Quarterly Workplace Inspection Checklist

Step 1 of 19

This form MUST be attached to the Safety Committee Meeting Minutes.

Record substandard conditions on the Quarterly Workplace Inspection Report Form (any item marked with an Fail).

Name of Inspector(Required)

First Last

Date of Inspection(Required)

Health and Safety Board

Copy of OHS Act and Regulation

Pass

Fail

N/A

Guide to Occupational Health & Safety Act

Pass

Fail

N/A

Health and Safety Policy posted

Pass

Fail

N/A

Policy is dated and current (less than 1 year old)

Pass

Fail

N/A

Signed by Owner

Pass

Fail

N/A

Workplace Violence and Harassment Prevention Policy is posted

Pass

Fail

N/A

Safety Committee Names Posted

Pass

Fail

N/A

Safety Committee Meeting Schedule

Pass

Fail

N/A

Safety Meeting Date Notification Form is posted with Agenda

Pass

Fail

N/A

Copy of Last Safety Committee Meeting Minutes

Pass

Fail

N/A

Copy of Last Workplace Inspection

Pass

Fail

N/A

Emergency Telephone Numbers

Pass

Fail

N/A

Emergency Response Site Plan

Pass

Fail

N/A

Emergency Evacuation Procedures

Pass

Fail

N/A

Health and Safety Officer’s Orders or Reports (if applicable)

Pass

Fail

N/A

WCB “If you are injured at work” Poster

Pass

Fail

N/A

First Aider Names and Contact Info

Pass

Fail

N/A

First aid Kit(s) Location Form

Pass

Fail

N/A

Is a list of certified First Aiders posted with copies of their current certificates

Pass

Fail

N/A

Blank copies of the Illness/Injury Reporting Form

Pass

Fail

N/A

Blank copies of the Accident/Incident Investigation Report

Pass

Fail

N/A

Work Incident Summary (if applicable)

Pass

Fail

N/A

Blank Hazard Reporting Forms available

Pass

Fail

N/A

WHMIS Regulations

Pass

Fail

N/A

WHMIS 2015 Pictogram Poster

Pass

Fail

N/A

WHMIS 2015 Pictogram Poster

Pass

Fail

N/A

First Aid Kit/Station

Is a portable First Aid Kit available for emergency use

Pass

Fail

N/A

Do kits have the required contents

Pass

Fail

N/A

Are the Kit locations marked conspicuously

Pass

Fail

N/A

Is at least one employee on each shift trained in First Aid

Pass

Fail

N/A

Emergency Prevention

Adequate lighting

Pass

Fail

N/A

Emergency Exits Signs lit

Pass

Fail

N/A

Emergency Exits clearly accessible

Pass

Fail

N/A

Fire and smoke doors closed

Pass

Fail

N/A

Emergency Exits open freely/ never locked

Pass

Fail

N/A

Have employees been instructed on evacuation procedures

Pass

Fail

N/A

Is emergency lighting working

Pass

Fail

N/A

Fire Extinguishers

Mounted

Pass

Fail

N/A

Fully accessible

Pass

Fail

N/A

Have sprinkler systems been checked within past year

Pass

Fail

N/A

Charged (green area)

Pass

Fail

N/A

Tag signed after inspection

Pass

Fail

N/A

Yearly inspection completed

Pass

Fail

N/A

Personal Protective Equipment

Is the following PPE available and used as required:

Protective footwear

Pass

Fail

N/A

Cut resistant gloves

Pass

Fail

N/A

Chemical Apron and Chemical Gloves

Pass

Fail

N/A

Reflective Outerwear

Pass

Fail

N/A

Hearing Protection (if applicable)

Pass

Fail

N/A

Work Gloves

Pass

Fail

N/A

Fall protection equipment

Pass

Fail

N/A

Hard Hats (if applicable) (i.e. yard staff and drivers)

Pass

Fail

N/A

Appropriate clothing available/worn

Pass

Fail

N/A

Are all employees properly maintaining their required PPE

Pass

Fail

N/A

Ventilation and Extraction

Adequate ventilation provided

Pass

Fail

N/A

Duct work made of non-combustible material

Pass

Fail

N/A

Is there regular maintenance of the ventilation system

Pass

Fail

N/A

Duct work adequately sealed and supported

Pass

Fail

N/A

Is the general ventilation system adequately providing clean air and removing airborne toxins

Pass

Fail

N/A

Housekeeping and Storage

Garbage dumpster locked

Pass

Fail

N/A

Are there an adequate number of refuse containers in serviceable condition?

Pass

Fail

N/A

Are there proper containers provided for oily rags, dusts, and flammable scraps?

Pass

Fail

N/A

Garbage properly disposed of

Pass

Fail

N/A

Is there water, ice, snow or other liquid on ground/floors that could cause a slip

Pass

Fail

N/A

Are shelves secured and sturdy

Pass

Fail

N/A

Maintained neat and orderly

Pass

Fail

N/A

Do shelves, racks, product, block aisles

Pass

Fail

N/A

No combustibles within 5 feet of gas heater

Pass

Fail

N/A

No trip hazards present

Pass

Fail

N/A

Visual signs of damage to product

Pass

Fail

N/A

Are materials properly labeled

Pass

Fail

N/A

Heavier items stored at waist level

Pass

Fail

N/A

Step stool/ ladder available

Pass

Fail

N/A

Is stock a min. of 18” below sprinklers

Pass

Fail

N/A

Are trip hazards present around desks

Pass

Fail

N/A

Are supplies and other material stored in or on shelves or file cabinets properly to avoid tripping or overloading

Pass

Fail

N/A

Racking and shelving in good repair

Pass

Fail

N/A

Aisles clear and unobstructed

Pass

Fail

N/A

Aisle ways, Emergency Exits clear and visible

Pass

Fail

N/A

Drawers closed

Pass

Fail

N/A

Chairs good repair (5-star)

Pass

Fail

N/A

Under desks not used for storage

Pass

Fail

N/A

Adequate lighting

Pass

Fail

N/A

Partitions secured to the floor and walls

Pass

Fail

N/A

Are coffee pots, etc. well marked with “caution hot”

Pass

Fail

N/A

Are photocopy and other office equipment in good condition

Pass

Fail

N/A

Lighting

Good operating condition

Pass

Fail

N/A

Emergency lighting in working condition

Pass

Fail

N/A

All lights have protective covering

Pass

Fail

N/A

All areas well lit

Pass

Fail

N/A

Floors and Stairs

Free of debris and clutter

Pass

Fail

N/A

No oil, grease, water, ice

Pass

Fail

N/A

No trip hazards, Aisle ways clear

Pass

Fail

N/A

Are stairs and landings clear

Pass

Fail

N/A

Stairs have non-skid surfaces

Pass

Fail

N/A

Hand railings available and secure

Pass

Fail

N/A

Wet Floor cones/signs available

Pass

Fail

N/A

Absorbent available

Pass

Fail

N/A

Ladder ways guarded by railing

Pass

Fail

N/A

Door openings guarded by railing

Pass

Fail

N/A

Proper signage by Pits, Tanks, ditches

Pass

Fail

N/A

Is there excessive amounts of stock in aisles

Pass

Fail

N/A

Compressed Gases

Stored upright and secured against falling over

Pass

Fail

N/A

Legibly marked and segregated by contents

Pass

Fail

N/A

Caps in place and hand tight

Pass

Fail

N/A

Protected against rust/corrosion

Pass

Fail

N/A

Stored away from stairs, elevators, and exit routes

Pass

Fail

N/A

Inspected for dents and corrosion

Pass

Fail

N/A

Adequate ventilation in storage areas

Pass

Fail

N/A

Are gas cylinders properly chained and/or caged and

Pass

Fail

N/A

Are oxygen/acetylene tanks stored properly and separately

Pass

Fail

N/A

Chemical Storage and Usage

Are SDSs available and up to date

Pass

Fail

N/A

All containers properly labeled

Pass

Fail

N/A

Containers damaged

Pass

Fail

N/A

PPE available

Pass

Fail

N/A

Chemicals stored below eye level

Pass

Fail

N/A

Chemical storage adheres to SDSs

Pass

Fail

N/A

Are batteries stored in a proper area to prevent damage

Pass

Fail

N/A

Are flammable liquids stored properly

Pass

Fail

N/A

Equipment and Tools

All tools and equipment in good condition

Pass

Fail

N/A

All wheels on carts work properly

Pass

Fail

N/A

All equipment guards intact and used

Pass

Fail

N/A

Equipment not in use/out of service is properly stored and labeled

Pass

Fail

N/A

Tools not in use/out of service are properly stored and labeled

Pass

Fail

N/A

Pre-use inspections are completed and documented

Pass

Fail

N/A

Lockout procedures being followed

Pass

Fail

N/A

Guards in place/good repair

Pass

Fail

N/A

Emergency Stop buttons function

Pass

Fail

N/A

SOP’s posted near equipment as required

Pass

Fail

N/A

Is there proper signage posted near all hazardous equipment

Pass

Fail

N/A

Are all jack stands operational and in good condition

Pass

Fail

N/A

Are air hoses in good condition and properly stored

Pass

Fail

N/A

Automatic doors and other door closures functioning properly

Pass

Fail

N/A

Are hoists used properly

Pass

Fail

N/A

Are hoists in good condition

Pass

Fail

N/A

Are annual inspections posted on each hoist

Pass

Fail

N/A

Have copies of all hoist inspections been provided to the Safety Committee/Representative

Pass

Fail

N/A

Shop vacuum in good condition

Pass

Fail

N/A

Power doors in good working order

Pass

Fail

N/A

Pressure washer(s) in good condition

Pass

Fail

N/A

Ladders and Step Stools

Safety Feet intact (portable ladders)

Pass

Fail

N/A

Hand or Side Rails intact

Pass

Fail

N/A

No Bent or defective metal

Pass

Fail

N/A

Stored to prevent trip hazard

Pass

Fail

N/A

Secured to prevent falling

Pass

Fail

N/A

Clean and clear of clutter

Pass

Fail

N/A

All portable ladders are Grade 1

Pass

Fail

N/A

Panel doors closed at all times

Pass

Fail

N/A

Electrical Panels

Fully accessible (not blocked within 42”)

Pass

Fail

N/A

Clean and clear of clutter

Pass

Fail

N/A

Panel doors closed at all times

Pass

Fail

N/A

Not used for storage shelves

Pass

Fail

N/A

Clearly labeled

Pass

Fail

N/A

Electrical Switches

Cover plates in good condition

Pass

Fail

N/A

Not blocked with combustibles

Pass

Fail

N/A

Outlets near water/damp areas are GFI protected

Pass

Fail

N/A

Electrical Cords

Are all cords and wires in good condition and out of the way

Pass

Fail

N/A

No frayed wiring on any equipment

Pass

Fail

N/A

No electrical tape used for repair

Pass

Fail

N/A

Extension cords are limited to temporary use only

Pass

Fail

N/A

All cords are properly stored when not in use

Pass

Fail

N/A

High voltage panels closed and secured

Pass

Fail

N/A

All electrical equipment protected from fluids

Pass

Fail

N/A

Explosion proof fixtures in flammable, dust or vapor areas

Pass

Fail

N/A

Employee Facilities

Are facilities kept clean and sanitary

Pass

Fail

N/A

Are facilities in good repair

Pass

Fail

N/A

Are lunchroom facilities provided away from toxic chemicals

Pass

Fail

N/A

Do workstations adhere to proper ergonomics

Pass

Fail

N/A

Drinking water available

Pass

Fail

N/A

General Items

Are parking lots, walkways and yards free of snow, ice, debris or other obstructions

Pass

Fail

N/A

Are curbs and other elevations painted/clearly marked to identify tripping hazard

Pass

Fail

N/A

Are all threshold plates on all doors secure

Pass

Fail

N/A

Are all solid glass doors/walls marked to alert customers/employees

Pass

Fail

N/A

Are customers/employees operating vehicles safely in parking lot

Pass

Fail

N/A

Traffic control signs posted

Pass

Fail

N/A

Are customers escorted when in auto bays

Pass

Fail

N/A