Title Page
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Site conducted
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Prepared by
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Date of Inspection
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Date of Last Inspection
Site Inspection
Previous Inspection
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Have you reviewed the previous inspection?
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Have all issues raised in last inspection have been resolved?
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What issues are still outstanding and how has been assigned to addressing them?
Fire Safety & Emergency Response
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Formal accident/incident report forms are easily available to employees?
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Date of last emergency evacuation drill
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Emergency evacuation maps are prominently displayed and accurate
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Is the emergency response procedure available?
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What is the date this document was last reviewed?
Outside Entrance
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Area outside entrance is in good condition and is free of hazards?
Entry Area
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Are all windows & doors in good condition and free from damage?
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Is the entry free from trip hazards?
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Is the air conditioning working and all vents in good condition?
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Is all the lighting in the area working and in good condition?
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Is the fire extinguisher unobstructed; free of any visual corrosion & damage; and tags indicate it has been serviced in the last 6 months?
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Are all exit lights working?
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Has all electrical equipment been tested and tagged?
Stairway & Hallway
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Is all the lighting in the area working and in good condition?
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Are all exit lights working?
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Steps/stairs/ramps are in safe condition with non-slip surfaces & secure handrails.
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Is there any visible structural damage to walls/ ceilings?
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Is safety signage adequate, clean, and visible?
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Are stairs, stairwells, and landings kept clear and unobstructed?
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Do stairs have anti-slip materials where warranted?
Kitchen
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Are the windows in good condition and free from damage?
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Is the entry free from trip hazards?
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Is the air conditioning working and all units in good condition?
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Is all the lighting in the area working and in good condition and adequately lit?
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Is the fire extinguisher unobstructed; free of any visual corrosion & damage; and tags indicate it has been serviced in the last 6 months?
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Are all exit lights working?
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Is all electrical equipment been tested and tagged?
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Are all items stored away safely, and in their correct places?
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Is the general condition/ cleanliness acceptable?
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Has all rubbish been correctly disposed of?
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Are all chemicals stored safely, and with their relevant and in date safety data sheet?
Male & Female Toilets
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Is the entry free from trip hazards?
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Are all exit lights working?
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Is the floor free from obstruction and trip hazards?
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Has all rubbish been correctly disposed of?
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Is the general condition/ cleanliness acceptable?
Office Area
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Are the windows & doors in good condition and free from damage?
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Is the air conditioning working and all vents in good condition?
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Is all the lighting in the area working and in good condition?
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Is the fire extinguisher unobstructed; free of any visual corrosion & damage; and tags indicate it has been serviced in the last 6 months?
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Are all exit lights working?
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Are all chairs, desks, monitors in good condition and electrical cords under desk secured away from feet.?
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Has all electrical equipment been tested and tagged?
Outdoor Parking Area
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Are all the lights working, and is it adequately lit?
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Are all entrance and exit points useable, and free from obstruction?
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Are all signs/ carpark markings clear and visible?
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Are the parking areas free from trip hazards (e.g., no potholes, cracks, etc.)?
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Is the parking lot kept free of debris?
Safety Conversation
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Find an employee onsite and ask if they have a couple of minutes to answer some questions. Explain that information will be used to improve processes where needed and it's used as a learning opportunity.
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Tell me what you know about the Employee Assistance Program (EAP) Employee was aware of EAP and accurately explained it. (Counselling service open to employees and direct members of their family. Also offers financial counselling, dietitians, sleep management etc)
- Has a clear awareness and understanding of what is available
- Has some awareness or understanding of what is available
- How no awareness or understanding of what is available
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What would you do if the fire alarm went off now? (You are looking for a confident understanding the process; their role in that process; and awareness of all evacuation point locations.
- Has a clear awareness and understanding of what is available
- Has some awareness or understanding of what is available
- How no awareness or understanding of what is available
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What understandings were missing? Has training been provided?
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How do you report an employee injury? (You are looking for a confident understanding of how they are able to do this?)
- Has a clear awareness and understanding of what is available
- Has some awareness or understanding of what is available
- How no awareness or understanding of what is available
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What understandings were missing? Has training been provided?
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Do you feel well trained for your role?
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Is there any additional training you require to complete your tasks safer? If yes, please provide detail.
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What training do you feel is required?
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Would you like to raise any safety issues or concerns? <br>Did the employee raise any safety issues? If yes, please list in comments. (If you need to investigate the issues further, raise an action item to get back to the person that raised the issues with you.)
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Detail issues/concerns:
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Name of employee service unit?
Sign Off
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Did you identify any fire hazards?
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What were these hazards?
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Were there any other issues identified that were not mentioned above? If yes, please provide details.
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What were these issues?
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General comments regarding the site or inspection
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List any other people accompanying you on inspection
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Name of person conducting inspection
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Signature
