Facilities Safety Assessment Template
Facilities Safety Assessment Template
Use this facilities safety assessment template to check the safety of a facility or operation. Take corrective action if necessary.
Facilities Safety Assessment Template
Use this facilities safety assessment template to check the safety of a facility or operation. Take corrective action if necessary.
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Preview of the template
Audit
Safety Programs
Hazard tracking log being worked.
Who is responsible for fix?
Safety meeting minutes avalible
Who is responsible for fix?
Evacuation routes posted
Who is responsible for fix?
OHSA Postings and OSHA logs (if applicable)
Who is responsible for fix?
Fire prevention and Emergency Action Plan.
Flammable materials are stored in the correct fire cabinets
Who is responsible for fix?
Flammable cabinets are in good operating condition.
Who is responsible for fix?
Exit route are clear and unobstructed.
Who is responsible for fix?
Emergency exits are lit by emergency lighting and self-illuminated exit signs.
Who is responsible for fix?
Fire extinguishers are in good condition, not blocked, and are being checked once per month.
Who is responsible for fix?
Personal space heaters cause fires and are not in the facility.
Who is responsible for fix?
Compressed gas cylinders are kept away from heat and are restrained to prevent tipping or rolling.
Who is responsible for fix?
If a room is sprinkled, the system will not work if there is less than 18" vertical clearance between the sprinkler head and materials below.
Who is responsible for fix?
Housekeeping and Walking/working surfaces
Storage of materials must not create a hazard.
Who is responsible for fix?
Walking and working surfaces must be kept in a clean and safe condition.
Who is responsible for fix?
Shelving systems must be in good condition, anchored, and free of damage. Industrial systems must be load rated and placarded.
Who is responsible for fix?
Any platform higher then 4 feet (3 in California) must be guarded against falls.
Who is responsible for fix?
Unguarded holes, trip hazards, ledges, or anything else that could cause a slip, trip, or fall, must be guarded, covered, or otherwise protected.
Who is responsible for fix?
Hazard Communication
All co-workers who work with chemicals know how to access the MSDS or SDS.
Who is responsible for fix?
Eye was stations and showers are in good condition, are functional, and are checked for operation once a month.
Who is responsible for fix?
All secondary containers are labeled with the name of the chemical within (sharpie marker is suitable). This must be done for non-hazardous chemicals as well (such as water).
Who is responsible for fix?
Any place where working with corrosive materials, such as battery charging and maintenance locations, have a plumbed eyewash near by.
Who is responsible for fix?
Electrical safety
Electrical panels must be clear of obstruction, have easy access, and the door must be closed.
Who is responsible for fix?
Extension cords used as permanent wiring must be removed. Daisy chaining (plugging and extension cord into another extension cord) is never safe.
Who is responsible for fix?
Electrical cords must be protected from accidental damage and be removed if found to have damage.
Who is responsible for fix?
Lightning fixtures less than 7 feet from the floor or in storage areas should be covered/guarded.
Who is responsible for fix?
All appliances (coffee makers, refrigerators, toasters, etc) must be plugged directly into the wall.
Who is responsible for fix?
All pull boxes, junction boxes, switches, and outlets must be covered. Pull boxes and junction boxes must also be labeled.
Who is responsible for fix?
Lock Out Tag Out (LOTO)
If we are trained to clear bag jams, LOTO procedures should be used and trained. If we depend on an outside company to clear bag jams, we should be trained on what a LOTO tag looks like and how we should never attempt to remove it.
Who is responsible for fix?
Machine Gaurding
Exposed shafting, gears, and chains less than 7 feet from the floor or working platform must be guarded in the bag room or anywhere else on the property.
Who is responsible for fix?
Personal Protection Equipment (PPE)
Hearing protection is used in high noise areas.
Who is responsible for fix?
High visibility vests are used on the ramp and in low visibility areas such as some bag rooms.
Who is responsible for fix?
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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.