Workplace Safety Observation Audit Form

• Department

• Conducted on

  Date

• Prepared by

• Location/Area
  Address

Fire Extinguisher

• Extinguishers in place, clearly marked for type of fire?

  Yes

  No

  N/A

• Extinguishers recently serviced? (Check monthly.)

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Yes

  No

  N/A

Exit

• Exits clear of obstructions?

  Yes

  No

  N/A

• Exit doors easily opened from inside?

  Yes

  No

  N/A

• Adequate direction notices for fire exits?

  Yes

  No

  N/A

Building Safety

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Entry and walkways kept clear?

  Yes

  No

  N/A

• Walkways adequately and clearly marked?

  Yes

  No

  N/A

• Intersections kept clear of boxes etc?

  Yes

  No

  N/A

• Stair and risers kept clear?

  Yes

  No

  N/A

• Are liquid spills removed quickly?

  Yes

  No

  N/A

• Are railings in good condition?

  Yes

  No

  N/A

• Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• Loading area clean and tidy?

  Yes

  No

  N/A

Storage Design and Use

• Materials stored in racks and bins wherever possible?

  Yes

  No

  N/A

• Storage designed to minimise lifting problems?

  Yes

  No

  N/A

• Floors around racking clear of rubbish?

  Yes

  No

  N/A

• General condition of racks and pallets?

  Yes

  No

  N/A

Hazcom/Chemical Safety

• Hazardous Substance Register complete and available?

  Yes

  No

  N/A

• Material Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• All containers labelled correctly?

  Yes

  No

  N/A

• Unused substances disposed of?

  Yes

  No

  N/A

• Do special storage conditions apply?

  Yes

  No

  N/A

• If applicable are special storage conditions followed?

  Yes

  No

  N/A

• If required is PPE available?

  Yes

  No

  N/A

• Is adequate ventilation provided?

  Yes

  No

  N/A

• Are eye washes and showers easily accessed?

  Yes

  No

  N/A

Ladders

• Are all ladders Industrial strength? (Non Household rated, check label.)

  Yes

  No

  N/A

• Are ladders in good condition?

  Yes

  No

  N/A

• If used for electrical work are they non conductive? (Wood or fibre glass.)

  Yes

  No

  N/A

• Used according to instructions?

  Yes

  No

  N/A

• For extension ladders are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

First Aid Facilities

• Are cabinets and contents clean and orderly?

  Yes

  No

  N/A

• Are contents regularly checked?

  Yes

  No

  N/A

• No contents past their expiration date?

  Yes

  No

  N/A

• Cabinets clearly labelled?

  Yes

  No

  N/A

• Is there easy access to cabinets?

  Yes

  No

  N/A

Office Hazards

• Condition of filing cabinets?

  Yes

  No

  N/A

• Condition of chairs? (Five star bases.)

  Yes

  No

  N/A

• Desks in good condition? (No damage.)

  Yes

  No

  N/A

• Tasks designed to prevent Occupational Overuse Syndrome? (Breaks included.)

  Yes

  No

  N/A

• Air conditioning systems regularly maintained?

  Yes

  No

  N/A

• Stable non-slip floor coverings in good condition?

  Yes

  No

  N/A

Vehicle Spot Check

• Condition of tires?

  Yes

  No

  N/A

• Brake performance?

  Yes

  No

  N/A

• Lights? (Check operation of brake, indicator and reversing lights)

  Yes

  No

  N/A

• Condition of drivers seat?

  Yes

  No

  N/A

• Condition of other seats?

  Yes

  No

  N/A

• First aid kit supplied and adequate?

  Yes

  No

  N/A

Forklift/Man-Lift Operations

• Verify operator license.

  Yes

  No

  N/A

• Prior to use inspection completed?

  Yes

  No

  N/A

• Operator wearing seatbelt?

  Yes

  No

  N/A

• Operator has clear view of travel?

  Yes

  No

  N/A

• Operating in Safe manner?

  Yes

  No

  N/A

Sign Off

• On site representative

  Sign

• Sr. Risk Analyst/Safety Officer signature

  Sign