?
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Are water depth markings clearly visible?
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Are pool suction fittings and plumbing grates/covers securely in place and in good condition?
Due Diligence
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Are you a member of an industry body?
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Do you subscribe to any industry specific publications that include safety issues within your industry?
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Have you attended any industry training/seminars/professional development courses in the previous 12 months?